Management of geriatric hip fractures: implementation of geriatric orthopedic co-management and comparison with practice in the UK
Author(s): YANG Ming-hui, WU Xin-bao, GONG Xiao-feng, WANG Geng, ZHANG Ping, WANG Man-yi
Pages: 169-173
Year: 2017 Issue: 3
Journal: Chinese Journal of Bone Tumor and Bone Disease
Keyword: Hip fractures; Aged; Interdisciplinary communication; Wounds and injuries;
Abstract: Objective Previous retrospective study showed that significant gaps existed in geriatric hip fracture management in our hospital compared with the best practice achieved in UK hospitals. The purpose of this study was to evaluate the results after we implemented geriatric orthopedic co-management in a geriatric unit. Methods From May 2015 we implemented geriatric orthopedic co-management in a geriatric unit for geriatric hip fractures ( age≥65 years ). A retrospective audit was undertaken for patients managed between May 2015 and April 2016. Data were compared with our previous results before co-management and the National Hip Fracture Database in UK. The parameters included gender, age, percentage of conservative treatment, patients received surgery within 48 h after admission, percentage of pre-operative geriatrician assessment and new pressure ulcers.Results Totally 492 geriatric hip fractures were managed between May 2015 and April 2016. There were 344 females and 148 males. The age on average was 79.6; 434 cases were treated operatively and the remaining 58 non-operatively. The percentage of conservative treatment was 12% compared with 2.5% in UK; 50% of patients received surgery within 48 h of admission compared with 8% before co-management and 83% in UK; 100% received geriatrician assessment compared with 27% before co-management and 70% in UK. New pressure ulcers developed in 0.6% of patients compared with 2% before co-management and 3.7% in UK.Conclusions Geriatric orthopedic co-management can improve the efficacy of treatment of geriatric hip fractures. Gap remains in hip fracture management in Beijing compared with the best practice achieved in UK.
Pages: 169-173
Year: 2017 Issue: 3
Journal: Chinese Journal of Bone Tumor and Bone Disease
Keyword: Hip fractures; Aged; Interdisciplinary communication; Wounds and injuries;
Abstract: Objective Previous retrospective study showed that significant gaps existed in geriatric hip fracture management in our hospital compared with the best practice achieved in UK hospitals. The purpose of this study was to evaluate the results after we implemented geriatric orthopedic co-management in a geriatric unit. Methods From May 2015 we implemented geriatric orthopedic co-management in a geriatric unit for geriatric hip fractures ( age≥65 years ). A retrospective audit was undertaken for patients managed between May 2015 and April 2016. Data were compared with our previous results before co-management and the National Hip Fracture Database in UK. The parameters included gender, age, percentage of conservative treatment, patients received surgery within 48 h after admission, percentage of pre-operative geriatrician assessment and new pressure ulcers.Results Totally 492 geriatric hip fractures were managed between May 2015 and April 2016. There were 344 females and 148 males. The age on average was 79.6; 434 cases were treated operatively and the remaining 58 non-operatively. The percentage of conservative treatment was 12% compared with 2.5% in UK; 50% of patients received surgery within 48 h of admission compared with 8% before co-management and 83% in UK; 100% received geriatrician assessment compared with 27% before co-management and 70% in UK. New pressure ulcers developed in 0.6% of patients compared with 2% before co-management and 3.7% in UK.Conclusions Geriatric orthopedic co-management can improve the efficacy of treatment of geriatric hip fractures. Gap remains in hip fracture management in Beijing compared with the best practice achieved in UK.
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