[Interdisciplinary geriatric intervention among nursing home residents with hip fracture reduces mortality].
BACKGROUND
Nursing home residents represent the majority of hip fracture hospitalisation cases. Quick discharge to nursing homes after surgery is common practice. A previous study indicates an increased risk of death immediately after discharge.


METHODS
A total of 211 residents, hospitalised from nursing homes for hip fracture surgery, were selected for a retrospective follow-up study. The orthopaedic ward's geriatric team (GO-team) visited the residents no later than one day after discharge. The number of visits depended on the need for treatment and rehabilitation. Intervention was, among others, focussed on: nutrition, fluid therapy and blood transfusion.


RESULTS
Intensive geriatric intervention reduced the 30-day mortality (odds ratio (OR) = 0.08; 95% confidence interval (CI): 0.01; 0.52) and reduced 3-month mortality (OR = 0.03; 95% CI: 0.003; 0.25). Fluid therapy and nutritional support were associated with reduced probability of death (OR = 0.12; 95% CI: 0.02; 0.67)/(OR = 0.23; 95% CI: 0.07; 0.79). Non-elective readmissions were reduced (OR = 0.20; 95% CI: 0.04; 0.91). Post-surgical blood transfusion was associated with improved functional ability (beta = 8.22; 95% CI: 1.44; 15.0).


CONCLUSIONS
Geriatric interdisciplinary intervention among residents in nursing homes has a positive effect and improves survival and reduces non-elective readmission within three months. Still, there is uncertainty about the effect of fluid therapy and blood transfusions and further investigations are needed.
Gregersen
Merete
M
Arhus Universitetshospital, Arhus Sygehus, Geriatrisk Afdeling, bygning 7, 1., 8000 Arhus C, Denmark. meregreg@rm.dk
Zintchouk
Dmitri
D
Hougaard
Kjeld
K
Krogshede
Anna
A
Almasi
Faranak
F
Holm-Petersen
Inge Østergaard
IØ
Damsgaard
Else Marie
EM
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D005851:Geriatric Nursing / Q000379:methods*; D006620:Hip Fractures / Q000401:mortality* / Q000534:rehabilitation / Q000601:surgery; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D009735:Nursing Homes; D009985:Orthopedics; D010348:Patient Care Team; D010351:Patient Discharge; D010359:Patient Readmission; D012189:Retrospective Studies; D000078329:Workforce