An Orthogeriatric Collaborative Intervention Program for Fragility Fractures: A Retrospective Cohort Study

Leung, Allen; Lam, TP; Cheung, Wing-Hoi; Chan, Tan; Sze, Pan-Ching; Lau, Thomas; Leung, Kwok-Sui

doi:10.1097/ta.0b013e31821f7e60

Cited by 68 publications

(61 citation statements)

References 19 publications

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“…27 A local study reviewed the effectiveness of geri-orthopaedic comanagement and found that in the geri-orthopaedic group, time to surgery was shorter, 1-year mortality rate was lower, and more remained independent in daily living activities. 28 Therefore, geri-orthopaedic care should be implemented in all hospitals in HK to achieve better patient care. This will further improve the KPI for fragility hip fractures in all hospitals in HK.…”

Section: Importance Of Geri-orthopaedic Co-managementmentioning

confidence: 99%

How well are we managing fragility hip fractures? A narrative report on the review with the attempt to setup a Fragility Fracture Registry in Hong Kong

Leung

Yuen

Ngai³

et al. 2017

Hong Kong Med J

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Section: Importance Of Geri-orthopaedic Co-managementmentioning

confidence: 99%

How well are we managing fragility hip fractures? A narrative report on the review with the attempt to setup a Fragility Fracture Registry in Hong Kong

Leung

Yuen

Ngai³

et al. 2017

Hong Kong Med J

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“…This includes 'orthogeriatric assessment, rapid optimisation of fitness for surgery, early identification of individual goals for multidisciplinary rehabilitation to recover mobility and independence, and to facilitate return to prefracture residence' [18]. The specific components of most organisational orthogeriatric care pathways do vary, but generally, they include four main steps: pre-operative care, postoperative care, rehabilitation along with secondary prevention Compared to an orthogeriatric liaison model and a joint care model: -Higher inpatient mortality rates [20,46] Compared to an orthogeriatric liaison and joint model of care: -Increased length of stay [47,48] No significant findings reported 2. Orthogeriatric liaison model of care…”

Section: Why Are Fragility Fractures Important?mentioning

confidence: 99%

“…Compared to a usual model of care: -Reduced inpatient mortality rates [46] Compared to a usual model of care: -Reduced length of stay [48] Compared to a usual model of care: -Reduced incidence of delirium in patients [49] -Reduced time to surgery [48] -Improved post-operative patient self-care, mobility and depressive symptoms [50] 3. Post-operative geriatric rehabilitation unit…”

Section: Why Are Fragility Fractures Important?mentioning

confidence: 99%

“…This is the rationale for national guidance, such as the NICE guidelines, which recommends that surgery is performed within 36 h of admission to hospital [18]. Leung et al performed a retrospective review of 548 patients with hip fracture who received either regular perioperative orthogeriatric input or a usual model of orthopaedic care [48]. The time to surgery was 17 % shorter, and the 12-month mortality rate was 8.9 % less in the intervention group, with both outcomes achieving statistical significance.…”

Section: Effect Of Orthogeriatric Management On Time To Surgerymentioning

confidence: 99%

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Orthogeriatrics in the management of frail older patients with a fragility fracture

Sabharwal¹,

Wilson

2015

Osteoporos Int

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This review article examines the role of orthogeriatric management for frail older patients with a fragility fracture. The history of orthogeriatrics and its application in clinical practice around the world is reported, and an evidence-based evaluation for the effect of orthogeriatric management on patient morbidity and mortality is also provided. It has been more than 50 years since the role of the geriatrician in the management of patients with a hip fracture was first described. The evidence that supports an orthogeriatric model of care has grown exponentially over the last decade. This evidence base is primarily related to hip fractures and demonstrates reduced morbidity and mortality rates amongst patients managed with a recognised model of orthogeriatric care. The societal and economic burden of hip fracture has led to health economic evaluations within this field, many of which have concluded that orthogeriatric management results in cost-effective clinical practice. Based on existing clinical and economic research, national clinical practice guidelines have been developed in several countries which recommend orthogeriatric participation in the management of older patients with a hip fracture. Compliance with such guidance has already demonstrated improved patient outcomes. Although the pathogenesis and prognosis of other types of fragility fracture may be as poor, there is a dearth of clinical research that evaluates the effect of orthogeriatric management on such injuries. Looking to the future, orthogeriatric management is likely to become more widespread, and the robust collection and reporting of patient outcomes from national registries will provide a greater understanding of the impact of orthogeriatric models in the care of all frail older patients with any type of fragility fracture.

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“…Ja n.a. Suhm et al [22] 2014 [19]. Darüber hinaus ergab eine Studie eine geringere 1-JahresMortalitätsrate bei Patienten in Komanagementbehandlung, allerdings war dies keine allgemeine Feststellung [22,23].…”

Section: Konzept Der Frakturzentrenunclassified

Geriatrische Frakturzentren

Kates

2015

Unfallchirurg

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The world's population is aging resulting in changes in the way we manage geriatric care. Furthermore, this population has a considerable risk of fragility fractures, most notably hip fractures. Hip fractures are associated with significant morbidity and mortality and have large economic consequences. It is due to these factors that the concept of an elderly trauma center was developed. These trauma centers utilize the expertise in orthopedic and geriatric disciplines to provide coordinated care to the elderly hip fracture patient. As a result, studies have demonstrated improvements in clinical outcomes within the hospital stay, a reduction in iatrogenic complications, and improvements in 1-year mortality rates compared to the usual care given at a similar facility. Furthermore, economic models have demonstrated that there is a role for regionalized hip fracture centers that can be both profitable and provide more efficient care to these patients.

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An Orthogeriatric Collaborative Intervention Program for Fragility Fractures: A Retrospective Cohort Study

Abstract: 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.

Cited by 68 publications

References 19 publications

How well are we managing fragility hip fractures? A narrative report on the review with the attempt to setup a Fragility Fracture Registry in Hong Kong

How well are we managing fragility hip fractures? A narrative report on the review with the attempt to setup a Fragility Fracture Registry in Hong Kong

Orthogeriatrics in the management of frail older patients with a fragility fracture

Geriatrische Frakturzentren

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