Perioperative and Postoperative Outcomes of Proximal Hip Fracture: A Comparison of Orthopedic and Geriatric Care Models.

Autor:	Lubovsky O; Orthopedics, Barzilai Medical Center, Ashkelon, ISR., Rosinsky PJ; Orthopedics, Barzilai Medical Center, Ashkelon, ISR., Artoul R; Geriatrics, Barzilai Medical Center, Ashkelon, ISR., Avraham D; Orthopedics, Kaplan Medical Center, Rehovot, ISR., Oulianski M; Orthopedics, Kaplan Medical Center, Rehovot, ISR.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Jul 31; Vol. 16 (7), pp. e65899. Date of Electronic Publication: 2024 Jul 31 (Print Publication: 2024).
DOI:	10.7759/cureus.65899
Abstrakt:	Introduction Orthogeriatric patients with femur fractures, despite their multiple comorbidities and associated healthcare costs, have a promising new approach. This approach suggests that most patients should be hospitalized in the geriatric department, with daily orthopedic follow-up. The potential for lower mortality rates through orthogeriatric co-management and dual care is a reason for hope in our field. Methods This study is retrospective and involved 285 patients with proximal hip fractures. Two treatment models were compared: hospitalization in orthopedic and geriatric departments with different treatment protocols. The study analyzed demographic data and postoperative outcomes. It also included an analysis of 26 patients who received conservative treatment. Results Our study revealed significant differences between patients hospitalized in the orthopedic and geriatric departments. Geriatric department patients, who were significantly older and had higher comorbidities, experienced extended hospitalization and higher mortality rates during hospitalization, at 30 days, and at one-year follow-up (p<0.05). Notably, a significantly higher proportion of geriatric patients were discharged to home rehabilitation at the end of hospitalization compared to orthopedic patients (17.5% vs. 7.4%; p<0.01). Among non-operated patients, the mortality rate was 57.7% compared to 16.5% in patients who underwent surgery during the one-year follow-up. Discussion Our study suggests that elderly patients with hip fractures may benefit from management in the geriatric department. Despite experiencing significantly longer hospital stays, these patients have a higher likelihood of being discharged home compared to those managed in the orthopedic department. These findings have important implications for the care of orthogeriatric patients and may help guide future treatment strategies. Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Institutional Review Board of Barzilai Medical Center issued approval 0008-21. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Lubovsky et al.)
Databáze:	MEDLINE
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