Challenges of discharge management in geriatric traumatology : Example of an integrated orthogeriatric service

• Published in: Der Unfallchirurg 2020-07, Vol.123 (7), p.534-540
• Main Authors: Scheidt, S, Gathen, M, Lukas, A, Welle, K, Burger, C, Kabir, K
• Format: Article
• Language: ger
• ISSN: 1433-044X
• DOI: 10.1007/s00113-020-00812-8

Geriatric patients are currently responsible for almost one third of all emergency hospital admissions. An increase of 50% is expected in the next decade. This age redistribution poses new challenges for inpatient care and discharge management. The requirements of an orthopedic trauma surgery clinic in the care of this patient group can be clarified with the help of this first collaboratively created geriatric orthopedic trauma surgery complex treatment unit of a university hospital. What influence do age and delirium have on discharge management, length of inpatient stay and discharge destination in a geriatric cohort? All patients who received inpatient treatment as part of the orthopedic trauma surgery geriatric complex treatment (GKB) between May 2017 and December 2019 were evaluated. An analysis of the demographics, length of inpatient stay, discharge destinations and evaluation of the Barthel index collected on admission and discharge, the mini-mental state examination (MMSE) and the geriatric depression scale (GDS) were carried out. Out of 312 patients, 110 men and 193 women with a median age of 81 years, 77 patients (24.6%) showed delirium when enrolled in the GKB and 39 (12.5%) dementia. Older patients presented more often with delirium than younger people (p = 0.013), especially those aged 70-79 years (p = 0.037). Dementia patients suffered more frequently from postoperative delirium (p