Increased Geriatric Treatment Frequency Improves Mobility and Secondary Fracture Prevention in Older Adult Hip Fracture Patients—An Observational Cohort Study of 23,828 Patients from the Registry for Geriatric Trauma (ATR-DGU)
Interdisciplinary orthogeriatric care of older adult hip fracture patients is of growing importance due to an ageing population, yet there is ongoing disagreement about the most effective model of care. This study aimed to compare different forms of orthogeriatric treatment, with focus on their impa...
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| Language: | English |
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MDPI AG
2021-11-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/23/5489 |
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| author | Johannes Gleich Evi Fleischhacker Katherine Rascher Thomas Friess Christian Kammerlander Wolfgang Böcker Benjamin Bücking Ulrich Liener Michael Drey Christine Höfer Carl Neuerburg |
| author_facet | Johannes Gleich Evi Fleischhacker Katherine Rascher Thomas Friess Christian Kammerlander Wolfgang Böcker Benjamin Bücking Ulrich Liener Michael Drey Christine Höfer Carl Neuerburg |
| author_sort | Johannes Gleich |
| collection | DOAJ |
| description | Interdisciplinary orthogeriatric care of older adult hip fracture patients is of growing importance due to an ageing population, yet there is ongoing disagreement about the most effective model of care. This study aimed to compare different forms of orthogeriatric treatment, with focus on their impact on postoperative mobilization, mobility and secondary fracture prevention. In this observational cohort study, patients aged 70 years and older with a proximal femur fracture requiring surgery, were included from 1 January 2016 to 31 December 2019. Data were recorded from hospital stay to 120-day follow-up in the Registry for Geriatric Trauma (ATR-DGU), a specific designed registry for older adult hip fracture patients. Of 23,828 included patients from 95 different hospitals, 72% were female, median age was 85 (IQR 80–89) years. Increased involvement of geriatricians had a significant impact on mobilization on the first day (OR 1.1, CI 1.1–1.2) and mobility seven days after surgery (OR 1.1, CI 1.1–1.2), initiation of an osteoporosis treatment during in-hospital stay (OR 2.5, CI 2.4–2.7) and of an early complex geriatric rehabilitation treatment (OR 1.3, CI 1.2–1.4). These findings were persistent after 120 days of follow-up. Interdisciplinary treatment of orthogeriatric patients is beneficial and especially during in-patient stay increased involvement of geriatricians is decisive for early mobilization, mobility and initiation of osteoporosis treatment. Standardized treatment pathways in certified geriatric trauma departments with structured data collection in specific registries improve outcome monitoring and interpretation. |
| first_indexed | 2024-03-10T04:52:01Z |
| format | Article |
| id | doaj.art-2cea9295a7e749b996fc9b0109966eff |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T04:52:01Z |
| publishDate | 2021-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-2cea9295a7e749b996fc9b0109966eff2023-11-23T02:34:49ZengMDPI AGJournal of Clinical Medicine2077-03832021-11-011023548910.3390/jcm10235489Increased Geriatric Treatment Frequency Improves Mobility and Secondary Fracture Prevention in Older Adult Hip Fracture Patients—An Observational Cohort Study of 23,828 Patients from the Registry for Geriatric Trauma (ATR-DGU)Johannes Gleich0Evi Fleischhacker1Katherine Rascher2Thomas Friess3Christian Kammerlander4Wolfgang Böcker5Benjamin Bücking6Ulrich Liener7Michael Drey8Christine Höfer9Carl Neuerburg10Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, 81377 Munich, GermanyDepartment of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, 81377 Munich, GermanyAUC—Academy for Trauma Surgery, 80538 Munich, GermanyAUC—Academy for Trauma Surgery, 80538 Munich, GermanyAUVA Traumahospital Styria, 8020 Graz, AustriaDepartment of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, 81377 Munich, GermanyCenter for Orthopedics and Trauma Surgery, DRK-Kliniken Nordhessen, 34121 Kassel, GermanyDepartment of Orthopedics and Trauma Surgery, Marienhospital, 70199 Stuttgart, GermanyDepartment of Medicine IV, University Hospital, LMU Munich, 80336 Munich, GermanyAUC—Academy for Trauma Surgery, 80538 Munich, GermanyDepartment of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, 81377 Munich, GermanyInterdisciplinary orthogeriatric care of older adult hip fracture patients is of growing importance due to an ageing population, yet there is ongoing disagreement about the most effective model of care. This study aimed to compare different forms of orthogeriatric treatment, with focus on their impact on postoperative mobilization, mobility and secondary fracture prevention. In this observational cohort study, patients aged 70 years and older with a proximal femur fracture requiring surgery, were included from 1 January 2016 to 31 December 2019. Data were recorded from hospital stay to 120-day follow-up in the Registry for Geriatric Trauma (ATR-DGU), a specific designed registry for older adult hip fracture patients. Of 23,828 included patients from 95 different hospitals, 72% were female, median age was 85 (IQR 80–89) years. Increased involvement of geriatricians had a significant impact on mobilization on the first day (OR 1.1, CI 1.1–1.2) and mobility seven days after surgery (OR 1.1, CI 1.1–1.2), initiation of an osteoporosis treatment during in-hospital stay (OR 2.5, CI 2.4–2.7) and of an early complex geriatric rehabilitation treatment (OR 1.3, CI 1.2–1.4). These findings were persistent after 120 days of follow-up. Interdisciplinary treatment of orthogeriatric patients is beneficial and especially during in-patient stay increased involvement of geriatricians is decisive for early mobilization, mobility and initiation of osteoporosis treatment. Standardized treatment pathways in certified geriatric trauma departments with structured data collection in specific registries improve outcome monitoring and interpretation.https://www.mdpi.com/2077-0383/10/23/5489hip fractureorthogeriatric carefragility fractureinterdisciplinary treatmentosteoporosisregistry |
| spellingShingle | Johannes Gleich Evi Fleischhacker Katherine Rascher Thomas Friess Christian Kammerlander Wolfgang Böcker Benjamin Bücking Ulrich Liener Michael Drey Christine Höfer Carl Neuerburg Increased Geriatric Treatment Frequency Improves Mobility and Secondary Fracture Prevention in Older Adult Hip Fracture Patients—An Observational Cohort Study of 23,828 Patients from the Registry for Geriatric Trauma (ATR-DGU) Journal of Clinical Medicine hip fracture orthogeriatric care fragility fracture interdisciplinary treatment osteoporosis registry |
| title | Increased Geriatric Treatment Frequency Improves Mobility and Secondary Fracture Prevention in Older Adult Hip Fracture Patients—An Observational Cohort Study of 23,828 Patients from the Registry for Geriatric Trauma (ATR-DGU) |
| title_full | Increased Geriatric Treatment Frequency Improves Mobility and Secondary Fracture Prevention in Older Adult Hip Fracture Patients—An Observational Cohort Study of 23,828 Patients from the Registry for Geriatric Trauma (ATR-DGU) |
| title_fullStr | Increased Geriatric Treatment Frequency Improves Mobility and Secondary Fracture Prevention in Older Adult Hip Fracture Patients—An Observational Cohort Study of 23,828 Patients from the Registry for Geriatric Trauma (ATR-DGU) |
| title_full_unstemmed | Increased Geriatric Treatment Frequency Improves Mobility and Secondary Fracture Prevention in Older Adult Hip Fracture Patients—An Observational Cohort Study of 23,828 Patients from the Registry for Geriatric Trauma (ATR-DGU) |
| title_short | Increased Geriatric Treatment Frequency Improves Mobility and Secondary Fracture Prevention in Older Adult Hip Fracture Patients—An Observational Cohort Study of 23,828 Patients from the Registry for Geriatric Trauma (ATR-DGU) |
| title_sort | increased geriatric treatment frequency improves mobility and secondary fracture prevention in older adult hip fracture patients an observational cohort study of 23 828 patients from the registry for geriatric trauma atr dgu |
| topic | hip fracture orthogeriatric care fragility fracture interdisciplinary treatment osteoporosis registry |
| url | https://www.mdpi.com/2077-0383/10/23/5489 |
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