Outcomes in Multidisciplinary Team-based Approach in Geriatric Hip Fracture Care: A Systematic Review.

Abstract

INTRODUCTION:

This systematic review analyzes the literature on the treatment of geriatric hip fractures by a multidisciplinary hip fracture service including geriatricians/internists and orthopaedic surgeons and what impact this has on patient outcomes.

METHODS:

A systematic review of several databases was conducted according to PRISMA guidelines. Studies comparing an orthopaedic-led care model versus a coordinated orthogeriatrics care model or a geriatrics-led care model to treat hip fractures with reported outcomes for time to surgery, length of stay, readmission rates, and postoperative mortality were included.

RESULTS:

Seventeen articles fitting the inclusion criteria were included. Differences between the results of an orthopaedic-led care model versus a coordinated orthogeriatrics care model or a geriatrics-led care model were assessed using chi-squared tests. With patients admitted under a coordinated orthogeriatrics care model or a geriatrics-led care model, there is a statistically significant decrease in time to surgery (P = 0.045), length of stay (P = 0.0036), and postoperative mortality rates (P = 0.0034).

CONCLUSIONS:

Although a heterogeneous group of studies, the aggregate data from several studies using an orthogeriatrics care model or a geriatrics-led care model trend toward improvements across several clinical and cost-related outcome measures: decreased time to surgery, shorter length of stay, improved postoperative clinical outcomes, decreased mortality, and lower cost.

• Authors: Jay N Patel, David S Klein, Swathy Sreekumar, Frank A Liporace, Richard S Yoon
• Journal: The Journal of the American Academy of Orthopaedic Surgeons (J Am Acad Orthop Surg) Vol. 28 Issue 3 Pg. 128-133 (Feb 01 2020) ISSN: 1940-5480 [Electronic] United States
• PMID: 31977613 (Publication Type: Journal Article, Systematic Review)

Topics

• Geriatrics
• Hip Fractures (mortality, surgery)
• Humans
• Length of Stay
• Patient Care Team
• Patient Readmission
• Time-to-Treatment