Increased Geriatric Treatment Frequency Improves Mobility and Secondary Fracture Prevention in Older Adult Hip Fracture Patients-An Observational Cohort Study of 23,828 Patients from the Registry for Geriatric Trauma (ATR-DGU)

被引:6
作者
Gleich, Johannes [1 ]
Fleischhacker, Evi [1 ]
Rascher, Katherine [2 ]
Friess, Thomas [2 ]
Kammerlander, Christian [3 ]
Boecker, Wolfgang [1 ]
Buecking, Benjamin [4 ]
Liener, Ulrich [5 ]
Drey, Michael [6 ]
Hoefer, Christine [2 ]
Neuerburg, Carl [1 ]
机构
[1] Musculoskeletal Univ Ctr Munich MUM, Univ Hosp, LMU Munich, Dept Orthopaed & Trauma Surg, D-81377 Munich, Germany
[2] AUC Acad Trauma Surg, D-80538 Munich, Germany
[3] AUVA Traumahosp Styria, A-8020 Graz, Austria
[4] DRK Kliniken Nordhessen, Ctr Orthoped & Trauma Surg, D-34121 Kassel, Germany
[5] Marienhospital, Dept Orthoped & Trauma Surg, D-70199 Stuttgart, Germany
[6] Ludwig Maximilians Univ Munchen, Univ Hosp, Dept Med 4, D-80336 Munich, Germany
关键词
hip fracture; orthogeriatric care; fragility fracture; interdisciplinary treatment; osteoporosis; registry; POPULATION-BASED COHORT; MORTALITY; DATABASE; SURGERY; PEOPLE; HEALTH; RISK;
D O I
10.3390/jcm10235489
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Interdisciplinary orthogeriatric care of older adult hip fracture patients is of growing importance due to an ageing population, yet there is ongoing disagreement about the most effective model of care. This study aimed to compare different forms of orthogeriatric treatment, with focus on their impact on postoperative mobilization, mobility and secondary fracture prevention. In this observational cohort study, patients aged 70 years and older with a proximal femur fracture requiring surgery, were included from 1 January 2016 to 31 December 2019. Data were recorded from hospital stay to 120-day follow-up in the Registry for Geriatric Trauma (ATR-DGU), a specific designed registry for older adult hip fracture patients. Of 23,828 included patients from 95 different hospitals, 72% were female, median age was 85 (IQR 80-89) years. Increased involvement of geriatricians had a significant impact on mobilization on the first day (OR 1.1, CI 1.1-1.2) and mobility seven days after surgery (OR 1.1, CI 1.1-1.2), initiation of an osteoporosis treatment during in-hospital stay (OR 2.5, CI 2.4-2.7) and of an early complex geriatric rehabilitation treatment (OR 1.3, CI 1.2-1.4). These findings were persistent after 120 days of follow-up. Interdisciplinary treatment of orthogeriatric patients is beneficial and especially during in-patient stay increased involvement of geriatricians is decisive for early mobilization, mobility and initiation of osteoporosis treatment. Standardized treatment pathways in certified geriatric trauma departments with structured data collection in specific registries improve outcome monitoring and interpretation.
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页数:9
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