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Outcome parameters in orthogeriatric co‑management – a mini-review

  • geriatrics: at crossroads of medicine
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Summary

Recognizing hip and other fragility fractures as an adverse event of chronic geriatric conditions led to the concept of orthogeriatric co-management (OGC). OGC today represents various forms of structural cooperation between orthopedic trauma surgeons and multiprofessional geriatric teams taking care of frail elderly patients. The models are country specific. Despite several published models there are still no clear recommendations on how this service should be best organized. The 12 outcome parameters published by the Experts’ Roundtable in 2013 were recommended to be used for the further assessment of different OCG models. This literature review was prepared accordingly and showed the need for further studies to determine the best OGC model and to define a uniform set of outcome parameters for use in future clinical studies.

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References

  1. Komadina R, Senekovič V, Dolenc I, Andoljšek M, Grabljevec K, Veninšek G, Preželj J, Kocjan T. Recommendations for hip fracture management in Slovenia. Zdrav Vestn. 2012;81:183–92.

    Google Scholar 

  2. WHO The Global Strategy and Action Plan on Ageing and Health 2016–2020. Available from: http://www.who.int/ageing/global-strategy/en/. Last access: June 2016.

  3. Edwards MH, Dennison EM, Aihie Sayer A, Fielding R, Cooper C. Osteoporosis and sarcopenia in older age. Bone. 2015;80:126–30.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Kanis JA, Johnell O, Oden A, Johansson H, McCloskey EV. FRAX™ and the assessment of fracture probability in men and women from the UK. Osteoporos Int. 2008;19:385–3975.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Ström O, Borgström F, Kanis JA, Compston J, Cooper C, McCloskey EV, et al. Osteoporosis: burden, health care provision and opportunities in the EU: a report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos. 2011;6:59–155.

    Article  PubMed  Google Scholar 

  6. Wendt K, Heim D, Josten C, Kdolsky R, Oestern HJ, Palm H, Sintenie JB, Komadina R, Copuroglu C. Recommendations on hip fracture management. Eur J Trauma Emerg Surg. 2016;42:425–31.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Bartoníček J. Early history of operative treatment of fractures. Arch Orthop Trauma Surg. 2010;130:1385–96.

    Article  PubMed  Google Scholar 

  8. Posinković B. Prijelom vrata bedrene kosti, femoral neck fracture. Zagreb: Školska knjiga; 1985, pp 11–5.

    Google Scholar 

  9. Friedman SM, Mendelson DA, Kates S, McCann R. Geriatric co-management of proximal femur fractures: total quality management and protocol driven care result in better outcomes for a frail patient population. J Am Geriatr Soc. 2008;56:1349–56.

    Article  PubMed  Google Scholar 

  10. Flikweert ER, Izaks GJ, Knobben BA, Stevens M, Wendt K. The development of a comprehensive multidisciplinary care pathway for patients with a hip fracture: design and results of a clinical trial. Bmc Musculoskelet Disord. 2014;15:188.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Kanis JA, Johnell O, Oden A. Ten year probabilities of osteoporotic fractures according to BMD and diagnostic tresholds. Osteoporos Int. 2001;12:989–95.

    Article  CAS  PubMed  Google Scholar 

  12. Kammerlander C, Roth T, Friedman SM, Suhm N, Luger TJ, Kammerlander Knauer U, Krappinger D. Ortho-geriatric service – a literature review comparing different models. Osteoporos Int. 2010;21(S4):637–46.

    Article  Google Scholar 

  13. Liem IS, Kammerlander C, Suhm N, Blauth M, Roth T, Gosch M, Hoang-Kim A, Mendelson D, Zuckerman J, Leung F, Burton J, Moran C, Parker M, Giusti A, Pioli G, Goldhahn J, Kates SL. Identifying a standard set of outcome parameters for the evaluation of orthogeriatric co-management for hip fractures. Injury. 2013;44:1403–12.

    Article  CAS  PubMed  Google Scholar 

  14. Bachmann S, Finger C, Huss A, Egger M, Stuck AE, Clough KM. Inpatient rehabilitation specifically designed for geriatric patients: systematic review and meta-analysis of randomized controlled trials. BMJ. 2010;340:1718.

    Article  Google Scholar 

  15. Wyller RB, Watne LO, Torbergsen A, Engedal K, Frihagen F, Juliebo V, Saltvedt I, Skovlund E, Raeder J, Conroy S. The effect of a pre- and postoperative orthogeriatric service on cognitive function in patients with hip fracture. The Protocol of the Oslo Orthogeriatrics Trial. BMC Geriatr. 2012;12:36–46.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Kanis JA, McCloskey EV, Johansson H, Cooper C, Rizzoli R, Reginster JY. European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int. 2013;24:23–57.

    Article  CAS  PubMed  Google Scholar 

  17. National institute for Health and Clinical Excellence. NICE technology appraisal guidances, 2011. Available from: https://www.nice.org.uk/about/what-we-do/our-programmes/nice-guidance/nice-technology-appraisal-guidance. Last access: June 2016.

  18. Grigoryan KV, Javedan H, Rudolph JL. Orthogeriatric care models and outcomes in hip fracture patients: A systematic Review and meta-analysis. J Orthop Trauma. 2014;3:49–55.

    Article  Google Scholar 

  19. Suhm N, Kaelin R, Studer P, Wang Q, Kressig RW, Rikli D, Jakob M, Pretto M. Orthogeriatric care pathway: a prospective survey of impact on length of stay, mortality and institutionalisation. Arch Orthop Trauma Surg. 2014;134:1261–9.

    Article  CAS  PubMed  Google Scholar 

  20. Ireland AW, Kelly PJ, Cumming RG. Total hospital stay for hip fracture: measuring the variations due to prefracture residence, rehabilitation, complications and comorbidities. BMC Health Serv Res. 2015;22:5–17.

    Google Scholar 

  21. Uriz-Otano F, Uriz-Otano JI, Malafarina V. Factors associated with short-term functional recovery in elderly people with a hip fracture. Influence of cognitive impairment. J Am Med Dir Assoc. 2015;16:215–20.

    Article  PubMed  Google Scholar 

  22. Mesa-Lampre MP, Canales-Cortes V, Castro-Vilela ME, Clarencia-Sierra M. Initial experience of an orthogeriatric unit. Rev Esp Cir Ortop Traumatol. 2015;59:429–38.

    CAS  PubMed  Google Scholar 

  23. Luger TJ, Luger MF. Anesthesiological care in orthogeriatric co-management: perioperative treatment of geriatric trauma. Z Gerontol Geriatr. 2016;49:237–55.

    Article  PubMed  Google Scholar 

  24. Lynch G, Shaban RZ, Messey D. Evaluating the orthogeriatric model of care at an Australian tertiary hospital. Int J Orthop Trauma Nurs. 2015;19:184–93.

    Article  PubMed  Google Scholar 

  25. Henderson CY, Ryan JP. Predicting mortality following hip fracture: an analysis of comorbidities and complications. Ir J Med Sci. 2015;184:667–71.

    Article  CAS  PubMed  Google Scholar 

  26. Prestmo A, Hagen G, Sletvold O, Helbostad J, Thingstad P, Taraldsen K, Lydersen S, Halsteinli V, Saltnes T, Lamb SE, Johnsen LG, Saltvedt J. Comprehensive geriatric care for patients with hip fractures: a prospective, randomised, controlled trial. Lancet. 2015;385:1623–33.

    Article  PubMed  Google Scholar 

  27. Buecking B, Timmesfeld N, Riem S, Bliemel C, Hartwig E, Fries T, Liener U, Ruchholtz S, Eschbach D. Early orthogeriatric treatment of trauma in the elderly. A systematic review and metaanalysis. Dtsch Arztebl Int. 2013;110:256–62.

    Google Scholar 

  28. Martocchia A, Curto M, Comite F, Scaccianoce S, Girardi P, Ferracuti S, Nicoletti F, Falaschi P. The prevention and treatment of delirium in elderly patients following hip fracture surgery. Recent Pat CNS Drug Discov. 2015;10:55–64.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Radko Komadina.

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R. Komadina, K.W. Wendt, G. Holzer, and T. Kocjan declare that they have no competing interests.

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Komadina, R., Wendt, K.W., Holzer, G. et al. Outcome parameters in orthogeriatric co‑management – a mini-review. Wien Klin Wochenschr 128 (Suppl 7), 492–496 (2016). https://doi.org/10.1007/s00508-016-1118-2

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  • DOI: https://doi.org/10.1007/s00508-016-1118-2

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