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

BMC Geriatrics

Research

Feng Gao¹  Weidong Peng¹  Xinbao Wu¹  Yimin Chen¹  Gang Liu¹  Shiwen Zhu¹  Yufeng Ge¹  Minghui Yang¹  Zhelun Tan¹  Mingyao Sun²  Sanbao Hu²  Xianhai Wang³  Fengpo Sun⁴  Liangyuan Wen⁴  Zongxin Shi⁵  Zishun Gong⁵  Jiusheng He⁶  Jing Zhang⁷  Maoyi Tian⁸  Xinyi Zhang⁹ 

[1] Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China;Peking University Fourth School of Clinical Medicine, Beijing, China;National Center of Orthopaedics, Beijing, China;Department of Orthopaedics, Beijing Anzhen Hospital, Capital Medical University, Beijing, China;Department of Orthopaedics, Beijing Changping District Hospital, Beijing, China;Department of Orthopaedics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China;Department of Orthopaedics, Beijing Liangxiang Hospital, Beijing, China;Department of Orthopaedics, Beijing Shunyi District Hospital, Beijing, China;School of Population Health, University of New South Wales, Sydney, NSW, Australia;School of Public Health, Harbin Medical University, Harbin, China;The George Institute for Global Health at Peking University Health Science Centre, Beijing, China;

关键词: Elderly;    Long-lived;    Hip fractures;    Co-management care;    Orthogeriatric;    Mortality;   

DOI  :  10.1186/s12877-023-04289-z

 received in 2022-11-23, accepted in 2023-09-06,  发布年份 2023

来源: Springer

【 摘 要 】

ObjectiveTo evaluate the clinical effectiveness of orthogeriatric co-management care in long-lived elderly hip fracture patients (age ≥ 90).MethodsSecondary 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.ResultsA 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).ConclusionsFor long-lived elderly hip fracture patients, orthogeriatric co-management care lowered early mortality, improved early mobility and compared with the traditional consultation mode.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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