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Comprehensive Geriatric Assessment in Orthogeriatrics

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Comprehensive Geriatric Assessment

Part of the book series: Practical Issues in Geriatrics ((PIG))

Abstract

Hip fractures (HF) are a major healthcare issue in developed countries, being associated with significant mortality, disability and relevant healthcare costs. The growing awareness of the detrimental consequences of hip and other fragility fractures have led to the development and implementation of integrated models of care alternative to the traditional ones for acute and post-acute management of fractured older adults. These services, generically designed as Orthogeriatric Units, were set to improve survival, quality of life, functional and clinical outcomes, and to reduce healthcare costs associated with HF.

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References

  1. Giusti A, Barone A, Razzano A et al (2015) Optimal setting and care organization in the management of older adults with hip fracture: a narrative review. Geriatr Care 1:5602

    Article  Google Scholar 

  2. Pioli G, Giusti A, Barone A (2008) Orthogeriatric care for the elderly with hip fractures: where are we? Aging Clin Exp Res 20:113–122

    Article  PubMed  Google Scholar 

  3. Roth T, Kammerlander C, Gosch M et al (2010) Outcome in geriatric fracture patients and how it can be improved. Osteoporos Int 21(Suppl 4):S615–S619

    Article  CAS  PubMed  Google Scholar 

  4. Gosch M, Hoffmann-Weltin Y, Roth T et al (2016) Orthogeriatric co-management improves the outcome of long-term care residents with fragility fractures. Arch Orthop Trauma Surg 136:1403–1409

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Pioli G, Barone A, Giusti A et al (2006) Predictors of mortality after hip fracture: results from 1-year follow-up. Aging Clin Exp Res 18:381–387

    Article  CAS  PubMed  Google Scholar 

  6. Barone A, Giusti A, Pizzonia M et al (2006) A comprehensive geriatric intervention reduces short- and long-term mortality in older people with hip fracture. J Am Geriatr Soc 54:1145–1147

    Article  PubMed  Google Scholar 

  7. Kammerlander C, Gosch M, Kammerlander-Knauer U et al (2011) Long-term functional outcome in geriatric hip fracture patients. Arch Orthop Trauma Surg 131:1435–1444

    Article  PubMed  Google Scholar 

  8. Giusti A, Barone A, Pioli G (2007) Rehabilitation after hip fracture in patients with dementia. J Am Geriatr Soc 55:1309–1310

    Article  PubMed  Google Scholar 

  9. Giusti A, Barone A, Oliveri M et al (2006) An analysis of the feasibility of home rehabilitation among elderly people with proximal femoral fractures. Arch Phys Med Rehabil 87:826–831

    Article  PubMed  Google Scholar 

  10. Piscitelli P, Iolascon G, Argentiero A et al (2012) Incidence and costs of hip fractures vs strokes and acute myocardial infarction in Italy: comparative analysis based on national hospitalization records. Clin Interv Aging 7:575–583

    Article  PubMed  PubMed Central  Google Scholar 

  11. Pilotto A, Cella A, Pilotto A et al (2017) Three decades of comprehensive geriatric assessment: evidence coming from different healthcare settings and specific clinical conditions. J Am Med Dir Assoc 18:192.e1–192.e11

    Article  Google Scholar 

  12. Ekegren CL, Edwards ER, Oppy A et al (2017) Twelve-month work-related outcomes following hip fracture in patients under 65 years of age. Injury 48(3):701–707. doi:10.1016/j.injury.2017.01.033

    Article  PubMed  Google Scholar 

  13. Ekegren CL, Edwards ER, Page R et al (2016) Twelve-month mortality and functional outcomes in hip fracture patients under 65 years of age. Injury 47:2182–2188

    Article  CAS  PubMed  Google Scholar 

  14. Ramoutar DN, Kodumuri P, Rodrigues JN et al (2017) The epidemiology and functional outcomes of operative fixation of extracapsular proximal femoral fractures (AO 31-A) in young adults. Eur J Orthop Surg Traumatol 27:267–272

    Article  CAS  PubMed  Google Scholar 

  15. Adachi JD, Adami S, Gehlbach S et al (2010) Impact of prevalent fractures on quality of life: baseline results from the global longitudinal study of osteoporosis in women. Mayo Clin Proc 85:806–813

    Article  PubMed  PubMed Central  Google Scholar 

  16. Fink HA, Ensrud KE, Nelson DB et al (2003) Disability after clinical fracture in postmenopausal women with low bone density: the fracture intervention trial (FIT). Osteoporos Int 14:69–76

    Article  CAS  PubMed  Google Scholar 

  17. Ensrud KE, Thompson DE, Cauley JA et al (2000) Prevalent vertebral deformities predict mortality and hospitalization in older women with low bone mass. Fracture intervention trial research group. J Am Geriatr Soc 48:241–249

    Article  CAS  PubMed  Google Scholar 

  18. Nevitt MC, Ettinger B, Black DM et al (1998) The association of radiographically detected vertebral fractures with back pain and function: a prospective study. Ann Intern Med 128:793–800

    Article  CAS  PubMed  Google Scholar 

  19. Gosch M, Druml T, Nicholas JA et al (2015) Fragility non-hip fracture patients are at risk. Arch Orthop Trauma Surg 135:69–77

    Article  CAS  PubMed  Google Scholar 

  20. Gladman JR (2016) Delivering comprehensive geriatric assessment in new settings: advice for frontline clinicians. J R Coll Physicians Edinb 46:174–179

    Article  CAS  PubMed  Google Scholar 

  21. Vitale E, Notarnicola A, Tafuri S et al (2014) Orthopedic multidimensional prognostic index (Ortho-MPI) in the elderly with hip or neck femur fracture: a pilot study. Arch Gerontol Geriatr 58:101–104

    Article  PubMed  Google Scholar 

  22. Vitale E, Notarnicola A, Moretti L et al (2012) Multidimensional prognostic index in the elderly with hip or neck femur fracture. Orthop Rev (Pavia) 4:e15

    Article  Google Scholar 

  23. Prestmo A, Hagen G, Sletvold O et al (2015) Comprehensive geriatric care for patients with hip fractures: a prospective, randomised, controlled trial. Lancet 385:1623–1633

    Article  PubMed  Google Scholar 

  24. Sletvold O, Helbostad JL, Thingstad P et al (2011) Effect of in-hospital comprehensive geriatric assessment (CGA) in older people with hip fracture. The protocol of the trondheim hip fracture trial. BMC Geriatr 11:18

    Article  PubMed  PubMed Central  Google Scholar 

  25. Liem IS, Kammerlander C, Suhm N et al (2013) Identifying a standard set of outcome parameters for the evaluation of orthogeriatric co-management for hip fractures. Injury 44:1403–1412

    Article  CAS  PubMed  Google Scholar 

  26. Giusti A, Barone A, Razzano M et al (2008) Predictors of hospital readmission in a cohort of 236 elderly discharged after surgical repair of hip fracture: one-year follow-up. Aging Clin Exp Res 20:253–259

    Article  PubMed  Google Scholar 

  27. Lawrence VA, Hilsenbeck SG, Noveck H et al (2002) Medical complications and outcomes after hip fracture repair. Arch Intern Med 162:2053–2057

    Article  PubMed  Google Scholar 

  28. Mitchell P, Åkesson K, Chandran M et al (2016) Implementation of models of care for secondary osteoporotic fracture prevention and orthogeriatric models of care for osteoporotic hip fracture. Best Pract Res Clin Rheumatol 30:536–558

    Article  PubMed  Google Scholar 

  29. Leal J, Gray AM, Hawley S et al (2017) Cost-effectiveness of orthogeriatric and fracture liaison service models of care for hip fracture patients: a population-based study. J Bone Miner Res 32:203–211

    Article  PubMed  Google Scholar 

  30. Blain H, Masud T, Dargent-Molina P et al (2016) A comprehensive fracture prevention strategy in older adults: the European union geriatric medicine society (EUGMS) statement. Aging Clin Exp Res 28:797–803

    Article  CAS  PubMed  Google Scholar 

  31. Hawley S, Javaid MK, Prieto-Alhambra D et al (2016) Clinical effectiveness of orthogeriatric and fracture liaison service models of care for hip fracture patients: population-based longitudinal study. Age Ageing 45:236–242

    Article  PubMed  PubMed Central  Google Scholar 

  32. Nakayama A, Major G, Holliday E et al (2016) Evidence of effectiveness of a fracture liaison service to reduce the re-fracture rate. Osteoporos Int 27:873–879

    Article  CAS  PubMed  Google Scholar 

  33. Martinez-Reig M, Ahmad L, Duque G (2012) The orthogeriatrics model of care: systematic review of predictors of institutionalization and mortality in post-hip fracture patients and evidence for interventions. J Am Med Dir Assoc 13:770–777

    Article  PubMed  Google Scholar 

  34. Pioli G, Lauretani F, Davoli ML et al (2012) Older people with hip fracture and IADL disability require earlier surgery. J Gerontol A Biol Sci Med Sci 67:1272–1277

    Article  PubMed  Google Scholar 

  35. Pilotto A, Ferrucci L, Franceschi M et al (2008) Development and validation of a multidimensional prognostic index for one-year mortality from comprehensive geriatric assessment in hospitalized older patients. Rejuvenation Res 11:151–161

    Article  PubMed  PubMed Central  Google Scholar 

  36. Grigoryan KV, Javedan H, Rudolph JL (2014) Orthogeriatric care models and outcomes in hip fracture patients: a systematic review and meta-analysis. J Orthop Trauma 28:e49–e55

    Article  PubMed  PubMed Central  Google Scholar 

  37. Kammerlander C, Gosch M, Blauth M et al (2011) The tyrolean geriatric fracture center: an orthogeriatric co-management model. Z Gerontol Geriatr 44:363–367

    Article  CAS  PubMed  Google Scholar 

  38. Adunsky A, Arad M, Levi R et al (2005) Five-year experience with the 'Sheba' model of comprehensive orthogeriatric care for elderly hip fracture patients. Disabil Rehabil 27:1123–1127

    Article  PubMed  Google Scholar 

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Correspondence to Andrea Giusti .

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Giusti, A., Kammerlander, C. (2018). Comprehensive Geriatric Assessment in Orthogeriatrics. In: Pilotto, A., Martin, F. (eds) Comprehensive Geriatric Assessment. Practical Issues in Geriatrics. Springer, Cham. https://doi.org/10.1007/978-3-319-62503-4_11

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  • DOI: https://doi.org/10.1007/978-3-319-62503-4_11

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-62502-7

  • Online ISBN: 978-3-319-62503-4

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