Dedicated orthogeriatric service reduces hip fracture mortality

Abstract

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.

How well are we managing fragility hip fractures? A narrative report on the review with the attempt to setup a Fragility Fracture Registry in Hong Kong

“…In this review, only one of the six studied hospitals had a geriatrician who routinely assessed hip fracture patients pre-and post- operatively, indicating a lack of geri-orthopaedic co-management in HK. Studies have shown better outcomes after hip fracture when patients receive geri-orthopaedic treatment, with a lower 1-year mortality rate, 26,27 reduced acute hospital stay, and less need for further rehabilitation. 27 A local study reviewed the effectiveness of geri-orthopaedic comanagement and found that in the geri-orthopaedic group, time to surgery was shorter, 1-year mortality rate was lower, and more remained independent in daily living activities.…”

“…Studies have shown better outcomes after hip fracture when patients receive geri-orthopaedic treatment, with a lower 1-year mortality rate, 26,27 reduced acute hospital stay, and less need for further rehabilitation. 27 A local study reviewed the effectiveness of geri-orthopaedic comanagement and found that in the geri-orthopaedic group, time to surgery was shorter, 1-year mortality rate was lower, and more remained independent in daily living activities. 28 Therefore, geri-orthopaedic care should be implemented in all hospitals in HK to achieve better patient care.…”

Upper gastrointestinal bleeding in neck of femur fracture patients: a single tertiary centre experience

“…Other qualitative factors may have also contributed to the low incidence in our cohort. In the geriatrician‐led orthogeriatric team, patients were medically optimised on admission to minimise delay to surgery and post‐operative complications . There was dedicated dietician input for intensive nutritional support post‐operatively in the form of oral nutritional supplement drinks and enteral feeding where appropriate.…”

“…In the geriatrician-led orthogeriatric team, patients were medically optimised on admission to minimise delay to surgery and post-operative complications. [13][14][15][16] There was dedicated dietician input for intensive nutritional support post-operatively in the form of oral nutritional supplement drinks and enteral feeding where appropriate. In critical care patients and burns patients, enteral feeding has been shown as an effective strategy for gastrointestinal stress ulceration prevention and lowers the incidence of UGIB.…”

A qualitative study of the dementia-care experiences and educational needs of physiotherapists in the Republic of Ireland

“…People with dementia have a higher risk of hip fractures and poorer outcomes after fracture, compared with people who are cognitively intact [4]. An Irish study found that 24% of all patients with hip fracture had co-existent dementia [5].…”