Orthogeriatric Management: Improvements in Outcomes during Hospital Admission Due to Hip Fracture.

Francisco José Tarazona-Santabalbina,José Ramón Caeiro,Concepción Cassinello-Ogea,Cristina Ojeda-Thies,Jesús Figueroa Rodríguez

doi:10.3390/ijerph18063049

Abstract

Hip fractures are an important socio-economic problem in western countries. Over the past 60 years orthogeriatric care has improved the management of older patients admitted to hospital after suffering hip fractures. Quality of care in orthogeriatric co-management units has increased, reducing adverse events during acute admission, length of stay, both in-hospital and mid-term mortality, as well as healthcare and social costs. Nevertheless, a large number of areas of controversy regarding the clinical management of older adults admitted due to hip fracture remain to be clarified. This narrative review, centered in the last 5 years, combined the search terms “hip fracture”, “geriatric assessment”, “second hip fracture”, “surgery”, “perioperative management” and “orthogeriatric care”, in order to summarise the state of the art of some questions such as the optimum analgesic protocol, the best approach for treating anemia, the surgical options recommendable for each type of fracture and the efficiency of orthogeriatric co-management and functional recovery.

Highlights

Osteoporotic hip fractures are one of the main health problems of geriatric patients.Approximately 1.3 million hip fractures were diagnosed in 1990 worldwide [1], and this worldwide annual incidence is expected to increase to over 6 million globally by 2050 [2].Nearly 80% of the fractures suffered by women and 50% of those in men occur after reaching the age of 70 years [3]
orthogeriatric co-management (OGC) was associated with lower length of stay (LOS) and 1-year mortality [27]
The role of an orthogeriatrician in an orthopaedic department who leads a multidisciplinary approach in the management of older patients with hip fractures is vital, ensuring that surgical delay is under 48 h after presentation, as well as reducing postoperative and total length of stay [30]

Summary

Introduction

Osteoporotic hip fractures are one of the main health problems of geriatric patients.Approximately 1.3 million hip fractures were diagnosed in 1990 worldwide [1], and this worldwide annual incidence is expected to increase to over 6 million globally by 2050 [2].Nearly 80% of the fractures suffered by women and 50% of those in men occur after reaching the age of 70 years [3]. Osteoporotic hip fractures are one of the main health problems of geriatric patients. 1.3 million hip fractures were diagnosed in 1990 worldwide [1], and this worldwide annual incidence is expected to increase to over 6 million globally by 2050 [2]. 80% of the fractures suffered by women and 50% of those in men occur after reaching the age of 70 years [3]. Ninety percent of the fractures occur after falls from standing height [4]. Mortality rates of 10% during acute hospital admission and 30%. Orthogeriatric care can be defined as the collaboration between orthopedic surgeons and geriatricians to improve hip fracture patient outcomes during hospital admission [8]

Methods

Results

Conclusion