title: Does a multidisciplinary team decrease complications in male patients with hip fractures?
abstract: BACKGROUND
  Men with hip fractures are more likely to experience postoperative complications than women. The Medical Orthopaedic Trauma Service program at New York Presbyterian Hospital utilizes a multidisciplinary team approach to care for patients with hip fractures. The service is comanaged by an attending hospitalist and orthopaedic surgeon, with daily walking rounds attended by the hospitalist, orthopaedic resident, physical therapist, social worker, and a dedicated Medical Orthopaedic Trauma Service physician assistant.
  
  
  OBJECTIVE
  We asked whether a multidisciplinary service for patients with hip fracture decreases (1) the incidence of inpatient complications in men, (2) the length of hospitalization, and (3) 90-day and 1-year mortality.
  
  
  METHODS
  We retrospectively reviewed the charts of 74 men who had surgery for a nonperiprosthetic femoral neck, intertrochanteric, or subtrochanteric fracture for two 7-month periods before and after implementation of the Medical Orthopaedic Trauma Service. Age, ethnicity, comorbidity status, time to surgery, and postoperative complication data were collected. Regression modeling was used to evaluate the likelihood of postoperative complications, length of hospitalization, and 90-day and 1-year mortality while controlling for age, Charlson Comorbidity Index score, fracture type, and time from admission to surgery.
  
  
  RESULTS
  We observed a decrease in the likelihood of experiencing at least one inpatient complication in male patients after implementation of the Medical Orthopaedic Trauma Service (odds ratio = 0.264). There was no difference in length of hospitalization, 90-day mortality, or 1-year mortality.
  
  
  CONCLUSIONS
  Multidisciplinary collaboration for patients with hip fractures can decrease the likelihood of experiencing inpatient complications in male patients.
  
  
  METHODS
  Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
authors.affiliation: Office of Academic Training, Hospital for Special Surgery, 525 East 70th Street, New York, NY 10021, USA. dyc@hss.edu
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Dy
authors.forename: Paul-Michel
authors.initials: PM
authors.lastname: Dossous
authors.forename: Quang V
authors.initials: QV
authors.lastname: Ton
authors.forename: James P
authors.initials: JP
authors.lastname: Hollenberg
authors.forename: Dean G
authors.initials: DG
authors.lastname: Lorich
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Lane
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006620:Hip Fractures / Q000401:mortality* / Q000628:therapy*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008571:Men; D008875:Middle Aged; D010348:Patient Care Team / Q000458:organization & administration*; D011183:Postoperative Complications; D012189:Retrospective Studies; D055502:Secondary Prevention / Q000379:methods* / Q000706:statistics & numerical data; D015996:Survival Rate