Mortality after hip fracture in the elderly: The role of a multidisciplinary approach and time to surgery in a retrospective observational study on 23,973 patients

Archives of Gerontology and Geriatrics

Volumn 66, Issue , 2016, Pages 13-17

  Forni, Silvia ^a   Pieralli, Francesca ^b   Sergi, Alessandro ^a   Lorini, Chiara ^b   Bonaccorsi, Guglielmo ^c   Vannucci, Andrea ^a  

^a Tuscan Region Health Agency   (Italy)

^b UNIVERSITY OF FLORENCE   (Italy)

^c UNIVERSITY OF FLORENCE   (Italy)

Author keywords

Elderly; Hip fracture; Hospital care; Orthogeriatric management; Patient outcomes; Time to surgery

Indexed keywords

ADULT; AGED; ARTICLE; CHARLSON COMORBIDITY INDEX; COMORBIDITY; FEMALE; FRACTURE REDUCTION; GERIATRICIAN; HIP ARTHROPLASTY; HIP FRACTURE; HIP HEMIARTHROPLASTY; HUMAN; ITALIAN (CITIZEN); MAJOR CLINICAL STUDY; MALE; MORTALITY; OBSERVATIONAL STUDY; OPEN REDUCTION; ORTHOPEDIC SURGEON; OSTEOSYNTHESIS; PRIORITY JOURNAL; RETROSPECTIVE STUDY; TIME TO TREATMENT; CEREBROVASCULAR DISORDERS; DEMENTIA; DIABETES MELLITUS; HEART FAILURE; HIP FRACTURES; HIP REPLACEMENT; HOSPITAL; HOSPITAL DISCHARGE; HOSPITALIZATION; ITALY; MULTILEVEL ANALYSIS; PATIENT CARE; PROCEDURES; PULMONARY DISEASE, CHRONIC OBSTRUCTIVE; STATISTICAL MODEL; TIME FACTOR; VERY ELDERLY;

AGED; AGED, 80 AND OVER; ARTHROPLASTY, REPLACEMENT, HIP; CEREBROVASCULAR DISORDERS; COMORBIDITY; DEMENTIA; DIABETES MELLITUS; FEMALE; FRACTURE FIXATION, INTERNAL; HEART FAILURE; HIP FRACTURES; HOSPITALIZATION; HOSPITALS; HUMANS; ITALY; LOGISTIC MODELS; MALE; MORTALITY; MULTILEVEL ANALYSIS; PATIENT CARE TEAM; PATIENT DISCHARGE; PULMONARY DISEASE, CHRONIC OBSTRUCTIVE; RETROSPECTIVE STUDIES; TIME FACTORS;

EID: 84965052526     PISSN: 01674943     EISSN: 18726976     Source Type: Journal    
DOI: 10.1016/j.archger.2016.04.014     Document Type: Article

References (36)

1. Belmont P.J., Garcia E.J., Bader D., Nelson J.O., Schoenfeld K.J., Romano A.J., et al. Risk factors for complications and in-hospital mortality following hip fractures: a study using the National Trauma Data Bank. Archives of Orthopaedic and Trauma Surgery 2014, 134:597-604.
2. Biber R., Singler K., Wicklein M., Sieber S., Bail C., Curschmann-Horter H.J. Implementation of a co-managed Geriatric Fracture Center reduces hospital stay and time-to-operation in elderly femoral neck fracture patients. Archives of Orthopaedic and Trauma Surgery 2013, 133:1527-1531.
3. Boddaert J., Cohen-Bittan J., Le Manach F., Raux Y., Beinis M., Khiami J.Y., et al. Postoperative admission to a dedicated geriatric unit decreases mortality in elderly patients with hip fracture. PLoS One 2014, 9:e8379.
4. Bottle A., Aylin P. Mortality associated with delay in operation after hip fracture: an observational study. BMJ 2006, 332:947-951.
5. Buecking B., Timmesfeld N., Bliemel S., Hartwig C., Friess E., Riem T., et al. Early orthogeriatric treatment of trauma in the elderly: a systematic review and metaanalysis. Deutsches Ärzteblatt International 2013, 110:255-262.
6. Carretta E., Bochicchio V., Fabbri P., Laus G., Fantini M., Rucci M.P. Hip fracture: effectiveness of early surgery to prevent 30-day mortality. International Orthopaedics 2011, 35:419-424.
7. Della Rocca G.J., Moylan K.C., Volgas B.D., Stannard D.A., Mehr J.P., Crist D.R. Comanagement of geriatric patients with hip fractures: a retrospective, controlled: cohort study. Geriatric Orthopaedic Surgery & Rehabilitation 2013, 4:10-15.
8. Dettoni F., Peveraro A., Dettoni A. Epidemiology of hip fractures in northwestern Italy: a multicentric regional study on incidence of hip fractures and their outcome at 3-year follow-up. Musculoskelet Surgery 2012, 96:41-46.
9. Deyo R.A., Cherkin D.C., Ciol M.A. Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. Journal of Clinical Epidemiology 1992, 45:613-619.
10. Flikweert E.R., Izaks G.J., Stevens B.A., Wendt M., Knobben K. The development of a comprehensive multidisciplinary care pathway for patients with a hip fracture:design and results of a clinical trial. BMC Musculoskeletal Disorders 2014, 15:188.
11. Friedman S.M., Mendelson D.A., Kates K.W., Bingham S.L. Impact of a comanaged geriatric fracture center on short-term hip fracture outcomes. Archives of Internal Medicine 2009, 169:1712-1717.
12. Frost S.A., Nguyen N.D., Eisman D.A., Nguyen J.A., Black T.V. Risk factors for in-hospital post-hip fracture mortality. Bone 2011, 49:553-558.
13. Gdalevich M., Cohen D., Yosef D., Tauber C. Morbidity and mortality after hip fracture: the impact of operative delay. Archives of Orthopaedic and Trauma Surgery 2004, 124:334-340.
14. Gregersen M., Mørch M.M., Damsgaard K.J., Hougaard E.M. Geriatric intervention in elderly patients with hip fracture in an orthopedic ward. The Journal of Injury and Violence Research 2012, 2012(4):45-51.
15. Grigoryan K.V., Javedan H., Rudolph J.L. Ortho-geriatric care models and outcomes in hip fracture patients: a systematic review and meta-analysis. Journal of Orthopaedic Trauma 2014, 28:e49-55.
16. Haentjens P., Magaziner J., Vanderschueren C.S., Milisen D., Velkeniers K., Colón-Emeric B., et al. Meta-analysis: excess mortality after hip fracture among older women and men. Annals of Internal Medicine 2010, 16(152):380-390.
17. Hip fracture. Evidence update march 2013. Available from: (Accessed 30.11.15). http://www.ncgc.ac.uk.
18. Holt G., Smith R., Finlayson K., Gregori D.F., Duncan A. Early mortality after surgical fixation of hip fractures in the elderly: an analysis of data from the Scottish hip fracture audit. The Journal of Bone and Joint Surgery 2008, 90:1357-1363.
19. Holt G., Smith R., McKeown K., Duncan D.W. Does delay to theatre for medical reasons affect the peri-operative mortality inpatients with a fracture of the hip?. The Journal of Bone and Joint Surgery 2010, 92:835-841.
20. Kates S.L., Mendelson D.A., Friedman S.M. Co-managed care for fragility hip fractures (Rochester model). Osteoporosis International 2010, 21(Suppl. 4):S621-S625.
21. Khan S.K., Kalra S., Khanna A., Parker M.M., Thiruvengada M.J. Timing of surgery for hip fractures: a systematic review of 52 published studies involving 291,413 patients. Injury 2009, 40:692-697.
22. Laforgia R., Maggi S., Bianchi C., Crepaldi D., Marzari G. Epidemiology of femoral neck fracture in old people in Italy. Journal of Bone and Joint Surgery 2006, 88B(Suppl. I):42.
23. Lau T.W., Fang C., Leung F. The effectiveness of a geriatric hip fracture clinical pathway in reducing hospital and rehabilitation length of stay and improving short-term mortality rates. Geriatric Orthopaedic Surgery & Rehabilitation 2013, 4:3-9.
24. Librero J., Peiró S., Merlo E., Bernal-Delgado J., Ridao E., Leutscher M., et al. Timing of surgery for hip fracture and in-hospital mortality: a retrospective population-based cohort study in the Spanish National Health System. BMC Health Services Research 2012, 12:15.
25. Lynch G., Tower M., Venturato L. Identifying outcomes associated with co-managed care models for patients who have sustained a hip fracture: an integrative literature review. The International Journal of Orthopaedic and Trauma Nursing 2015, 19:140-154.
26. Majumdar S.R., Beaupre L.A., Dick D.W., Cinats D.A., Jiang J.G., Johnston H.X. Lack of association between mortality and timing of surgical fixation in elderly patients with hip fracture: results of a retrospective population-based cohort study. Medical Care 2006, 44:552-559.
27. Moja L., Piatti A., Ricci V., Virgili C., Salanti G., Pecoraro G., et al. Timing matters in hip fracture surgery: patients operated within 48Hours have better outcomes a meta-analysis and meta-regression of over 190,000 patients. PLoS One 2012, 7:e46175.
28. NICE Clinical Guidelines No.124 The management of hip fracture in adults 2011, Royal College of Physicians (UK)., London, Accessed 30.11.15. http://www.ncbi.nlm.nih.gov/books/NBK83014/.
29. Orosz G.M., Magaziner J., Morrison E.L., Koval R.S., Gilbert K., Hannan M., et al. Association of timing of surgery for hip fracture and patient outcomes. JAMA 2004, 291:1738-1743.
30. Roche J.J., Wenn R.T., Sahota O., Moran C.G. Effect of comorbidities and postoperative complications on mortality after hip fracture in elderly people: prospective observational cohort study. BMJ 2005, 331:1374.
31. Rostagno C., Cartei A., Landi R., Gensini F., Buzzi G.F. Multidisciplinary approach to hip fracture in the elderly: florence experience. Emergency Medicine 2013, 3:148.
32. Simunovic N., Devereaux M.D., Guyatt S., Schemitsch G.H., Debeer E., Sprague J., et al. Effect of early surgery after hip fracture on mortality and complications: systematic review and meta-analysis. CMAJ 2010, 182:1609-1616.
33. Simunovic N., Devereaux P.J., Bhandari M. Surgery for hip fractures: does surgical delay affect outcomes?. Indian Journal of Orthopaedics 2011, 45:27-32.
34. Sund R., Liski A. Quality effects of operative delay on mortality in hip fracture treatment. Quality and Safety in Health Care 2005, 14:371-377.
35. Wilkins K. Health care consequences of falls for seniors. Health Reports 1999, 10:47-55.
36. Zuckerman J.D. Hip fracture. The New England Journal of Medicine 1996, 334:1519-1525.