Does a bicycle accident as the cause of proximal femur fracture indicate that geriatric co-management is superfluous? A retrospective cohort study
Abstract Background Deployment of geriatric care would be more sustainable if we could limit geriatric co-management to older hip fracture patients who benefit most from it. We assumed that riding a bicycle is a proxy of good health and hypothesized that older patients with a hip fracture due to a b...
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | European Review of Aging and Physical Activity |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s11556-023-00315-6 |
| _version_ | 1797865288641806336 |
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| author | Petra E. Spies Malene Fix Benjamin L. Emmink Tjard R. Schermer |
| author_facet | Petra E. Spies Malene Fix Benjamin L. Emmink Tjard R. Schermer |
| author_sort | Petra E. Spies |
| collection | DOAJ |
| description | Abstract Background Deployment of geriatric care would be more sustainable if we could limit geriatric co-management to older hip fracture patients who benefit most from it. We assumed that riding a bicycle is a proxy of good health and hypothesized that older patients with a hip fracture due to a bicycle accident have a more favorable prognosis than patients whose hip fracture was caused by another type of accident. Methods Retrospective cohort study of hip fracture patients ≥ 70 years admitted to hospital. Nursing home residents were excluded. Primary outcome was length of hospital stay (LOS). Secondary outcomes were delirium, infection, blood transfusion, intensive care unit stay and death during hospitalization. The group with a bicycle accident (BA) was compared to the non-bicycle accident (NBA) group using linear and logistic regression models, with correction for age and sex. Results Of the 875 patients included, 102 (11.7%) had a bicycle accident. BA patients were younger (79.8 versus 83.9 years, p < 0.001), less often female (54.9 versus 71.2%, p = 0.001) and lived independently more often (100 versus 85.1%, p < 0.001). Median LOS in the BA group was 0.91 times the median LOS in the NBA group (p = 0.125). For none of the secondary outcomes the odds ratio favored the BA group, except for infection during hospital stay (OR = 0.53, 95%CI 0.28–0.99; p = 0.048). Conclusions Although older hip fracture patients who had a bicycle accident appeared more healthy than other older hip fracture patients, their clinical course was not more favorable. Based on this study, a bicycle accident is not an indicator that geriatric co-management can be omitted. |
| first_indexed | 2024-04-09T23:06:15Z |
| format | Article |
| id | doaj.art-6d5bcfb2ad2d4685a8e5a362d9c54c8d |
| institution | Directory Open Access Journal |
| issn | 1861-6909 |
| language | English |
| last_indexed | 2024-04-09T23:06:15Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | European Review of Aging and Physical Activity |
| spelling | doaj.art-6d5bcfb2ad2d4685a8e5a362d9c54c8d2023-03-22T10:41:32ZengBMCEuropean Review of Aging and Physical Activity1861-69092023-03-012011710.1186/s11556-023-00315-6Does a bicycle accident as the cause of proximal femur fracture indicate that geriatric co-management is superfluous? A retrospective cohort studyPetra E. Spies0Malene Fix1Benjamin L. Emmink2Tjard R. Schermer3Department of Geriatric Medicine and Centre of Excellence for Old Age Medicine, Gelre HospitalsDepartment of Geriatric Medicine and Centre of Excellence for Old Age Medicine, Gelre HospitalsDepartment of Surgery, Gelre HospitalsDepartment of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical CenterAbstract Background Deployment of geriatric care would be more sustainable if we could limit geriatric co-management to older hip fracture patients who benefit most from it. We assumed that riding a bicycle is a proxy of good health and hypothesized that older patients with a hip fracture due to a bicycle accident have a more favorable prognosis than patients whose hip fracture was caused by another type of accident. Methods Retrospective cohort study of hip fracture patients ≥ 70 years admitted to hospital. Nursing home residents were excluded. Primary outcome was length of hospital stay (LOS). Secondary outcomes were delirium, infection, blood transfusion, intensive care unit stay and death during hospitalization. The group with a bicycle accident (BA) was compared to the non-bicycle accident (NBA) group using linear and logistic regression models, with correction for age and sex. Results Of the 875 patients included, 102 (11.7%) had a bicycle accident. BA patients were younger (79.8 versus 83.9 years, p < 0.001), less often female (54.9 versus 71.2%, p = 0.001) and lived independently more often (100 versus 85.1%, p < 0.001). Median LOS in the BA group was 0.91 times the median LOS in the NBA group (p = 0.125). For none of the secondary outcomes the odds ratio favored the BA group, except for infection during hospital stay (OR = 0.53, 95%CI 0.28–0.99; p = 0.048). Conclusions Although older hip fracture patients who had a bicycle accident appeared more healthy than other older hip fracture patients, their clinical course was not more favorable. Based on this study, a bicycle accident is not an indicator that geriatric co-management can be omitted.https://doi.org/10.1186/s11556-023-00315-6Geriatric traumatologyBicycleE-bikeFemur fractureCo-managementLength of stay |
| spellingShingle | Petra E. Spies Malene Fix Benjamin L. Emmink Tjard R. Schermer Does a bicycle accident as the cause of proximal femur fracture indicate that geriatric co-management is superfluous? A retrospective cohort study European Review of Aging and Physical Activity Geriatric traumatology Bicycle E-bike Femur fracture Co-management Length of stay |
| title | Does a bicycle accident as the cause of proximal femur fracture indicate that geriatric co-management is superfluous? A retrospective cohort study |
| title_full | Does a bicycle accident as the cause of proximal femur fracture indicate that geriatric co-management is superfluous? A retrospective cohort study |
| title_fullStr | Does a bicycle accident as the cause of proximal femur fracture indicate that geriatric co-management is superfluous? A retrospective cohort study |
| title_full_unstemmed | Does a bicycle accident as the cause of proximal femur fracture indicate that geriatric co-management is superfluous? A retrospective cohort study |
| title_short | Does a bicycle accident as the cause of proximal femur fracture indicate that geriatric co-management is superfluous? A retrospective cohort study |
| title_sort | does a bicycle accident as the cause of proximal femur fracture indicate that geriatric co management is superfluous a retrospective cohort study |
| topic | Geriatric traumatology Bicycle E-bike Femur fracture Co-management Length of stay |
| url | https://doi.org/10.1186/s11556-023-00315-6 |
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