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Impact of an orthogeriatrician on length of stay of elderly patient with hip fracture

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Abstract

Summary

Hip fracture patients are complex, and orthopaedic management is limited to the surgery phase. To provide better evaluation pre-operatively and an optimal level of post-operative care, an orthogeriatrician was introduced in the orthopaedic team. This ensured that time to surgery from admission consistently was below 48 h, decreasing hospitalization time after surgery and total length of stay.

Introduction

Hip fractures are a major health issue in elderly and frail patient. The integration of orthogeriatric care within the orthopaedic team could be useful to optimize the clinical conditions of these patients in perioperative phases and stabilize them after surgery, reducing hospital length of stay. The present study evaluates the role of an orthogeriatrician in the management of patients with a hip fracture.

Materials and methods

Data about patients admitted and operated from February to September 2018 and from February to September 2019 were collected from the San Giovanni di Dio e Ruggi d’Aragona Hospital of Salerno database. A total of 352 patients were identified and divided in two groups according to the year in which the orthogeriatrician was working in Orthopaedic Department. Records regarding age, sex, side and type of fracture, time of admission, day of surgery and discharge were collected and length of stay, days from the admission to surgery and days from surgery to discharge were calculated.

Results

There were no statistically significant differences in the pre-surgery phases of both groups, and all patients were operated at a mean of 2.1 days ± 1.8 SD from admission (p > 0.05). No statistically significant difference between demographic data in both groups (p > 0.01) was observed. There was, however, statistically significant reduction of hospitalization time after surgery and total LOS from 2018 to 2019 (p < 0.01).

Conclusion

An Orthogeriatric doctor in an Orthopaedic and Traumatology Department may lead a multidisciplinary approach to manage elderly patients with hip fractures, ensuring that the time to surgery from admission is less than 48 h, and reducing hospitalization time after surgery and total length of stay.

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Funding

Cristian Aletto, Rocco Aicale, Gabriela Pezzuti, Francesco Bruno and Nicola Maffulli declare that they did not receive any funding.

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Authors and Affiliations

  1. Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, 84084, Baronissi, Italy

    C. Aletto, R. Aicale & N. Maffulli

  2. Clinica Ortopedica, Ospedale San Giovanni di Dio e Ruggi D’Aragona, 84131, Salerno, Italy

    C. Aletto, R. Aicale, G. Pezzuti, F. Bruno & N. Maffulli

  3. Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, 275 Bancroft Road, London, E1 4DG, England

    N. Maffulli

  4. Faculty of Medicine, School of Pharmacy and Bioengineering, Guy Hilton Research Centre, Keele University, Thornburrow Drive, Hartshill, Stoke-on-Trent, ST4 7QB, England

    N. Maffulli

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  1. C. Aletto
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Aletto, C., Aicale, R., Pezzuti, G. et al. Impact of an orthogeriatrician on length of stay of elderly patient with hip fracture. Osteoporos Int 31, 2161–2166 (2020). https://doi.org/10.1007/s00198-020-05510-0

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