Skip to main content
Erschienen in: International Orthopaedics 1/2019

29.08.2018 | Original Paper

Functional outcomes and mortality in geriatric and fragility hip fractures—results of an integrated, multidisciplinary model experienced by the “Florence hip fracture unit”

verfasst von: Roberto Civinini, Tommaso Paoli, Luisella Cianferotti, Alessandro Cartei, Alberto Boccaccini, Adriano Peris, Maria Luisa Brandi, Carlo Rostagno, Massimo Innocenti

Erschienen in: International Orthopaedics | Ausgabe 1/2019

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The aim of this study was to evaluate the outcomes of an integrated multidisciplinary hip fracture unit through the following parameters: time to surgery, mortality, return to activities of daily living, adherence to re-fractures prevention programs.

Methods

Six hundred seventy-seven consecutive patients with hip fracture were included in the study. We calculated the time to surgery as the time in hours from admission until surgery. The in-hospital mortality was calculated as the number of deaths that occurred before discharge. Each patient was then evaluated post-operatively at six weeks, three months, and one year. We studied basic activity of daily living (BADL) and the New Mobility Scale (NMS). Adherence to re-fractures prevention programs was also evaluated.

Results

88.9% of patients underwent surgery within two calendar days from admission. In-hospital mortality was 2.4%, and the overall mortality at one year from the intervention was 18.7%. Full mobility status or a low impairment of the mobility status was reached in 32.1% of the patients at one year and a level ≥ 3 of autonomy in BADL was reached in 62.4% (338/542) of patients. Three hundred forty-two patients were prescribed a specific therapy for secondary prevention of re-fracture.

Conclusions

An integrated, multidisciplinary model for the treatment of hip fragility fractures was effective in reducing time to surgery and mortality, increasing the level autonomy and mobility status and promoting adherence to re-fracture therapy.
Literatur
2.
Zurück zum Zitat Innocenti M, Civinini R, Carulli C, Matassi F (2009) Proximal femural fractures: epidemiology. Clin Cases Miner Bone Metab 6:117–119PubMed Innocenti M, Civinini R, Carulli C, Matassi F (2009) Proximal femural fractures: epidemiology. Clin Cases Miner Bone Metab 6:117–119PubMed
6.
Zurück zum Zitat Leibson CL, Tosteson ANA, Gabriel SE et al (2002) Mortality, disability, and nursing home use for persons with and without hip fracture: a population-based study. J Am Geriatr Soc 50:1644–1650CrossRefPubMed Leibson CL, Tosteson ANA, Gabriel SE et al (2002) Mortality, disability, and nursing home use for persons with and without hip fracture: a population-based study. J Am Geriatr Soc 50:1644–1650CrossRefPubMed
7.
Zurück zum Zitat Cooper C (1997) The crippling consequences of fractures and their impact on quality of life. Am J Med 103:12S–17S discussion 17S–19SCrossRefPubMed Cooper C (1997) The crippling consequences of fractures and their impact on quality of life. Am J Med 103:12S–17S discussion 17S–19SCrossRefPubMed
8.
Zurück zum Zitat Magaziner J, Hawkes W, Hebel JR et al (2000) Recovery from hip fracture in eight areas of function. J Gerontol A Biol Sci Med Sci 55:M498–M507CrossRefPubMed Magaziner J, Hawkes W, Hebel JR et al (2000) Recovery from hip fracture in eight areas of function. J Gerontol A Biol Sci Med Sci 55:M498–M507CrossRefPubMed
11.
Zurück zum Zitat Giusti A, Barone A (2011) Optimal setting and care organization in the management of older adults with hip fracture. Eur J Phys Rehabil Med 47:281–290PubMed Giusti A, Barone A (2011) Optimal setting and care organization in the management of older adults with hip fracture. Eur J Phys Rehabil Med 47:281–290PubMed
13.
Zurück zum Zitat Academy A, Board OS, September D (2014) Clinical practice guideline on the treatment of hip fracture in the elderly adopted by the American Academy of Orthopaedic Surgeons Board of Directors. Aaos Academy A, Board OS, September D (2014) Clinical practice guideline on the treatment of hip fracture in the elderly adopted by the American Academy of Orthopaedic Surgeons Board of Directors. Aaos
16.
Zurück zum Zitat Parker MJ, Palmer CR (1993) A new mobility score for predicting mortality after hip fracture. J Bone Joint Surg (Br) 75:797–798CrossRef Parker MJ, Palmer CR (1993) A new mobility score for predicting mortality after hip fracture. J Bone Joint Surg (Br) 75:797–798CrossRef
20.
Zurück zum Zitat Moyet J, Deschasse G, Marquant B et al (2018) Which is the optimal orthogeriatric care model to prevent mortality of elderly subjects post hip fractures? A systematic review and meta-analysis based on current clinical practice. Int Orthop:1–6. https://doi.org/10.1007/s00264-018-3928-5 Moyet J, Deschasse G, Marquant B et al (2018) Which is the optimal orthogeriatric care model to prevent mortality of elderly subjects post hip fractures? A systematic review and meta-analysis based on current clinical practice. Int Orthop:1–6. https://​doi.​org/​10.​1007/​s00264-018-3928-5
26.
Zurück zum Zitat Shyu Y-IL, Liang J, Wu C-C et al (2008) Interdisciplinary intervention for hip fracture in older Taiwanese: benefits last for 1 year. J Gerontol A Biol Sci Med Sci 63:92–97CrossRefPubMed Shyu Y-IL, Liang J, Wu C-C et al (2008) Interdisciplinary intervention for hip fracture in older Taiwanese: benefits last for 1 year. J Gerontol A Biol Sci Med Sci 63:92–97CrossRefPubMed
Metadaten
Titel
Functional outcomes and mortality in geriatric and fragility hip fractures—results of an integrated, multidisciplinary model experienced by the “Florence hip fracture unit”
verfasst von
Roberto Civinini
Tommaso Paoli
Luisella Cianferotti
Alessandro Cartei
Alberto Boccaccini
Adriano Peris
Maria Luisa Brandi
Carlo Rostagno
Massimo Innocenti
Publikationsdatum
29.08.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
International Orthopaedics / Ausgabe 1/2019
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-018-4132-3

Weitere Artikel der Ausgabe 1/2019

International Orthopaedics 1/2019 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.