Geriatric Fracture Center

Folbert, Ellis; Smit, Ruth S.; Velde, Detlef van der; Regtuijt, E.M.; Klaren, M. Hester; Hegeman, J.H.

doi:10.1177/2151458512444288

Cited by 58 publications

(48 citation statements)

References 29 publications

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“…24 A study in the Netherlands showed that a geriatrician-led multidisciplinary approach was a key feature in reducing complications and 30-day readmission rates. 25…”

Section: Comparison With the Existing Literaturementioning

confidence: 99%

The effectiveness of geriatrician-led comprehensive hip fracture collaborative care in a new acute hip unit based in a general hospital setting in the UK

Gupta¹

2014

J R Coll Physicians Edinb

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“…24 A study in the Netherlands showed that a geriatrician-led multidisciplinary approach was a key feature in reducing complications and 30-day readmission rates. 25…”

Section: Comparison With the Existing Literaturementioning

confidence: 99%

The effectiveness of geriatrician-led comprehensive hip fracture collaborative care in a new acute hip unit based in a general hospital setting in the UK

Gupta¹

2014

J R Coll Physicians Edinb

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“…This has also been shown to lead to improved clinical outcomes [10–12]. Studies measuring the effects of guidelines on quality of care have shown significant improvements in the process of care [13–16].…”

Section: Introductionmentioning

confidence: 99%

Provider adherence to first antenatal care guidelines and risk of pregnancy complications in public sector facilities: a Ghanaian cohort study

Amoakoh-Coleman

Klipstein‐Grobusch

Agyepong

et al. 2016

BMC Pregnancy Childbirth

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BackgroundGuideline utilization aims at improvement in quality of care and better health outcomes. The objective of the current study was to determine the effect of provider complete adherence to the first antenatal care guidelines on the risk of maternal and neonatal complications in a low resource setting.MethodsWomen delivering in 11 health facilities in the Greater Accra region of Ghana were recruited into a cohort study. Their first antenatal visit records were reviewed to assess providers’ adherence to the guidelines, using a thirteen-point checklist. Information on their socio-demographic characteristics and previous pregnancy history was collected. Participants were followed up for 6 weeks post-partum to complete data collection on outcomes. The incidence of maternal and neonatal complications was estimated. The effects of complete adherence on risk of maternal and neonatal complications were estimated and expressed as relative risks (RRs) with their 95% confidence intervals (CI) adjusted for a potential clustering effect of health facilities.ResultsOverall, 926 women were followed up to 6 weeks post-partum. Mean age (SD) of participants was 28.2 (5.4) years. Complete adherence to guidelines pertained to the care of 48.5% of women. Incidence of preterm deliveries, low birth weight, stillbirths and neonatal mortality were 5.3, 6.1, 0.4 and 1.4% respectively. Complete adherence to the guidelines decreased risk of any neonatal complication [0.72 (0.65–0.93); p = 0.01] and delivery complication [0.66 (0.44–0.99), p = 0.04].ConclusionComplete provider adherence to antenatal care guidelines at first antenatal visit influences delivery and neonatal outcomes. While there is the need to explore and understand explanatory mechanisms for these observations, programs that promote complete adherence to guidelines will improve the pregnancy outcomes.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-016-1167-6) contains supplementary material, which is available to authorized users.

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“…However, we found no differences in readmission rates when comparing orthogeriatric care to traditional care. The literature seems to reveal inconsistency in the study of readmission rates; two prospective observational studies with retrospective (historical) control cohorts found decreases in such rates [4,5], while several studies found no differences [6,9,31,32]; the time lapse before assessing readmission rates varied from 30 days [5,6,32] to 12 months [31]. Valid comparison of readmission rates was also hindered by variation as to the data sources.…”

Section: Discussionmentioning

confidence: 99%

“…No similar association was reported in earlier studies investigating both postoperative complications and readmissions. Some studies report a decrease in postoperative complications comparing traditional care to orthogeriatric care, yet no difference in readmission rates were found [6,9]; other studies [4,5] found a significant decrease in both postoperative complications and readmissions. Thus, the overall changes in postoperative complications are not consistently associated with variations in readmission rates.…”

Section: Discussionmentioning

confidence: 99%

“…To address these challenges, orthogeriatric care was developed as a model of collaboration between geriatricians, orthopaedic surgeons, and an interprofessional team of nurses, therapists, and others [3]. Orthogeriatric care has been shown to decrease the prevalence of postoperative complications [4][5][6][7][8][9][10], readmission rates [4,5,9,11], and mortality [4,6,8,[11][12][13][14][15][16] in hip fracture patients, as compared to traditional orthopaedic care. The majority of these studies were designed as retrospective [6,7,9,10,[12][13][14]16] or prospective cohort studies with a historical cohort [4,5,11,15], and only one study as a randomized controlled trial [8].…”

Section: Introductionmentioning

confidence: 99%

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The impact of an orthogeriatric intervention in patients with fragility fractures: A cohort study

Abrahamsen

Nørgaard

Draborg

et al. 2019

Preprint

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Background: While orthogeriatric care to patients with hip fractures is established, the impact of similar intervention in patients with fragility fractures in general is lacking. Therefore, we aimed to assess the impact of an orthogeriatric intervention on postoperative complications and readmissions among patients admitted due to and surgically treated for fragility fractures. Methods: A prospective observational cohort study with a retrospective control was designed. A new orthogeriatric unit for acute patients of sixty-five years or older with fragility fractures in terms of hip, vertebral or appendicular fractures was opened on March 1, 2014. Patients were excluded if the fracture was cancer-related or caused by high-energy trauma, if the patient was operated on at another hospital, treated conservatively with no operation, or had been readmitted within the last month due to fracture-related complications. Results: We included 591 patients; 170 in the historical cohort and 421 in the orthogeriatric cohort. No significant differences were found between the two cohorts with regard to the proportion of participants experiencing complications (24.5% versus 28.3%, p = 0.36) or readmission within 30 days after discharge (14.1% vs 12.1%, p = 0.5). With both cohorts collapsed and adjusting for age, gender and CCI, the odds of having postoperative complications as a hip fracture patient was 4.45, compared to patients with an appendicular fracture (p < 0.001). Furthermore, patients with complications during admission were at a higher risk of readmission within 30 days than were patients without complications (22.3% vs 9.5%; p < 0.001). Conclusions: In older patients admitted with fragility fractures, our model of orthogeriatric care showed no significant differences regarding postoperative complications or readmissions compared to the traditional care. However, we found significantly higher odds of having postoperative complications among patients admitted with a hip fracture compared to other fragility fractures. Additionally, our study reveals an increased risk of being readmitted within 30 days for patients with postoperative complications.

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Geriatric Fracture Center

Cited by 58 publications

References 29 publications

The effectiveness of geriatrician-led comprehensive hip fracture collaborative care in a new acute hip unit based in a general hospital setting in the UK

The effectiveness of geriatrician-led comprehensive hip fracture collaborative care in a new acute hip unit based in a general hospital setting in the UK

Provider adherence to first antenatal care guidelines and risk of pregnancy complications in public sector facilities: a Ghanaian cohort study

The impact of an orthogeriatric intervention in patients with fragility fractures: A cohort study

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