RT Journal Article
T1 Geriatric fracture centre vs usual care after proximal femur fracture in older patients: what are the benefits? Results of a large international prospective multicentre study
A1 Blauth, Michael
A1 Joeris, Alexander
A1 Rometsch, Elke
A1 Espinoza-Rebmann, Kathrin
A1 Wattanapanom, Pannida
A1 Jarayabhand, Rahat
A1 Poeze, Martijn
A1 Wong, Merng K.
A1 Kwek, Ernest B. K.
A1 Hegeman, Johannes H.
A1 Perez-Uribarri, Carlos
A1 Guerado, Enrique
A1 Revak, Thomas J.
A1 Zohner, Sebastian
A1 Joseph, David
A1 Gosch, Markus
K1 trauma management
K1 hip
K1 geriatric medicine
K1 orthopaedic & trauma surgery
K1 health services administration & management
K1 Congestive-heart-failure
K1 Length-of-stay
K1 Hip fracture
K1 Orthogeriatric care
K1 Clinical pathway
K1 Mortality
K1 Quality
K1 Intervention
K1 Management
K1 Diagnosis
AB ObjectiveThe aim of this study was to determine the effect of treatment in geriatric fracture centres (GFC) on the incidence of major adverse events (MAEs) in patients with hip fractures compared with usual care centres (UCC). Secondary objectives included hospital-workflow and mobility-related outcomes.DesignCohort study recruiting patients between June 2015 and January 2017. Follow-up was 1year.SettingInternational (six countries, three continents) multicentre study.Participants281 patients aged >= 70 with operatively treated proximal femur fractures.InterventionsTreatment in UCCs (n=139) or GFCs (n=142), that is, interdisciplinary treatment including regular geriatric consultation and daily physiotherapy.Outcome measuresPrimary outcome was occurrence of prespecified MAEs, including delirium. Secondary outcomes included any other adverse events, time to surgery, time in acute ward, 1-year mortality, mobility, and quality of life.ResultsPatients treated in GFCs (n=142) had a mean age of 81.9 (SD, 6.6) years versus 83.9 (SD 6.9) years in patients (n=139) treated in UCCs (p=0.013) and a higher mean Charlson Comorbidity Index of 2.0 (SD, 2.1) versus 1.2 (SD, 1.5) in UCCs (p=0.001). More patients in GFCs (28.2%) experienced an MAE during the first year after surgery compared with UCCs (7.9%) with an OR of 4.56 (95% CI 2.23 to 9.34, p= 70 with operatively treated proximal femur fractures.InterventionsTreatment in UCCs (n=139) or GFCs (n=142), that is, interdisciplinary treatment including regular geriatric consultation and daily physiotherapy.Outcome measuresPrimary outcome was occurrence of prespecified MAEs, including delirium. Secondary outcomes included any other adverse events, time to surgery, time in acute ward, 1-year mortality, mobility, and quality of life.ResultsPatients treated in GFCs (n=142) had a mean age of 81.9 (SD, 6.6) years versus 83.9 (SD 6.9) years in patients (n=139) treated in UCCs (p=0.013) and a higher mean Charlson Comorbidity Index of 2.0 (SD, 2.1) versus 1.2 (SD, 1.5) in UCCs (p=0.001). More patients in GFCs (28.2%) experienced an MAE during the first year after surgery compared with UCCs (7.9%) with an OR of 4.56 (95% CI 2.23 to 9.34, p
PB Bmj publishing group
SN 2044-6055
YR 2021
FD 2021-05-01
LK https://hdl.handle.net/10668/26697
UL https://hdl.handle.net/10668/26697
LA en
DS RISalud
RD Apr 14, 2025