Orthogeriatric care pathway: a prospective survey of impact on length of stay, mortality and institutionalisation

Suhm, Norbert; Kaelin, Raphael; Studer, Patrick; Wang, Q.; Kressig, Reto W.; Rikli, Daniel; Jakob, Marcel; Pretto, Manuela

doi:10.1007/s00402-014-2057-x

Cited by 82 publications

(69 citation statements)

References 18 publications

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“…The implementation of an evidence-based algorithm for hip fracture surgery in Denmark facilitated a low reoperation rate 71. In the acute fracture care phase, orthogeriatric comanagement are recommended for the frail, elderly patient with multiple comorbidities and polypharmacy17 18 72 and has been shown to bring about a decreased length of stay73 and improved mobility 17…”

Section: Recommendationsmentioning

confidence: 99%

EULAR/EFORT recommendations for management of patients older than 50 years with a fragility fracture and prevention of subsequent fractures

et al. 2016

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The European League Against Rheumatism (EULAR) and the European Federation of National Associations of Orthopaedics and Traumatology (EFORT) have recognised the importance of optimal acute care for the patients aged 50 years and over with a recent fragility fracture and the prevention of subsequent fractures in high-risk patients, which can be facilitated by close collaboration between orthopaedic surgeons and rheumatologists or other metabolic bone experts. Therefore, the aim was to establish for the first time collaborative recommendations for these patients. According to the EULAR standard operating procedures for the elaboration and implementation of evidence-based recommendations, 7 rheumatologists, a geriatrician and 10 orthopaedic surgeons met twice under the leadership of 2 convenors, a senior advisor, a clinical epidemiologist and 3 research fellows. After defining the content and procedures of the task force, 10 research questions were formulated, a comprehensive and systematic literature search was performed and the results were presented to the entire committee. 10 recommendations were formulated based on evidence from the literature and after discussion and consensus building in the group. The recommendations included appropriate medical and surgical perioperative care, which requires, especially in the elderly, a multidisciplinary approach including orthogeriatric care. A coordinator should setup a process for the systematic investigations for future fracture risk in all elderly patients with a recent fracture. High-risk patients should have appropriate non-pharmacological and pharmacological treatment to decrease the risk of subsequent fracture.

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Section: Recommendationsmentioning

confidence: 99%

EULAR/EFORT recommendations for management of patients older than 50 years with a fragility fracture and prevention of subsequent fractures

et al. 2016

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“…Unfortunately, not all patients who undergo cephalomedullary nailing experienced good clinical outcomes despite the availability of various implant designs and meticulous surgical techniques because of a combination of factors such as medical comorbidities, fracture type, and bone quality [19]. Moreover, it has to be noticed that lag screw cut-out, one of the most common risk factors of fixation failure after the treatment of intertrochanteric hip fractures, is deeply associated with implant position, which is expressed as a combination of TAD and Cleveland zone [4,20] as well as fracture reduction quality.…”

Section: Variablementioning

confidence: 99%

Prospective randomized study comparing two cephalomedullary nails for elderly intertrochanteric fractures: Zimmer natural nail versus proximal femoral nail antirotation II

Shin

Chae

Kang

et al. 2017

Injury

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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

“…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]. Angemerkt wurde, dass es mög-licherweise eine Lernkurve gibt, die mit der Einrichtung eines geriatrischen Frakturzentrums einhergeht, was zu ungünstigeren Ergebnissen als erwartet führen könnte [4].…”

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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Orthogeriatric care pathway: a prospective survey of impact on length of stay, mortality and institutionalisation

Abstract: A care pathway for elderly hip fracture patients allowed decreased LoS without affecting mortality or change of residential status 1 year after fracture compared to prefracture baseline.

Cited by 82 publications

References 18 publications

EULAR/EFORT recommendations for management of patients older than 50 years with a fragility fracture and prevention of subsequent fractures

EULAR/EFORT recommendations for management of patients older than 50 years with a fragility fracture and prevention of subsequent fractures

Prospective randomized study comparing two cephalomedullary nails for elderly intertrochanteric fractures: Zimmer natural nail versus proximal femoral nail antirotation II

Geriatrische Frakturzentren

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