Ann Geriatr Med Res.
2016 Sep;20(3):125-130. 10.4235/agmr.2016.20.3.125.
Clinical Outcomes of Perioperative Geriatric Intervention in the Elderly Undergoing Hip Fracture Surgery
- Affiliations
-
- 1Pyeongchang Health Center & Country Hospital, Pyeongchang, Korea.
- 2Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. eunjulee@amc.seoul.kr
- 3Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Korea.
- 4Geriatric Center, Seoul National University Bundang Hospital, Seoul National College of Medicine, Seongnam, Korea.
- 5Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
- KMID: 2415689
- DOI: http://doi.org/10.4235/agmr.2016.20.3.125
Abstract
- BACKGROUND
Conventionally, elderly hip fracture patients are assessed by orthopedists to decide whether they need geriatric intervention. We aimed to evaluate the effect of perioperative geriatric intervention on healthcare outcomes in patients undergoing surgery for hip fractures.
METHODS
Our care model for hip fracture surgery resembles a combination of a routine geriatric consultation model and a geriatric ward model. We retrospectively reviewed the medical records of patients aged ≥65 years undergoing surgery for hip fracture at a single tertiary hospital from January 2010 to December 2013. We assessed comorbidity, indwelling status, fracture type, and mode of anesthesia. We also evaluated in-hospital expenditure, duration of admission, disposition at discharge and 1-year mortality as clinical outcomes. We developed a propensity score model using the variables of age, cholesterol, and creatinine and examined the effect of perioperative geriatric intervention on intergroup differences of clinical variables.
RESULTS
Among 639 patients, 138 patients received the geriatric intervention and 501 patients received the usual care. Univariate analysis showed that factors such as age; Charlson comorbidity index; and serum levels of cholesterol, albumin, and creatinine differed significantly between these 2 groups. There was no significant difference between the groups in terms of 1-year mortality, disposition at discharge, and in-hospital expenditure in the propensity matched model. However, the duration of hospitalization was shorter in the intervention group (8.9±0.8 days) than in the usual care group (14.2±3.7 days, p=0.006).
CONCLUSION
This care model of geriatric intervention for patients with hip fracture is associated with reduced hospitalization duration.
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