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.
References
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
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
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
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
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
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
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
Giusti A, Barone A, Pioli G (2007) Rehabilitation after hip fracture in patients with dementia. J Am Geriatr Soc 55:1309–1310
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
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
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
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
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
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
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
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
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
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
Gosch M, Druml T, Nicholas JA et al (2015) Fragility non-hip fracture patients are at risk. Arch Orthop Trauma Surg 135:69–77
Gladman JR (2016) Delivering comprehensive geriatric assessment in new settings: advice for frontline clinicians. J R Coll Physicians Edinb 46:174–179
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
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
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
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
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
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
Lawrence VA, Hilsenbeck SG, Noveck H et al (2002) Medical complications and outcomes after hip fracture repair. Arch Intern Med 162:2053–2057
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
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
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
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
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
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
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
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
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
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
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
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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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