Orthogeriatric co-managements lower early mortality in long-lived elderly hip fracture: a post-hoc analysis of a prospective study

作者：Gao, Feng; Liu, Gang; Ge, Yufeng; Tan, Zhelun; Chen, Yimin; Peng, Weidong; Zhang, Jing; Zhang, Xinyi; He, Jiusheng; Wen, Liangyuan; Wang, Xianhai; Shi, Zongxin; Hu, Sanbao; Sun, Fengpo; Gong, Zishun; Sun, Mingyao; Tian, Maoyi; Zhu, Shiwen; Yang, Minghui^*; Wu, Xinbao

来源：BMC Geriatrics, 2023, 23(1): 571.

DOI：10.1186/s12877-023-04289-z

• Elderly
• Long-lived
• Hip fractures
• Co-management care
• Orthogeriatric
• Mortality

Objective To evaluate the clinical effectiveness of orthogeriatric co-management care in long-lived elderly hip fracture patients (age = 90). @@@ Methods Secondary analysis was conducted in long-lived hip fracture patients between 2018 to 2019 in 6 hospitals in Beijing, China. Patients were divided into the orthogeriatric co-management group (CM group) and traditional consultation mode group (TC group) depending on the management mode. With 30-day mortality as the primary outcome, multivariate regression analyses were performed after adjusting for potential covariates. 30-day mobility and quality of life were compared between groups. @@@ Results A total of 233 patients were included, 223 of whom completed follow-up (125 in CM group, 98 in TC group). The average age was 92.4 +/- 2.5 years old (range 90-102). The 30-day mortality in CM group was significantly lower than that in TC group after adjustments for (2.4% vs. 10.2%; OR = 0.231; 95% CI 0.059 similar to 0.896; P = 0.034). The proportion of patients undergoing surgery and surgery performed within 48 h also favored the CM group (97.6% vs. 85.7%, P = 0.002; 74.4% vs. 24.5%, P < 0.001; respectively). In addition, much more patients in CM group could walk with or without aids in postoperative 30 days than in the TC group (87.7% vs. 60.2%, P < 0.05), although differences were not found after 1-year follow-up. And there was no significant difference in total cost between the two groups (P > 0.05). @@@ Conclusions For long-lived elderly hip fracture patients, orthogeriatric co-management care lowered early mortality, improved early mobility and compared with the traditional consultation mode.

• 单位
  中国医学科学院; 哈尔滨医科大学; 北京大学