Association of orthogeriatric services with long-term mortality in patients with hip fracture.

Autor: Pueyo-Sánchez MJ; Department of Health, Master Plan of Musculoskeletal Diseases, Travessera de les Corts 139-151, 08028, Barcelona, Spain. mjpueyo@gencat.cat.; Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain. mjpueyo@gencat.cat., Larrosa M; Department of Health, Master Plan of Musculoskeletal Diseases, Travessera de les Corts 139-151, 08028, Barcelona, Spain.; Rheumatology Department, Parc Taulí Hospital Universitari, Sabadell, Spain., Surís X; Department of Health, Master Plan of Musculoskeletal Diseases, Travessera de les Corts 139-151, 08028, Barcelona, Spain.; Rheumatology Department, Hospital General de Granollers, Granollers, Spain.; School of Medicine and Health Sciences, International University of Catalonia, Sant Cugat del Vallès, Spain., Sánchez-Ferrin P; Department of Health, Master Plan of Social and Health Care, Barcelona, Spain., Bullich-Marin I; Department of Health, Master Plan of Social and Health Care, Barcelona, Spain., Frigola-Capell E; Department of Health, Master Plan of Musculoskeletal Diseases, Travessera de les Corts 139-151, 08028, Barcelona, Spain.; Jordi Gol Institute for Research in Primary Care, IDIAP Jordi Gol, Barcelona, Spain., Ortún V; Department of Economics, Pompeu Fabra University, Barcelona, Spain.
Jazyk: angličtina
Zdroj: European geriatric medicine [Eur Geriatr Med] 2018 Apr; Vol. 9 (2), pp. 175-181. Date of Electronic Publication: 2018 Jan 29.
DOI: 10.1007/s41999-018-0028-4
Abstrakt: Purpose: To assess the impact of the comprehensive orthogeriatric care model (OGM) on 2-year survival, length of stay (LOS), discharges to nursing homes, and antiosteoporotic treatment (AOT) in patients with hip fracture.
Methods: Retrospective cohort study. Hospitals were classified as OGM if the patient was cared for in a comprehensive orthogeriatric unit. We included data from patients ≥ 65 years old discharged between 2012 and 2013. The main outcome was 12- and 24-month mortality. The variables collected were sex, type of fracture, comorbidities, AOT, LOS, and discharge to nursing homes. Survival analysis was performed with Kaplan-Meier method and comparison with Mantel-Haenszel test. Factors associated with death were determined by logistic regression.
Results: First admissions in the 12 (out of 32) hospitals with OGM were 3580 of 9215 (38.8%). Patients in OGM had more comorbidities and discharges to nursing homes, shorter LOS, and less prescription of AOT. Two years after the admission the deceased patients were 3000 (32.6%). The survival was lower in males (p < 0.001), in the older age groups (p < 0.001), and in patients with Charlson > 1 (p < 0.001). Factors associated with increased risk of death at 12 and 24 months (logistic regression) were male gender, age and Charlson > 1, while care in the OGM decreased the risk. OGM benefited more patients > 80 years and those with Charlson < 1.
Conclusions: Patients admitted in OGM have shorter stays, more discharges to nursing homes, lower prescription of AOT, and better 12- and 24-month survival adjusted by sex, age, and comorbidities compared to non-OGM care.
(© 2018. European Geriatric Medicine Society.)
Databáze: MEDLINE
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