title: Efficacy of a comprehensive geriatric intervention in older patients hospitalized for hip fracture: a randomized, controlled trial.
abstract: OBJECTIVE
  To evaluate whether an early multidisciplinary geriatric intervention in elderly patients with hip fracture reduced length of stay, morbidity, and mortality and improved functional evolution.
  
  
  METHODS
  Randomized, controlled intervention trial.
  
  
  METHODS
  Orthopedic ward in a university hospital.
  
  
  METHODS
  Three hundred nineteen patients aged 65 and older hospitalized for hip fracture surgery.
  
  
  METHODS
  Participants were randomly assigned to a daily multidisciplinary geriatric intervention (n=155) or usual care (n=164) during hospitalization in the acute phase of hip fracture.
  
  
  METHODS
  Primary endpoints were in-hospital length of stay and incidence of death or major medical complications. Secondary endpoints were the rate of recovery of previous activities of daily living and ambulation ability at 3, 6, and 12 months.
  
  
  RESULTS
  Median length of stay was 16 days in the geriatric intervention group and 18 days in the usual care group (P=.06). Patients assigned to the geriatric intervention showed a lower in-hospital mortality (0.6% vs 5.8%, P=.03) and major medical complications rate (45.2% vs 61.7%, P=.003). After adjustment for confounding variables, geriatric intervention was associated with a 45% lower probability of death or major complications (95% confidence interval=7-68%). More patients in the geriatric intervention group achieved a partial recovery at 3 months (57% vs 44%, P=.03), but there were no differences between the groups at 6 and 12 months.
  
  
  CONCLUSIONS
  Early multidisciplinary daily geriatric care reduces in-hospital mortality and medical complications in elderly patients with hip fracture, but there is not a significant effect on length of hospital stay or long-term functional recovery.
authors.affiliation: Department of Geriatric Medicine, Hospital General Universitario Gregorio Marañón, Madrid, Spain. mvidan.hgugm@salud.madrid.org
authors.forename: Maite
authors.initials: M
authors.lastname: Vidán
authors.forename: José A
authors.initials: JA
authors.lastname: Serra
authors.forename: Concepción
authors.initials: C
authors.lastname: Moreno
authors.forename: Gerardo
authors.initials: G
authors.lastname: Riquelme
authors.forename: Javier
authors.initials: J
authors.lastname: Ortiz
mesh_terms: D000368:Aged; D005260:Female; D006299:Health Services for the Aged; D006620:Hip Fractures / Q000150:complications / Q000401:mortality / Q000534:rehabilitation / Q000628:therapy*; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D010348:Patient Care Team; D016896:Treatment Outcome