The association between orthogeriatric co-management and mortality following hip fracture
Autor: | Clemens Becker, Kilian Rapp, Hans-Helmut König, Claudia Schulz, Gisela Büchele, Erich Hartwig, Ulrich Liener, Dietrich Rothenbacher, Chris Todd |
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Jazyk: | němčina |
Rok vydání: | 2020 |
Předmět: |
030222 orthopedics
medicine.medical_specialty Hip fracture business.industry Outcome measures General Medicine medicine.disease Rate ratio 03 medical and health sciences 0302 clinical medicine Age groups Emergency medicine Health insurance Medicine In patient Observational study 030212 general & internal medicine business Lower mortality |
Zdroj: | Rapp, K, Becker, C, Todd, C, Rothenbacher, D, Schulz, C, König, H, Liener, U, Hartwig, E & Büchele, G 2020, ' The association between orthogeriatric co-management and mortality following hip fracture ', Deutsches Aerzteblatt International . https://doi.org/10.3238/arztebl.2020.0053 |
Popis: | Background To meet the special needs of older patients with fragility fractures, models for collaborative orthogeriatric care have been developed. The objective of our study was to analyze the association of orthogeriatric co-management with mortality following hip fracture in older patients in Germany. Methods This observational study was based on health insurance claims data from 58 001 patients (79.4% women) aged ≥80 years admitted to the hospital with hip fracture between January 2014 and March 2016. They were treated in 828 German hospitals with or without orthogeriatric co-management. The outcome measure was cumulative mortality with adjustment of the regression analyses. Results The crude 30-day mortality was 10.3% for patients from hospitals with orthogeriatric co-management and 13.4% for patients from hospitals without orthogeriatric co-management. The adjusted 30-day mortality was 22% lower for patients in hospitals with orthogeriatric co-management (rate ratio 0.78; 95% CI [0.74; 0.82]; adjusted absolute difference -2.48%; 95% CI [-2.98; -1.98]). The difference in 30-day mortality remained nearly unchanged over the first 6 months. The risk reduction with orthogeriatric co-management was consistently observed in both women and men, across age groups, and in patients with and without care needs. The mean length of the index stay was 19.8 days in hospitals with orthogeriatric co-management and 14.4 days in hospitals without orthogeriatric co-management. Conclusion A multidisciplinary orthogeriatric approach is associated with lower mortality and a longer index stay in hospital after hip fracture. |
Databáze: | OpenAIRE |
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