Prospective randomised study of an orthopaedic geriatric inpatient service.

Gilchrist, W. J.; Newman, Robert J.; Hamblen, David L.; Williams, B.

doi:10.1136/bmj.297.6656.1116

Cited by 145 publications

(104 citation statements)

References 7 publications

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“…Similar models of comanaged care, including the geriatric fracture center described by Friedman et al [5,6] and the comprehensive geriatric intervention described by Vidán et al [21], are focused on protocol-driven care and quality management. The outcomes in our analysis of inpatient complications in male patients before and after implementation of the MOTS program replicate results most recently described in the United States [5,6], Australia [4], and Spain [21] but also the experiences described previously in the United Kingdom [7,12] (Table 3). As suggested by Vidán et al [21], it is likely the lower likelihood of experiencing at least one postoperative complication is due to early identification of high-risk patients through early and regular involvement of internists, as their more specialized training allows them to identify and properly treat medical problems.…”

Section: Discussionsupporting

confidence: 85%

“…Because of the retrospective nature of the study and its limit to a review of inpatient documentation, we were unable to evaluate for the functional impact of the MOTS program at further postdischarge time points. Vidán et al [21] have shown an improvement in recovery of previous activities and function at 3 months postdischarge with a comprehensive geriatric hip fracture intervention but were unable to show maintenance of this improvement at 6 and 12 months postdischarge When viewed in the context of similar studies that did not show a difference in within-year mortality [7,12,13], our findings further support the possibility that focused multidisciplinary models of care may improve short-term outcomes for patients with hip fractures but may not yield longer-term benefits.…”

Section: Discussionmentioning

confidence: 98%

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Does a Multidisciplinary Team Decrease Complications in Male Patients With Hip Fractures?

Dossous

Ton

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background Men with hip fractures are more likely to experience postoperative complications than women. The Medical Orthopaedic Trauma Service program at New York Presbyterian Hospital utilizes a multidisciplinary team approach to care for patients with hip fractures. The service is comanaged by an attending hospitalist and orthopaedic surgeon, with daily walking rounds attended by the hospitalist, orthopaedic resident, physical therapist, social worker, and a dedicated Medical Orthopaedic Trauma Service physician assistant. Questions/purposes We asked whether a multidisciplinary service for patients with hip fracture decreases (1) the incidence of inpatient complications in men, (2) the length of hospitalization, and (3) 90-day and 1-year mortality. Patients and Methods We retrospectively reviewed the charts of 74 men who had surgery for a nonperiprosthetic femoral neck, intertrochanteric, or subtrochanteric fracture for two 7-month periods before and after implementation of the Medical Orthopaedic Trauma Service. Age, ethnicity, comorbidity status, time to surgery, and postoperative complication data were collected. Regression modeling was used to evaluate the likelihood of postoperative complications, length of hospitalization, and 90-day and 1-year mortality while controlling for age, Charlson Comorbidity Index score, fracture type, and time from admission to surgery. Results We observed a decrease in the likelihood of experiencing at least one inpatient complication in male patients after implementation of the Medical Orthopaedic Trauma Service (odds ratio = 0.264). There was no difference in length of hospitalization, 90-day mortality, or 1-year mortality. Conclusions Multidisciplinary collaboration for patients with hip fractures can decrease the likelihood of experiencing inpatient complications in male patients.Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. Each author certifies that his or her institution approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 98%

Does a Multidisciplinary Team Decrease Complications in Male Patients With Hip Fractures?

Dossous

Ton

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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“…The results, however, are usually compared with historic data and patient selection probably occurs. 2 randomized studies show no differences in outcome (Gilchrist et al 1988, Fretwell et al 1990) when traditional acute care is compared with geriatric care. In our study, the stay in rehabilitation units in reality increased even more than the shortened acute hospital stay.…”

Section: Discussionmentioning

confidence: 99%

Prospective payment systems and hip fracture treatment costs

Strömberg

Öhlén

Svensson

1997

Acta Orthopaedica Scandinavica

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“…The rehabilitation ward was characterised by a weekly case conference and ward rounds by both geriatric and orthopaedic staff; this was the orthogeriatric model. 92,93 One trial demonstrated a significant reduction in discharge to institutional care and length of stay, 92 while the other demonstrated an increased number of comorbidities diagnosed and treated.…”

Section: Introductionmentioning

confidence: 99%

Models of care for the delivery of secondary fracture prevention after hip fracture: a health service cost, clinical outcomes and cost-effectiveness study within a region of England

Judge

Javaid

Leal

et al. 2016

Health Serv Deliv Res

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General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. Full terms of use are available: http://www.bristol.ac.uk/pure/about/ebr-terms VOLUME 4 ISSUE 28 SEPTEMBER 2016 ISSN 2050 DOI 10.3310/hsdr04280 HEALTH SERVICES AND DELIVERY RESEARCHModels of care for the delivery of secondary fracture prevention after hip fracture: a health service cost, clinical outcomes and cost-effectiveness study within a region of England Andrew Judge, M Kassim Javaid, José Leal, Samuel Hawley, Sarah Drew, Sally Sheard, Daniel Prieto-Alhambra, Rachael Gooberman-Hill, Janet Lippett, Andrew Farmer, Nigel Arden, Alastair Gray, Michael Goldacre, Antonella Delmestri and Cyrus Cooper Models of care for the delivery of secondary fracture prevention after hip fracture: a health service cost, clinical outcomes and cost-effectiveness study within a region of England Declared competing interests of authors: Daniel Prieto-Alhambra has received unrestricted research and educational grants from Amgen and Bioibérica S.A. Nigel Arden reports personal fees from Merck Sharp & Dohme (MSD), grants and personal fees from Roche, personal fees from Smith and Nephew, personal fees from Q-Med, personal fees from Nicox, personal fees from Flexion, personal fees from Bioibérica and personal fees from Servier. Cyrus Cooper has received consultancy fees, lecture fees and honoraria from Amgen, GlaxoSmithKline, Alliance for Better Bone Health, Eli Lilly, Pfizer, Novartis, MSD, Servier, Medtronic and Roche. M Kassim Javaid has in the last 5 years received honoraria for travel expenses, speaker fees and/or advisory committees from Lilly UK, Amgen, Servier, MSD, Medtronic, Internis, Consilient Health and Jarrow Formulas. He also serves on the Scientific Committee of the National Osteoporosis Society and International Osteoporosis Foundation. Andrew Judge has received consultancy fees, lecture fees and honoraria from Servier, UK Renal Registry, Oxford Craniofacial Unit, IDIAP Jordi Gol and Freshfields Bruckhaus Deringer, is a member of the Data Safety and Monitoring Board (which involved receipt of fees) from Anthera Pharmaceuticals, Inc., and received consortium research grants from Roche.Published September 2016 DOI: 10.3310/hsdr04280 This report should be referenced as follows:Judge A, Javaid MK, Leal J, Hawley S, Drew S, Sheard S, et al. Models of care for the delivery of secondary fracture prevention after hip fracture: a health service cost, clinical outcomes and cost-effectiveness study within a region of England. Health Serv Deliv Res 2016;4(28). Health Services and Delivery ResearchISSN 2050-4349 (Print) ISSN 2050-4357 (Online) This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: nihredit@southampton.ac.ukThe full HS&DR archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hsdr. Print-on-demand copies can be purchased from the repor...

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Prospective randomised study of an orthopaedic geriatric inpatient service.

Cited by 145 publications

References 7 publications

Does a Multidisciplinary Team Decrease Complications in Male Patients With Hip Fractures?

Does a Multidisciplinary Team Decrease Complications in Male Patients With Hip Fractures?

Prospective payment systems and hip fracture treatment costs

Models of care for the delivery of secondary fracture prevention after hip fracture: a health service cost, clinical outcomes and cost-effectiveness study within a region of England

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