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Efficacy of an interdisciplinary pathway in a first level trauma center orthopaedic unit: A prospective study of a cohort of elderly patients with hip fractures
- Source :
- Archives of gerontology and geriatrics. 86
- Publication Year :
- 2019
-
Abstract
- Background hip fracture has negative consequences for elderly people. Alternative models of care, with respect to traditional model, were developed to minimize complications and improve functional outcomes. The interdisciplinary model in orthopaedic wards has less evidence of efficacy compared to orthogeriatric units. Objective to compare the efficacy (in–hospital outcomes, mortality, functional status at 6 months after discharge) of an interdisciplinary pathway, based on comprehensive geriatric assessment, compared to a traditional model of care, in hip-fractured elderly patients. Design prospective study with retrospective control group conducted in a first-level trauma center Orthopaedic Unit. Subjects 97 patients treated with the traditional model and 127 with an interdisciplinary pathway (mean age 83.9 ± 7.4 vs 84 ± 6.7 years, p = 0.89). Methods in all participants we assessed: clinical history, functional pre-fracture status utilising Activities of Daily Living (ADL), in-hospital details. At 6 months after discharge, we evaluated functional status, place of residence, hospital readmissions, mortality. Results during hospital stay, significant differences emerged in mortality and in external visits. A higher proportion of patients of the orthogeriatric group lived alone at home at 6 months and showed a lower functional decline. Comprehensive geriatric assessment was associated with the ADL score (partial R2: 0.08, p Conclusions an interdisciplinary pathway in hip-fractured elderly patients, could reduce in–hospital mortality, improve functional recovery and increase the probability of living alone at home, at 6 months.
- Subjects :
- Male
Aging
medicine.medical_specialty
Health (social science)
Activities of daily living
functional recovery
Unit (housing)
Hip fracture
03 medical and health sciences
0302 clinical medicine
Trauma Centers
orthogeriatrics
Medicine
Humans
030212 general & internal medicine
Prospective Studies
Prospective cohort study
Geriatric Assessment
older adults
Aged
Retrospective Studies
Aged, 80 and over
030214 geriatrics
business.industry
Hip Fractures
Trauma center
Recovery of Function
Functional recovery
medicine.disease
mortality
Orthopedics
Cohort
Physical therapy
Functional status
Female
Geriatrics and Gerontology
business
Gerontology
Subjects
Details
- ISSN :
- 18726976
- Volume :
- 86
- Database :
- OpenAIRE
- Journal :
- Archives of gerontology and geriatrics
- Accession number :
- edsair.doi.dedup.....78c9483634744f3ba1aecff202cdd392