Interdisciplinary Intervention for Hip Fracture in Older Taiwanese: Benefits Last for 1 Year

Shyu, Yea‐Ing Lotus; Liang, Jersey; Wu, Chi‐Chuan; Su, Juin-Yih; Cheng, Huey‐Shinn; Chou, Shih‐Wei; Chen, Min-Chi; Yang, Ching‐Tzu

doi:10.1093/gerona/63.1.92

Cited by 71 publications

(91 citation statements)

References 14 publications

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“…Study design and characteristics Table 1 lists the methodological elements and outcomes of the 21 papers included, whereas eight were prospective randomized studies [6][7][8][9][10][11][12][13], nine were prospective cohort studies with different (retrospective) control groups [1,[14][15][16][17][18][19][20][21], and four were retrospective chart reviews [22][23][24][25].…”

Section: Study Selectionmentioning

confidence: 99%

“…Overall, 964 patients were treated in an intervention group and 673 in a standard care control group. Two trials [13,21] included patients over 65 years, and four [1,11,12,25] over 60. Three studies in this group were randomized controlled trials [11][12][13].…”

Section: Orthopedic Ward and Integrated Carementioning

confidence: 99%

“…Two trials [13,21] included patients over 65 years, and four [1,11,12,25] over 60. Three studies in this group were randomized controlled trials [11][12][13]. One [13] excluded patients who were not able to walk or were not independent in their basic activities of daily living before the fracture occurred, and in the two other investigations [11,12], patients who did not reach a Chinese Mini Mental score above ten were excluded and only patients with a Chinese Barthel Index above 70 were included.…”

Section: Orthopedic Ward and Integrated Carementioning

confidence: 99%

“…The in-hospital mortality was found to be significantly lower in the intervention group in one trial [13], whereas in three other investigations, no significant difference could be determined. The 1-year mortality was described in two trials [11][12][13] and found to be overall 16% in the intervention group and 20.97% in the control group. The length of stay was investigated in five trials and reached from 4.6 days in the intervention group [1,25] to 18.9 days in the control group [13].…”

Section: Orthopedic Ward and Integrated Carementioning

confidence: 99%

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Ortho-geriatric service—a literature review comparing different models

et al. 2010

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In the fast-growing geriatric population, we are confronted with both osteoporosis, which makes fixation of fractures more and more challenging, and several comorbidities, which are most likely to cause postoperative complications. Several models of shared care for these patients are described, and the goal of our systematic literature research was to point out the differences of the individual models. A systematic electronic database search was performed, identifying articles that evaluate in a multidisciplinary approach the elderly hip fracture patients, including at least a geriatrician and an orthopedic surgeon focused on in-hospital treatment. The different investigations were categorized into four groups defined by the type of intervention. The main outcome parameters were pooled across the studies and weighted by sample size. Out of 656 potentially relevant citations, 21 could be extracted and categorized into four groups. Regarding the main outcome parameters, the group with integrated care could show the lowest in-hospital mortality rate (1.14%), the lowest length of stay (7.39 days), and the lowest mean time to surgery (1.43 days). No clear statement could be found for the medical complication rates and the activities of daily living due to their inhomogeneity when comparing the models. The review of these investigations cannot tell us the best model, but there is a trend toward more recent models using an integrated approach. Integrated care summarizes all the positive features reported in the various investigations like integration of a Geriatrician in the trauma unit, having a multidisciplinary team, prioritizing the geriatric fracture patients, and developing guidelines for the patients' treatment. Each hospital implementing a special model for geriatric hip fracture patients should collect detailed data about the patients, process of care, and outcomes to be able to participate in audit processes and avoid peerlessness.

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Section: Study Selectionmentioning

confidence: 99%

Section: Orthopedic Ward and Integrated Carementioning

confidence: 99%

Section: Orthopedic Ward and Integrated Carementioning

confidence: 99%

Section: Orthopedic Ward and Integrated Carementioning

confidence: 99%

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Ortho-geriatric service—a literature review comparing different models

et al. 2010

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“…Additionally, 11 domain-specific measures were reviewed: three measures of emotional wellbeing -Geriatric Depression Scale (GDS) [42], Hamilton Rating Scale for Depression (HAM-D) [43] and the Zung Depression Inventory (ZungDI) [44]; and eight measures of (instrumental) activities of daily living (I/ADL): Barthel Index (BI) [45], Modified-Barthel Index [46], Functional Activities Index (FAI) [47], Functional Independence Measure (FIM) [48], Functional Status Questionnaire (FSQ) [49], Lawton IADL scale (Lawton-IADL) [50], Katz Index of Independence in ADL (Katz ADL) [51] and the OARS Multi-dimensional Functional Assessment Questionnaire (OMFAQ) [52]. One of these measures (Katz ADL) is clinician-completed but was included in the review due to its wide-spread use in this patient population.…”

Section: [Type Here]mentioning

confidence: 99%

Patient-reported outcome measures in older people with hip fracture: a systematic review of quality and acceptability

et al. 2016

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Purpose: Hip fracture is the most common serious injury of older people, often resulting in reduced mobility and loss of independence. However, guidance for the use of patient-reported outcome measures (PROMs) does not exist: we describe the first review to apply internationally endorsed criteria in support of PROM quality and acceptability in this group, and make recommendations for future applications.Methods: Systematic literature searches of major databases to identify published evidence of the application and quality of clearly defined measures. Evidence of measurement and practical properties, and the extent of active patient involvement, was sought. Study and PROM quality was assessed against recommended criteria.Results: 71 articles relating to 28 PROMs (Generic n=12; Specific n=16) were included. The SF-36 (v1) and EuroQoL EQ-5D 3L were the most widely evaluated measures with acceptable evidence of measurement properties, but limited evaluations of practical properties or relevance to this group. Evidence was mostly limited for the remaining measures. Hypothesized associations between variables were infrequently evaluated. Evidence of data quality, test-retest reliability, responsiveness, interpretation, acceptability and feasibility was also limited. Active patient involvement in PROM development or evaluation was not reported. There was limited evaluation of proxy completions. Conclusions:The paucity of robust evaluations is disappointing and prevents clear recommendations for PROM-based assessment. Further research must urgently seek to identify which outcomes really matter to this group. Future PROM selection must be underpinned by research which focuses on methodological quality, including issues of acceptability, relevance, feasibility of application, and proxy completion, whilst seeking to actively incorporate the perspective of patients and their advocates. Authors:Haywood KL, Brett J, Tutton E, Staniszewska S. Title:Patient-reported outcome measures in older people with hip fracture: a systematic review of quality and acceptability. Affiliation(s) and addresse(s):Haywood Abstract (257/250)Purpose: Hip fracture is the most common serious injury of older people, often resulting in reduced mobility and loss of independence. However, guidance for the use of patient-reported outcome measures (PROMs) does not exist: we describe the first review to apply internationally endorsed criteria in support of PROM quality and acceptability in this group, and make recommendations for future applications.Methods: Systematic literature searches of major databases to identify published evidence of the application and quality of clearly defined measures. Evidence of measurement and practical properties, and the extent of active patient involvement, was sought. Study and PROM quality was assessed against recommended criteria.Results: 71 articles relating to 28 PROMs (Generic n=12; Specific n=16) were included. The and EuroQoL EQ-5D 3L were the most widely evaluated measures with acceptable evidence of ...

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