[Interdisciplinary geriatric intervention among nursing home residents with hip fracture reduces mortality]

Ugeskr Laeger. 2010 Jun 21;172(25):1902-7.
[Article in Danish]

Abstract

Introduction: Nursing home residents represent the majority of hip fracture hospitalisation cases. Quick discharge to nursing homes after surgery is common practice. A previous study indicates an increased risk of death immediately after discharge.

Material and methods: A total of 211 residents, hospitalised from nursing homes for hip fracture surgery, were selected for a retrospective follow-up study. The orthopaedic ward's geriatric team (GO-team) visited the residents no later than one day after discharge. The number of visits depended on the need for treatment and rehabilitation. Intervention was, among others, focussed on: nutrition, fluid therapy and blood transfusion.

Results: Intensive geriatric intervention reduced the 30-day mortality (odds ratio (OR) = 0.08; 95% confidence interval (CI): 0.01; 0.52) and reduced 3-month mortality (OR = 0.03; 95% CI: 0.003; 0.25). Fluid therapy and nutritional support were associated with reduced probability of death (OR = 0.12; 95% CI: 0.02; 0.67)/(OR = 0.23; 95% CI: 0.07; 0.79). Non-elective readmissions were reduced (OR = 0.20; 95% CI: 0.04; 0.91). Post-surgical blood transfusion was associated with improved functional ability (beta = 8.22; 95% CI: 1.44; 15.0).

Conclusion: Geriatric interdisciplinary intervention among residents in nursing homes has a positive effect and improves survival and reduces non-elective readmission within three months. Still, there is uncertainty about the effect of fluid therapy and blood transfusions and further investigations are needed.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Female
  • Follow-Up Studies
  • Geriatric Assessment
  • Geriatric Nursing / methods*
  • Hip Fractures / mortality*
  • Hip Fractures / rehabilitation
  • Hip Fractures / surgery
  • Humans
  • Interdisciplinary Communication
  • Male
  • Nursing Homes
  • Orthopedics
  • Patient Care Team
  • Patient Discharge
  • Patient Readmission
  • Retrospective Studies
  • Workforce