TY - JOUR
T1 - Different approaches towards geriatric trauma care for hip fracture patients: an inter-hospital comparison
AU - Kusen, Jip
AU - van der Vet, Puck
AU - Wijdicks, Frans-Jasper
AU - Houwert, Marijn
AU - Dijkgraaf, Marcel
AU - Hamaker, Marije
AU - Geraghty, Olivia
AU - Verleisdonk, Egbert-Jan
AU - van der Velde, Detlef
PY - 2019/4/24
Y1 - 2019/4/24
N2 - Purpose: Hip fractures in geriatric patients have high morbidity and mortality rates. The implementation of a multidisciplinary geriatric care pathway (GCP) may improve treatment for this patient population. This study focusses on two level II hospitals with a different treatment protocols. A comparison was made between a multidisciplinary GCP and extensive standard care with a focus on geriatric hip fracture patients to assess if a multidisciplinary GCP leads to lower mortality and morbidity. Methods: This retrospective cohort study included patients aged 70 years or older with a unilateral proximal hip fracture who underwent surgery between January 2014 and December 2015. The primary outcome measures complications and 30-day mortality. Secondary outcome measures were time to surgery, hospital length of stay (HLOS) and secondary surgical interventions. Results: This study included a total of 898 patients. No differences were found between major postoperative complications, 30-day mortality, HLOS or the amount of secondary surgical interventions. Conclusions: Mortality, major complications, HLOS and the amount of secondary surgical interventions showed no differences between both hospitals. This inter-hospital comparison of two types of geriatric care models showed no outcome that favours one specific geriatric care model over another. This provides opportunities for future studies to get a better understanding of what specific factors of geriatric care models contribute most to an improvement in the treatment of this patient population and decide which approach is most cost effective.
AB - Purpose: Hip fractures in geriatric patients have high morbidity and mortality rates. The implementation of a multidisciplinary geriatric care pathway (GCP) may improve treatment for this patient population. This study focusses on two level II hospitals with a different treatment protocols. A comparison was made between a multidisciplinary GCP and extensive standard care with a focus on geriatric hip fracture patients to assess if a multidisciplinary GCP leads to lower mortality and morbidity. Methods: This retrospective cohort study included patients aged 70 years or older with a unilateral proximal hip fracture who underwent surgery between January 2014 and December 2015. The primary outcome measures complications and 30-day mortality. Secondary outcome measures were time to surgery, hospital length of stay (HLOS) and secondary surgical interventions. Results: This study included a total of 898 patients. No differences were found between major postoperative complications, 30-day mortality, HLOS or the amount of secondary surgical interventions. Conclusions: Mortality, major complications, HLOS and the amount of secondary surgical interventions showed no differences between both hospitals. This inter-hospital comparison of two types of geriatric care models showed no outcome that favours one specific geriatric care model over another. This provides opportunities for future studies to get a better understanding of what specific factors of geriatric care models contribute most to an improvement in the treatment of this patient population and decide which approach is most cost effective.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85064815400&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/31020360
U2 - https://doi.org/10.1007/s00068-019-01129-x
DO - https://doi.org/10.1007/s00068-019-01129-x
M3 - Article
C2 - 31020360
SN - 1863-9933
SP - 1
EP - 8
JO - European journal of trauma
JF - European journal of trauma
ER -