Irish Journal of Medical Science (1971 -)

, Volume 186, Issue 1, pp 179–184

Dedicated orthogeriatric service reduces hip fracture mortality

  • C. Y. Henderson
  • E. Shanahan
  • A. Butler
  • B. Lenehan
  • M. O’Connor
  • D. Lyons
  • J. P. Ryan
Original Article

Abstract

Background

Hip fracture is a common serious injury afflicting the geriatric population and is associated with poor clinical outcomes, functional and walking disabilities and high 1-year mortality rates. A multidisciplinary approach has been shown to improve outcomes of geriatric patients with fragility fracture.

Aims

We piloted a dedicated orthogeriatric service for hip fracture patients to determine if the service facilitated a change in major patient outcomes, such as mortality, length of stay and dependency.

Methods

A dedicated orthogeriatrics service for hip fracture was established as a collaborative project between the Department of Geriatric Medicine and Department of Orthopaedic Surgery at a university teaching hospital. Orthogeriatrics service data were collected prospectively on an orthogeriatric filemaker database from July 2011 to July 2012 (N = 206). Data were compared to previously recorded data (Irish Hip Fracture Database) on a cohort of hip fracture patients admitted to the same orthopaedic trauma unit from July 2009 to July 2010 (N = 248).

Results

Patients in the orthogeriatric service group experienced significant reductions in 1-year mortality (χ2 = 13.34, P < 0.001), length of acute hospital stay (U = −3.77, P < 0.001) and requirements for further rehabilitation (χ2 = 26.59, P < 0.001). Patients in the pre-service establishment group were significantly more dependent following their fracture than the patients in the orthogeriatric service group (χ2 = 5.34, P = 0.021).

Conclusions

A multidisciplinary management approach to fragility fracture of the femoral neck that involves comprehensive geriatric assessment, daily medical involvement of a geriatric team and specialised follow-up assessment leads to a significant reduction in mortality and improved outcomes.

Keywords

Orthogeriatric Fragility fracture Neck of femur Hip fracture Comprehensive geriatric assessment 

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Copyright information

© Royal Academy of Medicine in Ireland 2016

Authors and Affiliations

  • C. Y. Henderson
    • 1
  • E. Shanahan
    • 2
  • A. Butler
    • 3
  • B. Lenehan
    • 3
  • M. O’Connor
    • 2
  • D. Lyons
    • 2
  • J. P. Ryan
    • 2
  1. 1.Graduate Entry Medical SchoolUniversity of LimerickLimerickIreland
  2. 2.Department of Medicine, Division of GeriatricsUniversity Hospital LimerickLimerickIreland
  3. 3.Department of Trauma and OrthopaedicsUniversity Hospital LimerickLimerickIreland

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