title: An orthogeriatric collaborative intervention program for fragility fractures: a retrospective cohort study.
abstract: BACKGROUND
  This retrospective cohort study aims to investigate the impact of regular pre- and postoperative geriatric input into the management of geriatric patients with hip fracture, with specific interests in morbidity and mortality.
  
  
  METHODS
  Patients with hip fracture (n = 548) older than 60 years were identified within a 2-year period. In the first year, the patients (n = 270) were managed mainly by orthopedics and this group constituted the control group. In the second year, this group of patients (orthogeriatric group, n = 278) had reviews by orthopedic surgeons and geriatricians (physicians specializing in medicine for the elderly), within 48 hours of admission and regularly thereafter. The main outcomes measured included demographics, length of hospital stay, postoperative complications, mortality, and functional outcomes. Data were collected from records of acute and rehabilitation admissions, and outpatient consultations.
  
  
  RESULTS
  The admission to operation time for those in the orthogeriatric group was shorter by 17% (p = 0.02). The percentage of patients deceased at 12 months postoperative was 11.5% for the orthogeriatric group and 20.4% for the conventional group (p = 0.02). A higher percentage of patients in the orthogeriatric group remained independent for daily living activities (24.5%) when compared with the conventional group (23.7%; p = 0.02).
  
  
  CONCLUSIONS
  In addition to existing evidence that postoperative orthogeriatric collaboration improves mortality and functional outcomes in older patients with hip fractures, this study suggests that allowing preoperative geriatric input in this model of care can produce even more superior results.
authors: Specialty Registrar in Trauma and Orthopaedic Surgery, West of Scotland Training Programme, NHS Education for Scotland, Scotland, United Kingdom.
authors: Andraay Hon-Chi
authors: AH
authors: Leung
authors: Tsz-Ping
authors: TP
authors: Lam
authors: Wing-Hoi
authors: WH
authors: Cheung
authors: Tan
authors: T
authors: Chan
authors: Pan-Ching
authors: PC
authors: Sze
authors: Thomas
authors: T
authors: Lau
authors: Kwok-Sui
authors: KS
authors: Leung
mesh_terms: D000203:Activities of Daily Living; D000369:Aged, 80 and over; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D006620:Hip Fractures / Q000401:mortality / Q000534:rehabilitation / Q000601:surgery*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D010348:Patient Care Team / Q000458:organization & administration*; D011183:Postoperative Complications; D020127:Recovery of Function; D012189:Retrospective Studies