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Collaborative care provided by geriatricians and surgeons to older adults with hip fracture reduces risk of death and time in hospital

Grigoryan KV, Javedan H, Rudolph JL  Orthogeriatric care models and outcomes in hip fracture patients: A systematic review and meta-analysis Journal of Orthopaedic Trauma. 2014;28(3):e49-55.

Review question

What approaches to caring for older adults that suffer a hip fracture, and that involve both a geriatrician and a surgeon, are the most effective for improving patient outcomes?

Background

As the population of older adults grows in many countries, the number of hip fractures is expected to increase dramatically in the coming decades.

Hip fractures may lead to a loss of independence and the need for admittance into nursing home facilities, and also increase the risk of death.

Improving care may require additional collaboration between geriatricians and surgeons who perform hip-fracture surgeries.

How the review was done

Several online databases were searched for research published from 1992 to 2012, and studies were included if they met specific quality criteria, and focused on approaches involving a geriatrician and a surgeon for managing inpatient care of older adults with hip fractures.

1,480 unique studies were identified in searches and 18 were included in the review after being assessed by the authors for eligibility.

The study was funded by the National Institutes of Health in the United States.

What the researchers found

Collaboration between geriatricians and surgeons, consistently scheduled consultations between them, and care provided by teams can reduce length of stay in hospital and risk of death for older adults with a hip fracture.

Geriatricians need to play a key role in training health professionals who provide care to older adults with hip fracture, given their understanding of the interplay between aging, stress from undergoing surgery, and the impact of surgery on functioning.

Little evidence is available to suggest which model of collaborative care is the most effective, and more studies need to consider how different models of care affect physical functioning.

Conclusion

Collaborative models of care involving geriatricians and surgeons can reduce length of stay in hospital and reduce the risk of death among older adults with a hip fracture.

This summary is based on a review that was determined to be of medium methodological quality based on an assessment using the AMSTAR tool.