Impact of the intervention of a Mobile Geriatric Assessment Team on the diagnosis of significant comorbidities in elderly patients hospitalised after a hip fracture

Abstract

PurposeDespite the fact that traumatic fractures of the femoral neck are common in elderly subjects, we note that Mobile Geriatric Assessment Teams (MGATs) are rarely present in orthopaedic departments. We set out to show that the assistance provided by MGATs in the diagnosis and data collection of significant comorbidities of patients over 75years hospitalised in orthopaedic departments after a hip fracture could directly benefit the quality of care of these patients and indirectly enable greater acceptance of MGAT in these departments.Methodology We performed a prospective cohort study of patients over 75years referred for surgical treatment of traumatic fractures of the femoral neck. After the geriatric assessment of the patients enrolled, a data collection sheet was completed containing the main pathologies most likely to be identified. ResultsOne hundred and eighty-three patients’ orthopaedic visits were analyzed (mean age was 86.3±5.3; 78% [143] were women). In this population, the MGAT increased the diagnosis of significant comorbidities in elderly patients hospitalised after a hip fracture from10 to 50%. The financial evaluation of each hospital stay was also improved: the mean daily rate by treated cases changed from 520€ to 688€. ConclusionOur results reflect the complementary role of geriatricians and surgeons for optimal care management of elderly subjects operated for fracture. The improvement in the economic value of the hospital stay can also be seen as an indirect method of evaluating the financial value of services provided by an MGAT.