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Outcomes in Multidisciplinary Team-based Approach in Geriatric Hip Fracture Care

A Systematic Review

Patel, Jay N. DO; Klein, David S. DO; Sreekumar, Swathy MD; Liporace, Frank A. MD; Yoon, Richard S. MD

JAAOS - Journal of the American Academy of Orthopaedic Surgeons: May 30, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.5435/JAAOS-D-18-00425
Research Article: PDF Only
SDC

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.

From the Division of Orthopaedic Trauma & Adult Reconstruction, Department of Orthopaedic Surgery, Jersey City Medical Center, RWJBarnabas Health (Dr. Patel, Dr. Klein, Dr. Liporace, and Dr. Yoon); and Department of Internal Medicine, Jersey City Medical Center, RWJBarnabas Health (Dr. Sreekumar), Jersey City, NJ.

Correspondence to Dr. Yoon: yoonrich@gmail.com

None of the following authors or any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Patel, Dr. Klein, Dr. Sreekumar, Dr. Yoon, and Dr. Liporace.

© 2019 by American Academy of Orthopaedic Surgeons
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