Skip to main content
Erschienen in: Osteoporosis International 4/2010

01.12.2010 | Review

Outcome in geriatric fracture patients and how it can be improved

verfasst von: T. Roth, C. Kammerlander, M. Gosch, T. J. Luger, M. Blauth

Erschienen in: Osteoporosis International | Sonderheft 4/2010

Einloggen, um Zugang zu erhalten

Abstract

Geriatric fractures are an increasing medical problem worldwide. This article wants to give an overview on the literature concerning the outcome to be expected in geriatric fracture patients and what can be done to improve it. In literature, excess mortality rates vary from 12% to 35% in the first year after a hip fracture, and also, other geriatric fractures seem to reduce the patient’s remaining lifetime. Geriatric fractures and, in particular, hip fractures constitute a major source of disability and diminished quality of life in the elderly. Age, gender, comorbid conditions, prefracture functional abilities, and fracture type have an impact on the outcome regarding ambulation, activities of daily living, and quality of life. Comprehensive orthogeriatric comanagement might improve the outcome of geriatric fracture patients. For the future, well designed, large prospective randomized controlled trials with clear outcome variables are needed to finally prove the effectiveness of existing concepts.
Literatur
1.
Zurück zum Zitat Johnell O, Kanis J (2005) Epidemiology of osteoporotic fractures. Osteoporos Int 16(Suppl 2):S3–S7CrossRefPubMed Johnell O, Kanis J (2005) Epidemiology of osteoporotic fractures. Osteoporos Int 16(Suppl 2):S3–S7CrossRefPubMed
2.
Zurück zum Zitat Cooper C, Campion G, Melton LJ (1992) Hip fractures in the elderly: a world-wide projection. Osteoporos Int 2:285–289CrossRefPubMed Cooper C, Campion G, Melton LJ (1992) Hip fractures in the elderly: a world-wide projection. Osteoporos Int 2:285–289CrossRefPubMed
3.
Zurück zum Zitat Johnell O (1997) The socioeconomic burden of fractures: today and in the 21st century. Am J Med 103:20S–25S, discussion 25 S–26 SCrossRefPubMed Johnell O (1997) The socioeconomic burden of fractures: today and in the 21st century. Am J Med 103:20S–25S, discussion 25 S–26 SCrossRefPubMed
4.
Zurück zum Zitat Sernbo I, Johnell O (1993) Consequences of a hip fracture: a prospective study over 1 year. Osteoporos Int 3:148–153CrossRefPubMed Sernbo I, Johnell O (1993) Consequences of a hip fracture: a prospective study over 1 year. Osteoporos Int 3:148–153CrossRefPubMed
5.
Zurück zum Zitat Giversen IM (2007) Time trends of mortality after first hip fractures. Osteoporos Int 18:721–732CrossRefPubMed Giversen IM (2007) Time trends of mortality after first hip fractures. Osteoporos Int 18:721–732CrossRefPubMed
6.
Zurück zum Zitat Haleem S, Lutchman L, Mayahi R, Grice JE, Parker MJ (2008) Mortality following hip fracture: trends and geographical variations over the last 40 years. Injury 39:1157–1163CrossRefPubMed Haleem S, Lutchman L, Mayahi R, Grice JE, Parker MJ (2008) Mortality following hip fracture: trends and geographical variations over the last 40 years. Injury 39:1157–1163CrossRefPubMed
7.
Zurück zum Zitat Center JR, Nguyen TV, Schneider D, Sambrook PN, Eisman JA (1999) Mortality after all major types of osteoporotic fracture in men and women: an observational study. Lancet 353:878–882CrossRefPubMed Center JR, Nguyen TV, Schneider D, Sambrook PN, Eisman JA (1999) Mortality after all major types of osteoporotic fracture in men and women: an observational study. Lancet 353:878–882CrossRefPubMed
8.
Zurück zum Zitat Johnell O, Kanis JA, Odén A, Sernbo I, Redlund-Johnell I, Petterson C, De Laet C, Jönsson B (2004) Mortality after osteoporotic fractures. Osteoporos Int 15:38–42CrossRefPubMed Johnell O, Kanis JA, Odén A, Sernbo I, Redlund-Johnell I, Petterson C, De Laet C, Jönsson B (2004) Mortality after osteoporotic fractures. Osteoporos Int 15:38–42CrossRefPubMed
9.
Zurück zum Zitat Bliuc D, Nguyen ND, Milch VE, Nguyen TV, Eisman JA, Center JR (2009) Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA 301:513–521CrossRefPubMed Bliuc D, Nguyen ND, Milch VE, Nguyen TV, Eisman JA, Center JR (2009) Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA 301:513–521CrossRefPubMed
10.
Zurück zum Zitat Browner WS, Seeley DG, Vogt TM, Cummings SR (1991) Non-trauma mortality in elderly women with low bone mineral density. Study of osteoporotic fractures research group. Lancet 338:355–358CrossRefPubMed Browner WS, Seeley DG, Vogt TM, Cummings SR (1991) Non-trauma mortality in elderly women with low bone mineral density. Study of osteoporotic fractures research group. Lancet 338:355–358CrossRefPubMed
11.
Zurück zum Zitat Johansson C, Black D, Johnell O, Odén A, Mellström D (1998) Bone mineral density is a predictor of survival. Calcif Tissue Int 63:190–196CrossRefPubMed Johansson C, Black D, Johnell O, Odén A, Mellström D (1998) Bone mineral density is a predictor of survival. Calcif Tissue Int 63:190–196CrossRefPubMed
12.
Zurück zum Zitat Magaziner J, Simonsick EM, Kashner TM, Hebel JR, Kenzora JE (1990) Predictors of functional recovery one year following hospital discharge for hip fracture: a prospective study. J Gerontol 45:M101–M107PubMed Magaziner J, Simonsick EM, Kashner TM, Hebel JR, Kenzora JE (1990) Predictors of functional recovery one year following hospital discharge for hip fracture: a prospective study. J Gerontol 45:M101–M107PubMed
13.
Zurück zum Zitat Koval KJ, Skovron ML, Aharonoff GB, Meadows SE, Zuckerman JD (1995) Ambulatory ability after hip fracture. A prospective study in geriatric patients Clin Orthop Relat Res 310:150–159 Koval KJ, Skovron ML, Aharonoff GB, Meadows SE, Zuckerman JD (1995) Ambulatory ability after hip fracture. A prospective study in geriatric patients Clin Orthop Relat Res 310:150–159
14.
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 17 S–19 SCrossRefPubMed Cooper C (1997) The crippling consequences of fractures and their impact on quality of life. Am J Med 103:12S–17S, discussion 17 S–19 SCrossRefPubMed
15.
Zurück zum Zitat van Balen R, Steyerberg EW, Polder JJ, Ribbers TL, Habbema JD, Cools HJ (2001) Hip fracture in elderly patients: outcomes for function, quality of life, and type of residence. Clin Orthop Relat Res 390:232–243CrossRefPubMed van Balen R, Steyerberg EW, Polder JJ, Ribbers TL, Habbema JD, Cools HJ (2001) Hip fracture in elderly patients: outcomes for function, quality of life, and type of residence. Clin Orthop Relat Res 390:232–243CrossRefPubMed
16.
Zurück zum Zitat Leibson CL, Tosteson ANA, Gabriel SE, Ransom JE, Melton LJ (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, Ransom JE, Melton LJ (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
17.
Zurück zum Zitat Rosell PAE, Parker MJ (2003) Functional outcome after hip fracture. A 1-year prospective outcome study of 275 patients. Injury 34:529–532CrossRefPubMed Rosell PAE, Parker MJ (2003) Functional outcome after hip fracture. A 1-year prospective outcome study of 275 patients. Injury 34:529–532CrossRefPubMed
18.
Zurück zum Zitat Boonen S, Autier P, Barette M, Vanderschueren D, Lips P, Haentjens P (2004) Functional outcome and quality of life following hip fracture in elderly women: a prospective controlled study. Osteoporos Int 15:87–94CrossRefPubMed Boonen S, Autier P, Barette M, Vanderschueren D, Lips P, Haentjens P (2004) Functional outcome and quality of life following hip fracture in elderly women: a prospective controlled study. Osteoporos Int 15:87–94CrossRefPubMed
19.
Zurück zum Zitat Einsiedel T, Becker C, Stengel D, Schmelz A, Kramer M, Däxle M, Lechner F, Kinzl L, Gebhard F (2006) Do injuries of the upper extremity in geriatric patients end up in helplessness? A prospective study for the outcome of distal radius and proximal humerus fractures in individuals over 65. Z Gerontol Geriatr 39:451–461CrossRefPubMed Einsiedel T, Becker C, Stengel D, Schmelz A, Kramer M, Däxle M, Lechner F, Kinzl L, Gebhard F (2006) Do injuries of the upper extremity in geriatric patients end up in helplessness? A prospective study for the outcome of distal radius and proximal humerus fractures in individuals over 65. Z Gerontol Geriatr 39:451–461CrossRefPubMed
20.
Zurück zum Zitat Flierl MA, Gerhardt DC, Hak DJ, Morgan SJ, Stahel PF (2010) Key issues and controversies in the acute management of hip fractures. Orthopedics 33:102–110CrossRefPubMed Flierl MA, Gerhardt DC, Hak DJ, Morgan SJ, Stahel PF (2010) Key issues and controversies in the acute management of hip fractures. Orthopedics 33:102–110CrossRefPubMed
22.
Zurück zum Zitat Nikolaou VS, Papathanasopoulos A, Giannoudis PV (2008) What’s new in the management of proximal femoral fractures? Injury 39:1309–1318CrossRefPubMed Nikolaou VS, Papathanasopoulos A, Giannoudis PV (2008) What’s new in the management of proximal femoral fractures? Injury 39:1309–1318CrossRefPubMed
23.
Zurück zum Zitat Egol KA, Strauss EJ (2009) Perioperative considerations in geriatric patients with hip fracture: what is the evidence? J Orthop Trauma 23:386–394CrossRefPubMed Egol KA, Strauss EJ (2009) Perioperative considerations in geriatric patients with hip fracture: what is the evidence? J Orthop Trauma 23:386–394CrossRefPubMed
24.
Zurück zum Zitat Mak JCS, Cameron ID, March LM, NHaMR C (2010) Evidence-based guidelines for the management of hip fractures in older persons: an update. Med J Aust 192:37–41PubMed Mak JCS, Cameron ID, March LM, NHaMR C (2010) Evidence-based guidelines for the management of hip fractures in older persons: an update. Med J Aust 192:37–41PubMed
25.
Zurück zum Zitat Hempsall VJ, Robertson DR, Campbell MJ, Briggs RS (1990) Orthopaedic geriatric care–is it effective? A prospective population-based comparison of outcome in fractured neck of femur. J R Coll Physicians Lond 24:47–50PubMed Hempsall VJ, Robertson DR, Campbell MJ, Briggs RS (1990) Orthopaedic geriatric care–is it effective? A prospective population-based comparison of outcome in fractured neck of femur. J R Coll Physicians Lond 24:47–50PubMed
26.
Zurück zum Zitat Boyd RV, Hawthorne J, Wallace WA, Worlock PH, Compton EH (1983) The Nottingham orthogeriatric unit after 1000 admissions. Injury 15:193–196CrossRefPubMed Boyd RV, Hawthorne J, Wallace WA, Worlock PH, Compton EH (1983) The Nottingham orthogeriatric unit after 1000 admissions. Injury 15:193–196CrossRefPubMed
27.
Zurück zum Zitat Zuckerman JD, Sakales SR, Fabian DR, Frankel VH (1992) Hip fractures in geriatric patients. Results of an interdisciplinary hospital care program Clin Orthop Relat Res 274:213–225 Zuckerman JD, Sakales SR, Fabian DR, Frankel VH (1992) Hip fractures in geriatric patients. Results of an interdisciplinary hospital care program Clin Orthop Relat Res 274:213–225
28.
Zurück zum Zitat Koval KJ, Chen AL, Aharonoff GB, Egol KA, Zuckerman JD (2004) Clinical pathway for hip fractures in the elderly: the Hospital for Joint Diseases experience. Clin Orthop Relat Res 425:72–81CrossRefPubMed Koval KJ, Chen AL, Aharonoff GB, Egol KA, Zuckerman JD (2004) Clinical pathway for hip fractures in the elderly: the Hospital for Joint Diseases experience. Clin Orthop Relat Res 425:72–81CrossRefPubMed
29.
Zurück zum Zitat Adunsky A, Lusky A, Arad M, Heruti RJ (2003) A comparative study of rehabilitation outcomes of elderly hip fracture patients: the advantage of a comprehensive orthogeriatric approach. J Gerontol A Biol Sci Med Sci 58:542–547PubMed Adunsky A, Lusky A, Arad M, Heruti RJ (2003) A comparative study of rehabilitation outcomes of elderly hip fracture patients: the advantage of a comprehensive orthogeriatric approach. J Gerontol A Biol Sci Med Sci 58:542–547PubMed
30.
Zurück zum Zitat Adunsky A, Arad M, Levi R, Blankstein A, Zeilig G, Mizrachi E (2005) Five-year experience with the ‘Sheba’ model of comprehensive orthogeriatric care for elderly hip fracture patients. Disabil Rehabil 27:1123–1127CrossRefPubMed Adunsky A, Arad M, Levi R, Blankstein A, Zeilig G, Mizrachi E (2005) Five-year experience with the ‘Sheba’ model of comprehensive orthogeriatric care for elderly hip fracture patients. Disabil Rehabil 27:1123–1127CrossRefPubMed
31.
Zurück zum Zitat Vidan M, Serra JA, Moreno C, Riquelme G, Ortiz J (2005) Efficacy of a comprehensive geriatric intervention in older patients hospitalized for hip fracture: a randomized, controlled trial. J Am Geriatr Soc 53:1476–1482CrossRefPubMed Vidan M, Serra JA, Moreno C, Riquelme G, Ortiz J (2005) Efficacy of a comprehensive geriatric intervention in older patients hospitalized for hip fracture: a randomized, controlled trial. J Am Geriatr Soc 53:1476–1482CrossRefPubMed
32.
Zurück zum Zitat Friedman SM, Mendelson DA, Kates SL, McCann RM (2008) Geriatric co-management of proximal femur fractures: total quality management and protocol-driven care result in better outcomes for a frail patient population. J Am Geriatr Soc 56:1349–1356CrossRefPubMed Friedman SM, Mendelson DA, Kates SL, McCann RM (2008) Geriatric co-management of proximal femur fractures: total quality management and protocol-driven care result in better outcomes for a frail patient population. J Am Geriatr Soc 56:1349–1356CrossRefPubMed
33.
Zurück zum Zitat Friedman SM, Mendelson DA, Bingham KW, Kates SL (2009) Impact of a comanaged geriatric fracture center on short-term hip fracture outcomes. Arch Intern Med 169:1712–1717CrossRefPubMed Friedman SM, Mendelson DA, Bingham KW, Kates SL (2009) Impact of a comanaged geriatric fracture center on short-term hip fracture outcomes. Arch Intern Med 169:1712–1717CrossRefPubMed
34.
Zurück zum Zitat Handoll HH, Cameron ID, Mak JC, Finnegan TP (2009) Multidisciplinary rehabilitation for older people with hip fractures. Cochrane Database Syst Rev CD007125 Handoll HH, Cameron ID, Mak JC, Finnegan TP (2009) Multidisciplinary rehabilitation for older people with hip fractures. Cochrane Database Syst Rev CD007125
Metadaten
Titel
Outcome in geriatric fracture patients and how it can be improved
verfasst von
T. Roth
C. Kammerlander
M. Gosch
T. J. Luger
M. Blauth
Publikationsdatum
01.12.2010
Verlag
Springer-Verlag
Erschienen in
Osteoporosis International / Ausgabe Sonderheft 4/2010
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-010-1401-4

Weitere Artikel der Sonderheft 4/2010

Osteoporosis International 4/2010 Zur Ausgabe

Arthropedia

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

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Update Orthopädie und Unfallchirurgie

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