The Combined Effect of ADL Impairment and Delay in Time from Fracture to Surgery on 12-Month Mortality: An Observational Study in Orthogeriatric Patients

Bellelli, Giuseppe; Mazzola, Paolo; Corsi, Maurizio; Zambon, Antonella; Corrao, Giovanni; Castoldi, G; Zatti, Giovanni; Annoni, Giorgio

doi:10.1016/j.jamda.2012.06.007

Cited by 30 publications

(34 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Hip fractures are one of the most important causes of loss of function and most studies view functional status prior to fracture as a predictor of mortality [22,23] and institutionalization [24]. We observed that ability to walk after the fracture is a long term mortality predictor.…”

Section: Discussionmentioning

confidence: 62%

Factors associated to institutionalization and mortality over three years, in elderly people with a hip fracture—An observational study

Úriz-Otano¹,

Pla-Vidal

Tiberio-López

et al. 2016

Maturitas

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 62%

Factors associated to institutionalization and mortality over three years, in elderly people with a hip fracture—An observational study

Úriz-Otano¹,

Pla-Vidal

Tiberio-López

et al. 2016

Maturitas

View full text Add to dashboard Cite

“…Our previous findings showed that patients without disability in Katz's ADL do not experience a significant increase in the 1-year mortality rate after hip fracture surgery, when the procedure is performed more than 48 h postadmission. The female patient described above was worthy of early surgery (\48 h), but the severity of the clinical condition and the necessity of hemodialysis would have increased considerably the risk of intraoperative mortality; for this reason, we optimized the clinical condition and contained the surgical delay by slightly exceeding the time goal of 48 h (refer to Bellelli et al [3] for the rationale).…”

Section: Discussionmentioning

confidence: 99%

“…1, begins when a hip fracture is suspected in the Emergency Department (ED), after which the patient undergoes clinical and instrumental evaluation for confirmation of the diagnosis. Meanwhile, an orthopedic surgeon consults with a geriatrician regarding the eligibility criteria for admission to the OGU [3]. Briefly, these criteria include a diagnosis of femur fracture in a patient C70 years old and at least one of the following pre-fracture characteristics: presence of at least two chronic comorbid conditions, use of multiple medications (C3) or of anticoagulants, and poor social support.…”

Section: The Ogu Model Of Care and A Case Reportmentioning

confidence: 99%

“…Briefly, these criteria include a diagnosis of femur fracture in a patient C70 years old and at least one of the following pre-fracture characteristics: presence of at least two chronic comorbid conditions, use of multiple medications (C3) or of anticoagulants, and poor social support. Refer to Mazzola et al and Bellelli et al [2,3] for more detailed characteristics of the OGU criteria.…”

Section: The Ogu Model Of Care and A Case Reportmentioning

confidence: 99%

See 1 more Smart Citation

Simultaneous bilateral femoral neck fracture and end-stage renal disease in a 76-year-old woman: a case report

et al. 2015

Self Cite

View full text Add to dashboard Cite

Hip fracture is a common occurrence in the elderly. Due to the growing demand for the specific care of these patients, we established the Orthogeriatric Unit (OGU) at San Gerardo University Hospital (Italy) in 2007. However, simultaneous bilateral femoral neck fractures among the geriatric population (those aged ≥65 years) are rarely reported in the literature. Reporting the rare case of a frail 76-year-old woman admitted with bilateral hip fracture and end-stage renal disease, we explain the important role played by the OGU and its flexible multidisciplinary approach for providing comprehensive care to patients with multimorbidity and clinical complexity. The team of geriatricians, orthopedic surgeons, anesthesiologists, and, in this case, a nephrologist, helped in the careful planning and timing of the single-step surgical repair, decided the appropriate type of anesthesia, and optimized outcomes. After a prompt evaluation of the patient, the OGU approach can achieve clinical stabilization prior to intervention. Along with a strict follow-up in the postoperative phase, this could result in a significant reduction of complications and mortality rates and an early start to a tailored rehabilitation process. We strongly suggest employing facilities with multidisciplinary teams for cases involving complex patients at short-term high risk for poor clinical outcomes. Indeed, the usual single-specialist model of care is gradually being abandoned worldwide.

show abstract

“…A number of studies have already described HF in the elderly, but the available literature focusing on centenarians is limited [2,[5][6][7][8]. The present manuscript reviews the activity of our Orthogeriatric Unit (OGU) at San Gerardo University Hospital (Northern Italy), which is a reference center for hip fractures in Lombardy region [9,10]. We focused on centenarians admitted from 2007, when the OGU was established, until December, 2014.…”

Section: Introductionmentioning

confidence: 99%

Hip fracture in centenarians: Retrospective analysis of an orthogeriatric unit reveals the limitations of the current research

Mazzola¹,

Perego²,

Picone³

et al. 2015

Glob Anesth Perioper Med

Self Cite

View full text Add to dashboard Cite

Life expectancy of Italian people is among the highest in the world, at 80 years for males and 85 years for females. Estimates from the National Institute of Statistics show that people aged 65 years and older represent more than 21% of the Italian population. Among them, centenarians represent the age group with the highest growing rate. Hip fracture incidence increases with advancing age, and currently represents one of the major causes of hospitalization in the elderly. Many studies regarding hip fracture in the elderly have been published, but research focusing on centenarians is still very limited despite their growing trend. This manuscript reviews the activity of the Orthogeriatric Unit at San Gerardo University Hospital (Northern Italy) from its establishment in 2007 until the present, and enlightens the limitations of the research in this area reviewing the literature currently available.Over a 7-year period, we admitted a small population of 10 centenarian female patients, all of whom underwent surgery. Their in-hospital (1 out of 10) and 1-year mortality rates (8 out of 10) are consistent with the existing literature.Centenarians pose an increasing challenge to physicians and surgeons. Rates of recovery of the pre-fracture condition are undoubtedly lower than those in younger geriatric patients, but surgery and early rehabilitation should not be denied solely due to the extreme age of these subjects. However, the research in this area presents several limitations up to now. The available studies are sparse, describe small populations, and are generally a single-center retrospective review of the local hospital admissions registry. Moreover, the objectives and outcome measurements vary considerably between studies, making a statistical comparison unfeasible.In this scenario, the implementation and analysis of large-scale databases would allow appropriate research among centenarians, including cost-effectiveness of specific surgical treatments.

show abstract

The Combined Effect of ADL Impairment and Delay in Time from Fracture to Surgery on 12-Month Mortality: An Observational Study in Orthogeriatric Patients

Cited by 30 publications

References 29 publications

Factors associated to institutionalization and mortality over three years, in elderly people with a hip fracture—An observational study

Factors associated to institutionalization and mortality over three years, in elderly people with a hip fracture—An observational study

Simultaneous bilateral femoral neck fracture and end-stage renal disease in a 76-year-old woman: a case report

Hip fracture in centenarians: Retrospective analysis of an orthogeriatric unit reveals the limitations of the current research

Contact Info

Product

Resources

About