Osteologie 2019; 28(04): 291-292
DOI: 10.1055/s-0039-1700639
Abstracts
Georg Thieme Verlag KG Stuttgart · New York

Improved outcome in hip fracture patients in the aging population following co-managed care compared to conventional surgical treatment: A retrospective, dual-center cohort study

C Neuerburg
1   Department of General, Trauma and Reconstructive Surgery, University Hospital Ludwig-Maximilians-University (LMU) Munich, Munich, Germany
,
S Foerch
2   Department of Trauma, Hand and Reconstructive Surgery, Hospital of Augsburg, Augsburg, Germany
,
J Gleich
1   Department of General, Trauma and Reconstructive Surgery, University Hospital Ludwig-Maximilians-University (LMU) Munich, Munich, Germany
,
W Böcker
1   Department of General, Trauma and Reconstructive Surgery, University Hospital Ludwig-Maximilians-University (LMU) Munich, Munich, Germany
,
M Gosch
3   Department of Medicine 2/Geriatrics, Paracelsus Medical University, General Hospital Nuremberg, Nuremberg, Germany
,
C Kammerlander
1   Department of General, Trauma and Reconstructive Surgery, University Hospital Ludwig-Maximilians-University (LMU) Munich, Munich, Germany
,
E Mayr
2   Department of Trauma, Hand and Reconstructive Surgery, Hospital of Augsburg, Augsburg, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
14 November 2019 (online)

 

Introduction:

Hip fracture patients in the aging population frequently present with various comorbidities, whilst preservation of independency and activities of daily living can be challenging. Thus, an interdisciplinary orthogeriatric treatment of these patients has recognized a growing acceptance in the last years. As there is still limited data on the impact of this approach, the present study aimed to evaluate the long-term outcome in elderly hip fracture patients, by comparing the treatment of a hospital with integrated orthogeriatric care (OGC) with a conventional trauma care (CTC).

Materials and methods:

We conducted a retrospective, two-center, cohort study. In two maximum care hospitals all patients presenting with a hip fracture at the age of > 70 years were consecutively assigned within a one year period and underwent follow-up examination 12 months after surgery. Patients treated in hospital site A were treated with an interdisciplinary orthogeriatric approach (co-managed care), patients treated in hospital B underwent conventional trauma care. Main outcome parameters were one year mortality, readmission rate, requirement of care (RC) and personal activities of daily living (ADL).

Results:

A total of 436 patients were included (219 with OGC/217 with CTC). The mean age was 83.55 (66 – 99) years for OGC and 83.50 (70 – 103) years for CTC (76.7% and 75.6% of the patients respectively were female). One year mortality rates were 22.8% (OGC) and 28.1% (CTC; p = 0.029), readmission rates were 25.7% for OGC compared to 39.7% for CTC (p = 0.014). Inconsistent data were found for activities of daily living. After one year, 7.8% (OGC) and 13.8% (CTC) of the patients were lost to follow-up.

Discussion:

Interdisciplinary orthogeriatric management revealed encouraging impact on the long-term outcome of hip fracture patients in the aging population. The observed reduction of mortality, requirements of care and readmission rates to hospital clearly support the health-economic impact of an interdisciplinary orthogeriatric care on specialized wards.

Key words:

Orthogeriatrics, Hip fracture, Integrated Care, Frailty

*= The authors contributed equally and share senior authorship