Validation of the Geriatrics at Risk Score (GeRi-Score) on 120-day follow-up, the influence of preoperative geriatric visits, and the time to surgery on the outcome of hip fracture patients: an analysis from the Registry for Geriatric Trauma (ATR-DGU).

Autor: Heuser L; Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, 45276, Essen, Germany., Schoeneberg C; Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, 45276, Essen, Germany., Rascher K; AUC, Academy for Trauma Surgery (AUC), Munich, Germany., Lendemans S; Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, 45276, Essen, Germany., Knobe M; Department of Orthopaedic Trauma, Hospital Westmünsterland, Ahaus, Germany., Aigner R; Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany., Ruchholtz S; Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany., Neuerburg C; Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Germany., Pass B; Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, 45276, Essen, Germany. bastian.Pass@krupp-krankenhaus.de.
Jazyk: angličtina
Zdroj: Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA [Osteoporos Int] 2024 Oct; Vol. 35 (10), pp. 1797-1805. Date of Electronic Publication: 2024 Jul 04.
DOI: 10.1007/s00198-024-07177-3
Abstrakt: A validation of the GeRi-Score on 120-day mortality, the impact of a pre-operative visit by a geriatrician, and timing of surgery on the outcome was conducted. The score has predictive value for 120-day mortality. No advantage was found for surgery within 24 h or a preoperative geriatric visit.
Purpose: Numerous tools predict mortality among patients with hip fractures, but they include many variables, require time-consuming assessment, and are difficult to calculate. The GeRi-Score provides a quick method of pre-operative assessment. The aim of this study is to validate the score in the 120-day follow-up and determine the impact of a pre-operative visit by a geriatrician and timing of surgery on the patient outcome.
Methods: A retrospective analysis of the AltersTraumaRegister DGU ® from 2017 to 2021 was conducted, including all proximal femur fractures. The patients were divided into low-, moderate-, and high-risk groups based on the GeRi-Score. Mortality was analyzed using logistic regression. To determine the influence of the time to surgery and the preoperative visit by a geriatrician, matching was performed using the exact GeRi-Score, preoperative walking ability, type of fracture, and the time to surgery.
Results: The study included 38,570 patients, divided into 12,673 low-risk, 18,338 moderate-risk, and 7,559 high-risk patients. The moderate-risk group had three times the mortality risk of the low-risk group (OR 3.19 (95% CI 2.68-3.79; p<0.001)), while the high-risk group had almost eight times the mortality risk than the low-risk group (OR 7.82 (95% CI 6.51-9.93; p<0.001)). No advantage was found for surgery within the first 24 h across all groups. There was a correlation of a preoperative geriatric visit and mortality showing an increase in the moderate and high-risk group on in-house mortality.
Conclusions: The GeRi-Score has predictive value for 120-day mortality. No advantage was found for surgery within 24 h. The analysis did not demonstrate a benefit of the preoperative geriatric visit, but more data are needed.
(© 2024. International Osteoporosis Foundation and Bone Health and Osteoporosis Foundation.)
Databáze: MEDLINE
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