The impact of an orthogeriatric intervention in patients with fragility fractures: a cohort study
Abstract Background While orthogeriatric care to patients with hip fractures is established, the impact of similar intervention in patients with fragility fractures in general is lacking. Therefore, we aimed to assess the impact of an orthogeriatric intervention on postoperative complications and re...
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doaj-318c895403954e209ec082cf3dceeebf2020-11-25T03:41:21ZengBMCBMC Geriatrics1471-23182019-10-0119111110.1186/s12877-019-1299-4The impact of an orthogeriatric intervention in patients with fragility fractures: a cohort studyCharlotte Abrahamsen0Birgitte Nørgaard1Eva Draborg2Morten Frost Nielsen3Department of Orthopaedic Surgery, Kolding Hospital a part of Hospital LillebaeltDepartment of Public Health, University of Southern DenmarkDepartment of Public Health, University of Southern DenmarkEndocrine Research Unit & KMEB, Odense University hospitalAbstract Background While orthogeriatric care to patients with hip fractures is established, the impact of similar intervention in patients with fragility fractures in general is lacking. Therefore, we aimed to assess the impact of an orthogeriatric intervention on postoperative complications and readmissions among patients admitted due to and surgically treated for fragility fractures. Methods A prospective observational cohort study with a retrospective control was designed. A new orthogeriatric unit for acute patients of sixty-five years or older with fragility fractures in terms of hip, vertebral or appendicular fractures was opened on March 1, 2014. Patients were excluded if the fracture was cancer-related or caused by high-energy trauma, if the patient was operated on at another hospital, treated conservatively with no operation, or had been readmitted within the last month due to fracture-related complications. Results We included 591 patients; 170 in the historical cohort and 421 in the orthogeriatric cohort. No significant differences were found between the two cohorts with regard to the proportion of participants experiencing complications (24.5% versus 28.3%, p = 0.36) or readmission within 30 days after discharge (14.1% vs 12.1%, p = 0.5). With both cohorts collapsed and adjusting for age, gender and CCI, the odds of having postoperative complications as a hip fracture patient was 4.45, compared to patients with an appendicular fracture (p < 0.001). Furthermore, patients with complications during admission were at a higher risk of readmission within 30 days than were patients without complications (22.3% vs 9.5%, p < 0.001). Conclusions In older patients admitted with fragility fractures, our model of orthogeriatric care showed no significant differences regarding postoperative complications or readmissions compared to the traditional care. However, we found significantly higher odds of having postoperative complications among patients admitted with a hip fracture compared to other fragility fractures. Additionally, our study reveals an increased risk of being readmitted within 30 days for patients with postoperative complications.http://link.springer.com/article/10.1186/s12877-019-1299-4Frail elderlyFragility fractureOsteoporotic fracturesOrthogeriatricPostoperative complications |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Charlotte Abrahamsen Birgitte Nørgaard Eva Draborg Morten Frost Nielsen |
spellingShingle |
Charlotte Abrahamsen Birgitte Nørgaard Eva Draborg Morten Frost Nielsen The impact of an orthogeriatric intervention in patients with fragility fractures: a cohort study BMC Geriatrics Frail elderly Fragility fracture Osteoporotic fractures Orthogeriatric Postoperative complications |
author_facet |
Charlotte Abrahamsen Birgitte Nørgaard Eva Draborg Morten Frost Nielsen |
author_sort |
Charlotte Abrahamsen |
title |
The impact of an orthogeriatric intervention in patients with fragility fractures: a cohort study |
title_short |
The impact of an orthogeriatric intervention in patients with fragility fractures: a cohort study |
title_full |
The impact of an orthogeriatric intervention in patients with fragility fractures: a cohort study |
title_fullStr |
The impact of an orthogeriatric intervention in patients with fragility fractures: a cohort study |
title_full_unstemmed |
The impact of an orthogeriatric intervention in patients with fragility fractures: a cohort study |
title_sort |
impact of an orthogeriatric intervention in patients with fragility fractures: a cohort study |
publisher |
BMC |
series |
BMC Geriatrics |
issn |
1471-2318 |
publishDate |
2019-10-01 |
description |
Abstract Background While orthogeriatric care to patients with hip fractures is established, the impact of similar intervention in patients with fragility fractures in general is lacking. Therefore, we aimed to assess the impact of an orthogeriatric intervention on postoperative complications and readmissions among patients admitted due to and surgically treated for fragility fractures. Methods A prospective observational cohort study with a retrospective control was designed. A new orthogeriatric unit for acute patients of sixty-five years or older with fragility fractures in terms of hip, vertebral or appendicular fractures was opened on March 1, 2014. Patients were excluded if the fracture was cancer-related or caused by high-energy trauma, if the patient was operated on at another hospital, treated conservatively with no operation, or had been readmitted within the last month due to fracture-related complications. Results We included 591 patients; 170 in the historical cohort and 421 in the orthogeriatric cohort. No significant differences were found between the two cohorts with regard to the proportion of participants experiencing complications (24.5% versus 28.3%, p = 0.36) or readmission within 30 days after discharge (14.1% vs 12.1%, p = 0.5). With both cohorts collapsed and adjusting for age, gender and CCI, the odds of having postoperative complications as a hip fracture patient was 4.45, compared to patients with an appendicular fracture (p < 0.001). Furthermore, patients with complications during admission were at a higher risk of readmission within 30 days than were patients without complications (22.3% vs 9.5%, p < 0.001). Conclusions In older patients admitted with fragility fractures, our model of orthogeriatric care showed no significant differences regarding postoperative complications or readmissions compared to the traditional care. However, we found significantly higher odds of having postoperative complications among patients admitted with a hip fracture compared to other fragility fractures. Additionally, our study reveals an increased risk of being readmitted within 30 days for patients with postoperative complications. |
topic |
Frail elderly Fragility fracture Osteoporotic fractures Orthogeriatric Postoperative complications |
url |
http://link.springer.com/article/10.1186/s12877-019-1299-4 |
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