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Elderly adults with isolated hip fractures- orthogeriatric care vs standard care: A practice management guideline from the Eastern Association for the Surgery of Trauma

The Journal of Trauma and Acute Care Surgery Feb 06, 2020

Mukherjee K, Brooks SE, Barraco RD, et al. - Considering that orthogeriatric (OG) management services, in which geriatric specialists primarily manage or co-manage patients after admission, may improve outcomes (morbidity and mortality) in elderly patients suffering from isolated hip fractures, researchers here sought to present recommendations regarding the role of OG services. The Practice Management Guidelines Committee of the Eastern Association for the Surgery of Trauma carried a systematic review of the literature from January 1, 1900, to August 31, 2017, employing GRADE methodology with meta-analyses. They evaluated 45 articles were evaluated. The criteria for quantitative analysis were fulfilled by six randomized controlled trials and seven retrospective case-control studies. For critical outcomes, retrospective case-control studies illustrated OG as beneficial in achieving improvement in 30-day mortality, however, this was not confirmed prospectively or at 1 year. With OG, superior functional outcomes were achieved, particularly there was an improvement in score on the Short Physical Performance Battery at 4 months and an improvement in score on the Mini Mental Status Examination at 12 months. With OG, improved execution of activities of daily living was noted as measured by two separate tests at 4 and 12 months. Further, the OG group had fewer hospital-acquired pressure ulcers. Overall low quality of evidence was generated in this work. In view of these findings, they conditionally recommend an OG care model to improve patient outcomes for geriatric patients with isolated hip fracture.
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