Functional outcomes and mortality in geriatric and fragility hip fractures—results of an integrated, multidisciplinary model experienced by the “Florence hip fracture unit”
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The aim of this study was to evaluate the outcomes of an integrated multidisciplinary hip fracture unit through the following parameters: time to surgery, mortality, return to activities of daily living, adherence to re-fractures prevention programs.
Six hundred seventy-seven consecutive patients with hip fracture were included in the study. We calculated the time to surgery as the time in hours from admission until surgery. The in-hospital mortality was calculated as the number of deaths that occurred before discharge. Each patient was then evaluated post-operatively at six weeks, three months, and one year. We studied basic activity of daily living (BADL) and the New Mobility Scale (NMS). Adherence to re-fractures prevention programs was also evaluated.
88.9% of patients underwent surgery within two calendar days from admission. In-hospital mortality was 2.4%, and the overall mortality at one year from the intervention was 18.7%. Full mobility status or a low impairment of the mobility status was reached in 32.1% of the patients at one year and a level ≥ 3 of autonomy in BADL was reached in 62.4% (338/542) of patients. Three hundred forty-two patients were prescribed a specific therapy for secondary prevention of re-fracture.
An integrated, multidisciplinary model for the treatment of hip fragility fractures was effective in reducing time to surgery and mortality, increasing the level autonomy and mobility status and promoting adherence to re-fracture therapy.
KeywordsBasic activity of daily living (BADL) Hip fractures (HF) Mortality
Compliance with ethical standards
Conflict of interest
The authors declare that there is no conflict of interest.
- 2.Innocenti M, Civinini R, Carulli C, Matassi F (2009) Proximal femural fractures: epidemiology. Clin Cases Miner Bone Metab 6:117–119Google Scholar
- 11.Giusti A, Barone A (2011) Optimal setting and care organization in the management of older adults with hip fracture. Eur J Phys Rehabil Med 47:281–290Google Scholar
- 12.British Orthopaedic Association (2007) The care of patients with fragility fractures. (Guideline ref ID: BOA2007). https://doi.org/10.1136/bmj.2.5211.1518
- 13.Academy A, Board OS, September D (2014) Clinical practice guideline on the treatment of hip fracture in the elderly adopted by the American Academy of Orthopaedic Surgeons Board of Directors. AaosGoogle Scholar
- 20.Moyet J, Deschasse G, Marquant B et al (2018) Which is the optimal orthogeriatric care model to prevent mortality of elderly subjects post hip fractures? A systematic review and meta-analysis based on current clinical practice. Int Orthop:1–6. https://doi.org/10.1007/s00264-018-3928-5
- 24.Forni C, Gazineo D, D’Alessandro F et al (2018) Predictive factors for thirty day mortality in geriatric patients with hip fractures: a prospective study. Int Orthop. https://doi.org/10.1007/s00264-018-4057-x