title: Orthogeriatric care: improving patient outcomes.
abstract: Hip fractures are a very serious socio-economic problem in western countries. Since the 1950s, orthogeriatric units have introduced improvements in the care of geriatric patients admitted to hospital because of hip fractures. During this period, these units have reduced mean hospital stays, number of complications, and both in-hospital mortality and mortality over the middle term after hospital discharge, along with improvements in the quality of care and a reduction in costs. Likewise, a recent clinical trial has reported greater functional gains among the affected patients. Studies in this field have identified the prognostic factors present upon admission or manifesting themselves during admission and that increase the risk of patient mortality or disability. In addition, improved care afforded by orthogeriatric units has proved to reduce costs. Nevertheless, a number of management issues remain to be clarified, such as the optimum anesthetic, analgesic, and thromboprophylactic protocols; the type of diagnostic and therapeutic approach best suited to patients with cognitive problems; or the efficiency of the programs used in convalescence units or in home rehabilitation care. Randomized clinical trials are needed to consolidate the evidence in this regard.
authors.affiliation: Geriatric Medicine Unit, Internal Medicine Department, Hospital Universitario de la Ribera; Medical School, Universidad Católica de Valencia San vicente Mártir, Valencia, Spain.
authors.forename: Francisco José
authors.initials: FJ
authors.lastname: Tarazona-Santabalbina
authors.affiliation: Geriatric Medicine Unit, Internal Medicine Department, Hospital Universitario de la Ribera; Medical School, Universidad Católica de Valencia San vicente Mártir, Valencia, Spain.
authors.forename: Ángel
authors.initials: Á
authors.lastname: Belenguer-Varea
authors.affiliation: Geriatric Medicine Unit, Internal Medicine Department, Hospital Universitario de la Ribera; Medical School, Universidad Católica de Valencia San vicente Mártir, Valencia, Spain.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Rovira
authors.affiliation: Geriatric Medicine Unit, Internal Medicine Department, Hospital Universitario de la Ribera; Medical School, Universidad Católica de Valencia San vicente Mártir, Valencia, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Cuesta-Peredó
mesh_terms: D000368:Aged; D015577:Geriatric Assessment / Q000379:methods; D006299:Health Services for the Aged; D006620:Hip Fractures / Q000150:complications / Q000401:mortality / Q000451:nursing*; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D010348:Patient Care Team / Q000458:organization & administration*; D016032:Randomized Controlled Trials as Topic; D020127:Recovery of Function
keywords: geriatric assessment; hip fractures; mortality; orthogeriatric care; recovery of function