Introduction

As the global number of geriatric hip fracture cases continues to proliferate, a newly developed orthogeriatric co-management multidisciplinary care model has been implemented since November 2018 to meet further increases in demand. Our objective was to evaluate the effectiveness of the new pathway in improving the clinical outcomes of fragility hip fractures.

Methods

The data of geriatric hip fracture patients from 1 April 2018 till 30 October 2018 was collected as the conventional orthopaedic care model (pre-orthogeriatric care model) to compare with data from the orthogeriatric co-management model, 1 Feb 2019 till 31 August 2019. Clinical outcomes were analyzed between the groups, with the efficiency of the programme reflected in the total length of stay in acute and convalescent hospitals.

Results

194 patients were recruited to the conventional group and 207 were recruited to the orthogeriatric group, 290 patients (72.3%) were female. The mean (SD) patient age was 84.2 (7.9) years. The median length of stay in the acute and rehabilitation hospitals decreased by 1 day and 2 days, respectively (P=.001). The orthogeriatric group was associated with a higher Modified Barthel Index score on discharge from the rehabilitation hospital and more patients in the orthogeriatric collaboration group received osteoporosis medication prescription within one year after the index fracture. There was no difference in the 28-days unplanned readmission rate, complication rate, mortality rate or Elderly Mobility Scale scores on discharge from the rehabilitation hospital between the two groups.

Conclusion

Orthogeriatric collaboration has been proven to be effective in terms of a decreased length of stay in both the acute and the rehabilitation hospitals.

中文翻译：

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跨急性和康复护理的正畸多学科共同管理可改善老年髋部骨折患者的住院时间、功能结果和并发症

介绍

随着全球老年髋部骨折病例数量持续激增，自 2018 年 11 月起实施了一种新开发的正畸联合管理多学科护理模式，以满足进一步增长的需求。我们的目标是评估新途径在改善脆性髋部骨折临床结果方面的有效性。

方法

收集 2018 年 4 月 1 日至 2018 年 10 月 30 日的老年髋部骨折患者数据，作为常规骨科护理模型（pre-orthogeriatric care model），与 2019 年 2 月 1 日至 2019 年 8 月 31 日的骨科共同管理模型的数据进行比较。对各组之间的临床结果进行了分析，该计划的效率反映在急诊和康复医院的总住院时间上。

结果

常规组194例，老年组207例，女性290例（72.3%）。平均 (SD) 患者年龄为 84.2 (7.9) 岁。在急诊和康复医院的中位住院时间分别减少了 1 天和 2 天（P=0.001）。骨科组与康复医院出院时的改良 Barthel 指数评分较高相关，骨科合作组中有更多患者在指数骨折后一年内接受骨质疏松症药物处方。两组在康复医院出院时的28天计划外再入院率、并发症发生率、死亡率或老年人活动量表评分无差异。

结论

骨科合作已被证明在减少急诊和康复医院的住院时间方面是有效的。