Geriatrische Frakturzentren

Kates, Stephen L.

doi:10.1007/s00113-015-0121-9

Cited by 3 publications

(3 citation statements)

References 21 publications

(11 reference statements)

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“…A similar trend could be seen in pulmonary complications and delirium. Thus, our results contradict previous studies, which predominantly observed a reduced detection of the aforementioned complications [9,11]. Fisher et al, for example, were able to demonstrate a reduction in delirium from 11.7 % to 5.9% and a reduction in urinary tract infections from 8.9% to 6.7% in the co-care of older patients with hip fractures [9].…”

Section: Primary Outcome Measurescontrasting

confidence: 99%

“…While there have been conflicting results on the outcome of ortho-geriatric co-management in the early years [7], numerous studies recently demonstrated a reduction in complications, readmission rates, and mortality [8][9][10]. In addition, as the economic burden of patient care is getting more important, the advantages of such models were analyzed and highlighted by several working groups [11,12].…”

Section: Introductionmentioning

confidence: 99%

“…Since then, 108 GTCs certified by the German Society for Trauma Surgery (DGU ® ) have been established in Germany, Austria, and Switzerland. However, scientific evaluation regarding the need, effectiveness, and outcome of these centers in Germany and other countries worldwide is mostly limited to geriatric patients with hip fractures, as these are the leading fracture type in quantity, mortality, and economic burden [11,12]. Since the numbers of pelvic and spine fractures are rapidly increasing [16,17] and comorbidities and treatment pathways differ between the types of fractures, it is necessary to investigate a broader spectrum of fractures and evaluate them in the context of ortho-geriatric co-management.…”

Section: Introductionmentioning

confidence: 99%

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Care of Geriatric Patients with Lumbar Spine, Pelvic, and Acetabular Fractures before and after Certification as a Geriatric Trauma Center DGU®: A Retrospective Cohort Study

et al. 2021

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Background: More than 750,000 fragility fractures occur in Germany every year, with an expected increase in the following years. Interdisciplinary care pathways for geriatric patients are increasingly established to improve the treatment process and outcome, but there has been only limited evaluation of their use. Objectives: This study aimed to compare patient care before and after the implementation of a geriatric trauma center (GTC) in conformity with the German Society for Trauma Surgery (DGU®). Patients and Methods: We performed a retrospective single-center cohort study, including 361 patients > 70 years old with lumbar spine, pelvic, and acetabular fractures, admitted between January 2012 and September 2019. Patients were divided into a usual care cohort (UC, n = 137) before implementation and an ortho-geriatric care cohort (OGC, n = 224) after implementation of the GTC DGU®. We recorded and compared demographic data, fracture type, geriatric assessment and management, therapy, complications, and various clinical parameters, e.g., length of stay, time to surgery, hours admitted to ICU, and change in walking ability. Results: The geriatric assessment revealed significant geriatric co-morbidities and a need for geriatric intervention in 75% of the patients. With orthogeriatric co-management, a significant increase in the detection of urological complications (UC: 25.5% vs. OGC: 37.5%; p = 0.021), earlier postoperative mobilization (UC: 57.1% vs. OGC: 86.3%; p < 0.001), an increased prescription of anti-osteoporotic treatment at discharge (UC: 13.1% vs. OGC: 46.8%; p < 0.001), and lower rates of revision surgery (UC: 5.8% vs. OGC: 3.1%; p = 0.012) could be seen. Conclusions: Our results emphasize the improvement in patient care and clinical outcome by implementing a GTC DGU® and provide opportunities for future improvement in ortho-geriatric patient care.

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Section: Primary Outcome Measurescontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Care of Geriatric Patients with Lumbar Spine, Pelvic, and Acetabular Fractures before and after Certification as a Geriatric Trauma Center DGU®: A Retrospective Cohort Study

et al. 2021

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Hüftgelenksnahe Frakturen im Alter

Koehl¹,

Pelk²,

Necula³

et al. 2022

MMW - Fortschritte der Medizin

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Risk of Contralateral Hip Fracture Following Initial Hip Fracture Among Geriatric Fragility Fracture Patients

et al. 2023

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Background: Geriatric hip fractures are common and associated with high morbidity and mortality. This study aimed to evaluate the incidence, timing, and risk factors of contralateral hip fracture after initial hip fracture. Methods: Initial hip fractures in patients older than 65 years were abstracted from the national, administrative M91Ortho PearlDiver data set. Incidence and timing of contralateral hip fractures in the following 10 years were identified. Kaplan-Meier survival analysis until contralateral hip fracture was conducted. To account for patient mortality over the later years, 2-year univariate and multivariate analyses were used to determine factors predictive of contralateral hip fracture. Results: Of the initial 104,311 hip fractures identified, contralateral hip fracture in the 10 years that followed was identified for 7,186 (6.9%), of which 68.4% occurred in the first 2 years. Kaplan-Meier survival analysis until contralateral fracture revealed the 10-year incidence to be 12.9% when controlling for those lost from the data set during the study period. Multivariate logistic regression revealed independent predictors of contralateral hip fracture in the 2 years after index hip fracture, when the incidence was greatest, to be female sex (odds ratio [OR] 1.15), body mass index < 20 (OR 1.30), and percutaneous pinning surgery for initial hip fracture fixation (OR 1.58) (P < 0.0001 for each). Conclusions: In a national cohort of 104,311 geriatric hip fractures, Kaplan-Meier analysis for contralateral hip fracture found the 10-year incidence to be 12.9%, of which nearly 70% were in the first 2 years, and predisposing factors were defined. As such, future research should aim to identify the cause and mitigate the risk of secondary contralateral hip fractures in geriatric patients.

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Geriatrische Frakturzentren

Cited by 3 publications

References 21 publications

Care of Geriatric Patients with Lumbar Spine, Pelvic, and Acetabular Fractures before and after Certification as a Geriatric Trauma Center DGU®: A Retrospective Cohort Study

Care of Geriatric Patients with Lumbar Spine, Pelvic, and Acetabular Fractures before and after Certification as a Geriatric Trauma Center DGU®: A Retrospective Cohort Study

Hüftgelenksnahe Frakturen im Alter

Risk of Contralateral Hip Fracture Following Initial Hip Fracture Among Geriatric Fragility Fracture Patients

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