Date: 31 Jul 2013
A comparison between two co-managed geriatric programmes for hip fractured elderly patients
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Background and aims: Hip fracture in older people is an event associated with a high incidence of morbidity and mortality. In this study we compared the clinical outcomes of two groups of orthogeriatric patients in an orthogeriatric care (OC) programme. The OC course, developed into the GeriatricWard, starts from the Emergency Department (OC-1, n=174) or from the Orthopaedic Department after surgery (OC-2, n=87). Methods: For this purpose, OC patients were prospectively enrolled from March 2007 to June 2009, following OC criteria. Door-to-bed time, time to surgery, mobilisation time, length of stay, and post-operative complications were compared between the OC groups. Results: OC-1 patients differ from OC-2 ones only for residence at admission (14.4% vs 4.6% lived in nursing homes, p=0.02). Concerning outcomes, in the OC-1 group only mobilization time was significantly lower (p=0.01). No differences were observed in post-operative complications. Conclusions: In frail older people, hip fracture co-management, with the geriatrician as primary attendant, leads to satisfying outcomes. The OC-1 and OC-2 courses exhibit similar clinical results. An improvement in several organisational aspects, including coordination between hospital and rehabilitation services, is warranted.
Wiktirowicz ME, Goeree R, Papaioannou A et al. Economic implications of hip fracture: Health service use, institutional care and cost in Canada. Osteoporos Int 2001; 12: 271–8.CrossRef
Morris AH, Zuckerman JD. National consensus conference on improving the continuum of care for patients with hip fracture. J Bone Joint Surg Am 2002; 84A: 670–4.
Cummings SR, Rubin SM, Black D. The future of hip fractures in the United States. Number, costs, and potential effects of postmenopausal estrogen. Clin Orthop Relat Res 1990; 252: 163–6.PubMed
Adunsky A, Arad M, Levi R. Five-year experience with the ‘Sheba’ model of comprehensive orthogeriatric care for elderly hip fracture patients. Disabil Rehabil 2005; 27: 1123–7.CrossRef
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, ed 4, Text Revision, Washington, American Psychiatric Association, 2000.
World Health Organization. The ICD-10 classification of mental and behavioral disorders: diagnostic criteria for research. Geneva, World Health Organization, 1993.
Federal Interagency Forum on Aging-Related Statistics. 2008 Older Americans: key indicators of well-being. http://www.agingstats.gov/agingstatsdotnet.
SIGN: Scottish Intercollegiate Guidelines Network. www.sign.co.uk
- A comparison between two co-managed geriatric programmes for hip fractured elderly patients
Aging Clinical and Experimental Research
Volume 23, Issue 5-6 , pp 431-436
- Cover Date
- Print ISSN
- Online ISSN
- Springer International Publishing
- Additional Links
- hip fracture
- older people
- orthogeriatric section
- Author Affiliations
- 1. Geriatric Clinic, S. Gerardo Hospital, University of Milano-Bicocca, Floor 7 C, Via Pergolesi 33, 20052, Monza, Italy
- 2. Orthopaedic and Traumatologic Clinic, S. Gerardo Hospital, University of Milano-Bicocca, Monza, Italy