Orthogeriatric co-managements lower early mortality in long-lived elderly hip fracture: a post-hoc analysis of a prospective study

Abstract

Objective To evaluate the clinical effectiveness of orthogeriatric co-management care in long-lived elderly hip fracture patients (age ≥ 90). Methods Secondary analysis was conducted in long-lived hip fracture patients between 2018 to 2019 in 6 hospitals in Beijing, China. Patients were divided into the orthogeriatric co-management group (CM group) and traditional consultation mode group (TC group) depending on the management mode. With 30-day mortality as the primary outcome, multivariate regression analyses were performed after adjusting for potential covariates. 30-day mobility and quality of life were compared between groups. Results A total of 233 patients were included, 223 of whom completed follow-up (125 in CM group, 98 in TC group). The average age was 92.4 ± 2.5 years old (range 90–102). The 30-day mortality in CM group was significantly lower than that in TC group after adjustments for (2.4% vs. 10.2%; OR = 0.231; 95% CI 0.059 ~ 0.896; P = 0.034). The proportion of patients undergoing surgery and surgery performed within 48 h also favored the CM group (97.6% vs. 85.7%, P = 0.002; 74.4% vs. 24.5%, P < 0.001; respectively). In addition, much more patients in CM group could walk with or without aids in postoperative 30 days than in the TC group (87.7% vs. 60.2%, P < 0.05), although differences were not found after 1-year follow-up. And there was no significant difference in total cost between the two groups (P > 0.05). Conclusions For long-lived elderly hip fracture patients, orthogeriatric co-management care lowered early mortality, improved early mobility and compared with the traditional consultation mode.

Orthogeriatric Care Following Hip Fracture: Improving Post-Operative Outcomes in an Aged Population

“…Regular orthogeriatric input has been demonstrated to be associated with significant improvement in decreasing length of hospital stay, reduction of financial burden, decreased time to operation, reduced mortality, early mortality, and improvement in early mobility [15][16][17][18][19][20][21]. This study demonstrates that the implementation of regular orthogeriatric review is associated with a significant decrease in non-surgical site infections (NSSIs) only in individuals with severe cognitive impairment and infection-associated mortality.…”

“…Importantly, Lisk et al, 2023 showed that orthogeriatric liaison services were associated with a significant decrease in the length of hospital stay, and the introduction of the service was also linked to savings of EUR 2.7 million per 1000 patients [15]. Several studies have indicated that orthogeriatric liaison services are associated with improvements in the length of hospital stay, decreased time to surgery, reduced early mortality, and improvements in early mobility [16][17][18][19][20][21]. The success of orthogeriatric services in acute hospitals or rehabilitation units depends on its multidisciplinary approach, including nutritional support [22,23].…”