IBMS BoneKEy | BoneKEy Watch
Elderly patients with hip fractures fare better with focused care
DOI:10.1038/bonekey.2015.71
A total of 387 elderly patients in Norway who sustained a hip fracture received either standard orthopedic care in their hospital emergency department (n=199) or comprehensive geriatric care on a geriatric ward (n=198).
After four months, some elderly patients in both groups had died. The remaining patients were assessed for their ability to walk, balance when standing and to see how well they could get up from a chair, using the Short Physical Performance Battery test (SPPB). The mean scores were 4-38 (SE 0–20) for the 170 patients in the orthopedic care group and 5-12 (SE (0–20) for the 174 patients in the geriatric care group. The difference between the groups was significant (P=0.010).
A cost effectiveness analysis showed that comprehensive geriatric care could be a feasible alternative to current standard care, leading to a significant increase in outcome at four months.
Editor’s comment: This randomized study demonstrates the added value of a pre- and post-surgery orthogeriatric clinical pathway on mobility and performance in elderly patients with hip fractures. Quite surprisingly, the total amount of human resources necessary for the multidisciplinary, comprehensive approach was not markedly higher than the standard orthopedic approach. However, large numbers of patients both groups still remained quite impaired at 4 and 12 months (SPPB score<6).
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