Different approaches towards geriatric trauma care for hip fracture patients: an inter-hospital comparison

• Published in: European journal of trauma and emergency surgery (Munich : 2007) 2021-04, Vol.47 (2), p.557-564
• Main Authors: Kusen, Jip, van der Vet, Puck, Wijdicks, Frans-Jasper, Houwert, Marijn, Dijkgraaf, Marcel, Hamaker, Marije, Geraghty, Olivia, Verleisdonk, Egbert-Jan, van der Velde, Detlef
• Format: Article
• Language: English
• Subjects: Critical Care Medicine; Emergency medical care; Emergency Medicine; Fractures; Geriatrics; Health risk assessment; Hip joint; Intensive; Medicine; Medicine & Public Health; Mortality; Original Article; Patients; Sports Medicine; Surgery; Surgical Orthopedics; Traumatic Surgery
• ISSN: 1863-9933; 1863-9941
• DOI: 10.1007/s00068-019-01129-x

Purpose Hip fractures in geriatric patients have high morbidity and mortality rates. The implementation of a multidisciplinary geriatric care pathway (GCP) may improve treatment for this patient population. This study focusses on two level II hospitals with a different treatment protocols. A comparison was made between a multidisciplinary GCP and extensive standard care with a focus on geriatric hip fracture patients to assess if a multidisciplinary GCP leads to lower mortality and morbidity. Methods This retrospective cohort study included patients aged 70 years or older with a unilateral proximal hip fracture who underwent surgery between January 2014 and December 2015. The primary outcome measures complications and 30-day mortality. Secondary outcome measures were time to surgery, hospital length of stay (HLOS) and secondary surgical interventions. Results This study included a total of 898 patients. No differences were found between major postoperative complications, 30-day mortality, HLOS or the amount of secondary surgical interventions. Conclusions Mortality, major complications, HLOS and the amount of secondary surgical interventions showed no differences between both hospitals. This inter-hospital comparison of two types of geriatric care models showed no outcome that favours one specific geriatric care model over another. This provides opportunities for future studies to get a better understanding of what specific factors of geriatric care models contribute most to an improvement in the treatment of this patient population and decide which approach is most cost effective.