title: Orthogeriatric Service Reduces Mortality in Patients With Hip Fracture.
abstract: BACKGROUND
  Orthogeriatric service has been shown to improve outcomes in patients with hip fracture. The purpose of this study is to evaluate the effect of orthogeriatrics at Bispebjerg University Hospital, Denmark. The primary outcome is mortality inhospital and after 1, 3, and 12 months for patients with hip fracture. The secondary outcome is mortality for home dwellers and nursing home inhabitants.
  
  
  METHODS
  This is a retrospective clinical cohort study with an historic control group including all patients with hip fracture admitted from 2007 to 2011. Patients with hip fracture are registered in a local database, and data are retrieved retrospectively using the Danish Civil Registration Number.
  
  
  RESULTS
  We included 993 patients in the intervention group and 989 patients in the control group. A univariate analysis showed only significantly decreased mortality inhospital 6.3% vs 3.1% (P = .009) after orthogeriatrics. However, when adjusting for age, gender, and American Society of Anaesthesiologists (ASA) score in a multivariate analysis, including all patients with hip fracture, we find significantly reduced mortality inhospital (odds ratio [OR] 0.35), after 30 [OR 0.66] and 90 days [OR 0.72] and 1 year [OR 0.79]). When using a univariate analysis for home-dwelling patients, we found significantly reduced mortality inhospital (8.3-2.0%, P < .0001), after 30 days (12.2-6.8%, P = .004) and 90 days (20.5-13.0%, P = .002). One-year mortality was not significant. Patients from nursing homes had no significant decreasing mortality at any point of time in the univariate analysis.
  
  
  CONCLUSIONS
  We have shown significant decreases for inhospital, 30 day, 90 day, and 1-year mortality after implementation of orthogeriatric service at Bispebjerg Hospital when adjusting for age, gender, and ASA score. Future trials should include frail patients with other fracture types who can benefit from orthogeriatrics.
authors.affiliation: Department of Orthopedic Surgery, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Stenqvist
authors.affiliation: Department of Orthopedic Surgery, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Christian Medom
authors.initials: CM
authors.lastname: Madsen
authors.affiliation: Department of Orthopedic Surgery, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Troels
authors.initials: T
authors.lastname: Riis
authors.affiliation: Department of Clinical Biochemistry, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Henrik Løvendahl
authors.initials: HL
authors.lastname: Jørgensen
authors.affiliation: Department of Orthopedic Surgery, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Benn Rønnow
authors.initials: BR
authors.lastname: Duus
authors.affiliation: Department of Orthopedic Surgery, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Jes Bruun
authors.initials: JB
authors.lastname: Lauritzen
authors.affiliation: Department of Orthopedic Surgery, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Susanne
authors.initials: S
authors.lastname: van der Mark
keywords: Denmark; hip fracture; mortality; orthogeriatrics