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24.04.2019 | Original Article

Different approaches towards geriatric trauma care for hip fracture patients: an inter-hospital comparison

Zeitschrift:
European Journal of Trauma and Emergency Surgery
Autoren:
Jip Kusen, Puck van der Vet, Frans-Jasper Wijdicks, Marijn Houwert, Marcel Dijkgraaf, Marije Hamaker, Olivia Geraghty, Egbert-Jan Verleisdonk, Detlef van der Velde

Abstract

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.

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