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Different approaches towards geriatric trauma care for hip fracture patients: an inter-hospital comparison

  • Original Article
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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

Hip fractures in geriatric patients have high morbidity and mortality rates. The implementation of a multidisciplinary geriatric care pathway (GCP) may improve treatment for this patient population. This study focusses on two level II hospitals with a different treatment protocols. A comparison was made between a multidisciplinary GCP and extensive standard care with a focus on geriatric hip fracture patients to assess if a multidisciplinary GCP leads to lower mortality and morbidity.

Methods

This retrospective cohort study included patients aged 70 years or older with a unilateral proximal hip fracture who underwent surgery between January 2014 and December 2015. The primary outcome measures complications and 30-day mortality. Secondary outcome measures were time to surgery, hospital length of stay (HLOS) and secondary surgical interventions.

Results

This study included a total of 898 patients. No differences were found between major postoperative complications, 30-day mortality, HLOS or the amount of secondary surgical interventions.

Conclusions

Mortality, major complications, HLOS and the amount of secondary surgical interventions showed no differences between both hospitals. This inter-hospital comparison of two types of geriatric care models showed no outcome that favours one specific geriatric care model over another. This provides opportunities for future studies to get a better understanding of what specific factors of geriatric care models contribute most to an improvement in the treatment of this patient population and decide which approach is most cost effective.

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Authors and Affiliations

  1. Department of Surgery, Diakonessenhuis Utrecht, Bosboomstraat Utrecht 1, 3582 KE, Utrecht, The Netherlands

    Jip Kusen, Puck van der Vet, Frans-Jasper Wijdicks & Egbert-Jan Verleisdonk

  2. Department of Surgery, UMC Utrecht, Utrecht, The Netherlands

    Marijn Houwert

  3. Department of Clinical Epidemiology, AMC Amsterdam, Amsterdam, The Netherlands

    Marcel Dijkgraaf

  4. Department of Geriatrics, Diakonessenhuis Utrecht, Utrecht, The Netherlands

    Marije Hamaker

  5. Department of Geriatrics, Antoniusziekenhuis Nieuwegein, Nieuwegein, The Netherlands

    Olivia Geraghty

  6. Department of Surgery, Antoniusziekenhuis Nieuwegein, Nieuwegein, The Netherlands

    Detlef van der Velde

Authors
  1. Jip Kusen
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  2. Puck van der Vet
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  8. Egbert-Jan Verleisdonk
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  9. Detlef van der Velde
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Corresponding author

Correspondence to Frans-Jasper Wijdicks.

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Conflict of interest

J. Q. Kusen, P. C. R. van der Vet, F. J. G. Wijdicks, R. M. Houwert, M. G. W. Dijkgraaf, M.E. Hamaker, O. Geraghty, E. J. M. M. Verleisdonk, D. van der Velde declare that they have no conflict of interest.

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Kusen, J., van der Vet, P., Wijdicks, FJ. et al. Different approaches towards geriatric trauma care for hip fracture patients: an inter-hospital comparison. Eur J Trauma Emerg Surg 47, 557–564 (2021). https://doi.org/10.1007/s00068-019-01129-x

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  • DOI: https://doi.org/10.1007/s00068-019-01129-x

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