A comparison between two co-managed geriatric programmes for hip fractured elderly patients.
OBJECTIVE
Hip fracture in older people is an event associated with a high incidence of morbidity and mortality. In this study we compared the clinical outcomes of two groups of orthogeriatric patients in an orthogeriatric care (OC) programme. The OC course, developed into the GeriatricWard, starts from the Emergency Department (OC-1, n=174) or from the Orthopaedic Department after surgery (OC-2, n=87).


METHODS
For this purpose, OC patients were prospectively enrolled from March 2007 to June 2009, following OC criteria. Door-to-bed time, time to surgery, mobilisation time, length of stay, and post-operative complications were compared between the OC groups.


RESULTS
OC-1 patients differ from OC-2 ones only for residence at admission (14.4% vs 4.6% lived in nursing homes, p=0.02). Concerning outcomes, in the OC-1 group only mobilization time was significantly lower (p=0.01). No differences were observed in post-operative complications.


CONCLUSIONS
In frail older people, hip fracture co-management, with the geriatrician as primary attendant, leads to satisfying outcomes. The OC-1 and OC-2 courses exhibit similar clinical results. An improvement in several organisational aspects, including coordination between hospital and rehabilitation services, is warranted.
University of Milano-Bicocca, Geriatric Clinic, S. Gerardo Hospital, Monza, Floor 7 C, Via Pergolesi 33, 20052 Monza, Italy.
Paolo
P
Mazzola
Francesco
F
De Filippi
Giuseppe
G
Castoldi
Paola
P
Galetti
Giovanni
G
Zatti
Giorgio
G
Annoni
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006299:Health Services for the Aged; D006620:Hip Fractures / Q000534:rehabilitation / Q000601:surgery / Q000628:therapy*; D006801:Humans; D008297:Male; D019637:Orthopedic Procedures