Four-month outcome after proximal femur fractures and influence of early geriatric rehabilitation: data from the German Centres of Geriatric Trauma DGU.
Hip fracture
Mortality
Orthogeriatric co-management
Proximal femur fracture
Quality of life
Journal
Archives of osteoporosis
ISSN: 1862-3514
Titre abrégé: Arch Osteoporos
Pays: England
ID NLM: 101318988
Informations de publication
Date de publication:
12 04 2021
12 04 2021
Historique:
received:
01
12
2020
accepted:
16
03
2021
entrez:
13
4
2021
pubmed:
14
4
2021
medline:
22
4
2021
Statut:
epublish
Résumé
This study analyzed the outcome of orthogeriatric patients with hip fracture 4 months after surgery. The overall mortality rate was 12.2%. Sixty-five percent presented a degradation in walking ability, and 16% had to move to a nursing home. Early geriatric rehabilitation reduces the mortality rate and increases the rate of anti-osteoporotic treatment. Hip fractures are increasingly common with severe consequences. Therefore, the German Trauma Society (DGU) implemented an orthogeriatric co-management and developed the concept for certified Centre for Geriatric Trauma DGU. The patients' treatment data and the optional 120 days of follow-up were collected in the Registry for Geriatric Trauma DGU (ATR-DGU). This study analyzed these 4-month treatment results. A retrospective analysis of the ATR-DGU was conducted. Outcome parameters were the rate of readmission, rate of re-surgery, anti-osteoporotic therapy, housing, mortality, walking ability, and quality of life (QoL) 120 days post-surgery. The influence of the early geriatric rehabilitation (EGR) was evaluated using a regression analysis. The follow-up data from 9780 patients were included. After 120 days, the mortality rate was 12.2%, the readmission rate 4%, and the re-surgery rate 3%. The anti-osteoporotic treatment increased from 20% at admission to 32%; 65% of the patients had a degradation in walking ability, and 16% of the patients who lived in their domestic environment pre-surgery had to move to a nursing home. QoL was distinctly reduced. The EGR showed a positive influence of anti-osteoporotic treatment (p<0.001) and mortality (p=0.011) but led to a slight reduction in QoL (p=0.026). The 4-month treatment results of the ATR-DGU are comparable to international studies. The EGR led to a significant rise in anti-osteoporotic treatment and a reduction in mortality with a slight reduction in QoL.
Identifiants
pubmed: 33846869
doi: 10.1007/s11657-021-00930-9
pii: 10.1007/s11657-021-00930-9
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
68Références
Veronese N, Maggi S (2018) Epidemiology and social costs of hip fracture. Injury 49:1458–1460. https://doi.org/10.1016/j.injury.2018.04.015
doi: 10.1016/j.injury.2018.04.015
Friedman SM, Mendelson DA, Bingham KW, Kates SL (2009) Impact of a comanaged Geriatric Fracture Center on short-term hip fracture outcomes. Arch Intern Med 169:1712–1717. https://doi.org/10.1001/archinternmed.2009.321
doi: 10.1001/archinternmed.2009.321
pubmed: 19822829
Hempsall VJ, Robertson DRC, Campbell MJ, Briggs RS (1990) Orthopaedic geriatric care—is It effective? A prospective population-based comparison of outcome in fractured neck of femur. J R Coll Physicians Lond 24:47–50
pubmed: 2308114
pmcid: 5387449
Vidán M, Serra JA, Moreno C et al (2005) Efficacy of a comprehensive geriatric intervention in older patients hospitalized for hip fracture: a randomized, controlled trial. J Am Geriatr Soc 53:1476–1482. https://doi.org/10.1111/j.1532-5415.2005.53466.x
doi: 10.1111/j.1532-5415.2005.53466.x
pubmed: 16137275
Knobe M, Böttcher B, Coburn M, Friess T, Bollheimer LC, Heppner HJ, Werner CJ, Bach JP, Wollgarten M, Poßelt S, Bliemel C, Bücking B (2019) Geriatric Trauma Center DGU®: evaluation of clinical and economic parameters: a pilot study in a German university hospital. Unfallchirurg 122:134–146. https://doi.org/10.1007/s00113-018-0502-y
doi: 10.1007/s00113-018-0502-y
pubmed: 29675629
Buecking B, Timmesfeld N, Riem S, Bliemel C, Hartwig E, Friess T, Liener U, Ruchholtz S, Eschbach D (2013) Early orthogeriatric treatment of trauma in the elderly: a systematic review and metaanalysis. Dtsch Arztebl Int 110:255–262. https://doi.org/10.3238/arztebl.2013.0255
doi: 10.3238/arztebl.2013.0255
pubmed: 23667392
pmcid: 3647136
Hawley S, Javaid MK, Prieto-Alhambra D, Lippett J, Sheard S, Arden NK, Cooper C, Judge A, REFReSH study group (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. https://doi.org/10.1093/ageing/afv204
doi: 10.1093/ageing/afv204
pubmed: 26802076
pmcid: 4776625
Kammerlander C, Roth T, Friedman SM, Suhm N, Luger TJ, Kammerlander-Knauer U, Krappinger D, Blauth M (2010) Ortho-geriatric service—a literature review comparing different models. Osteoporos Int 21:637–646. https://doi.org/10.1007/s00198-010-1396-x
doi: 10.1007/s00198-010-1396-x
Kristensen PK, Thillemann TM, Pedersen AB, Søballe K, Johnsen SP (2017) Socioeconomic inequality in clinical outcome among hip fracture patients: a nationwide cohort study. Osteoporos Int 28:1233–1243. https://doi.org/10.1007/s00198-016-3853-7
doi: 10.1007/s00198-016-3853-7
pubmed: 27909785
Prestmo A, Hagen G, Sletvold O, Helbostad JL, Thingstad P, Taraldsen K, Lydersen S, Halsteinli V, Saltnes T, Lamb SE, Johnsen LG, Saltvedt I (2015) Comprehensive geriatric care for patients with hip fractures: a prospective, randomised, controlled trial. Lancet 385:1623–1633. https://doi.org/10.1016/S0140-6736(14)62409-0
doi: 10.1016/S0140-6736(14)62409-0
pubmed: 25662415
Moyet J, Deschasse G, Marquant B, Mertl P, Bloch F (2019) Which is the optimal orthogeriatric care model to prevent mortality of elderly subjects post hip fractures? A systematic review and meta-analysis based on current clinical practice. Int Orthop 43:1449–1454. https://doi.org/10.1007/s00264-018-3928-5
doi: 10.1007/s00264-018-3928-5
pubmed: 29691612
Zeltzer J, Mitchell RJ, Toson B, Harris IA, Ahmad L, Close J (2014) Orthogeriatric services associated with lower 30-day mortality for older patients who undergo surgery for hip fracture. Med J Aust 201:409–411. https://doi.org/10.5694/mja14.00055
doi: 10.5694/mja14.00055
pubmed: 25296064
Friess T, Hartwig E, Liener U, Sturm J, Hoffmann R (2016) Geriatric trauma centers from the idea to implementation. What has been achieved? (Geriatric trauma centers from the idea to implementation. What has been achieved?). Unfallchirurg 119:7–11. https://doi.org/10.1007/s00113-015-0114-8
doi: 10.1007/s00113-015-0114-8
pubmed: 26601847
Rapp K, Becker C, Todd C, Rothenbacher D, Schulz C, König HH, Liener U, Hartwig E, Büchele G (2020) The association between orthogeriatric co-management and mortality following hip fracture. Dtsch Arztebl Int 117:53–59. https://doi.org/10.3238/arztebl.2020.0053
doi: 10.3238/arztebl.2020.0053
pubmed: 32036854
pmcid: 7036469
Kristensen PK, Thillemann TM, Søballe K, Johnsen SP (2016) Can improved quality of care explain the success of orthogeriatric units? A population-based cohort study. Age Ageing 45:66–71. https://doi.org/10.1093/ageing/afv155
doi: 10.1093/ageing/afv155
pubmed: 26582757
Singh R, Küçükdeveci AA, Grabljevec K, Gray A (2018) The role of interdisciplinary teams in physical and rehabilitation medicine. J Rehabil Med 50:673–678. https://doi.org/10.2340/16501977-2364
doi: 10.2340/16501977-2364
pubmed: 29944171
Bachmann S, Finger C, Huss A, Egger M, Stuck AE, Clough-Gorr KM (2010) Inpatient rehabilitation specifically designed for geriatric patients: systematic review and meta-analysis of randomised controlled trials. BMJ 340:c1718. https://doi.org/10.1136/bmj.c1718
doi: 10.1136/bmj.c1718
pubmed: 20406866
pmcid: 2857746
Deutsches Institut für Medizinische Dokumentation und Information OPS Version 2020: Kapitel 8 Nicht operative therapeutsche Massnahmen. https://www.dimdi.de/static/de/klassifikationen/ops/kode-suche/opshtml2020/block-8-55…8-60.htm . Accessed 29 Nov 2020
AUC - Academie for Trauma Surgery, Working Committee on Geriatric Trauma Surgery (2019) The geriatric trauma register of the DGU - current status, methods and publication guidelines (The geriatric trauma register of the DGU-current status, methods and publication guidelines). Unfallchirurg 122:820–822. https://doi.org/10.1007/s00113-019-0698-5
doi: 10.1007/s00113-019-0698-5
Greiner W (2005) Health economic evaluation of disease management programs: the German example. Eur J Health Econ 6:191–196. https://doi.org/10.1007/s10198-005-0305-2
doi: 10.1007/s10198-005-0305-2
pubmed: 16133095
Schoeneberg C, Knobe M, Babst R et al (2020) 120-days follow-up after proximal femoral fractures - first results from the Geriatric Trauma Registry DGU® (120-day follow-up after proximal femoral fractures-first results from the Geriatric Trauma Registry DGU®). Unfallchirurg 123:375–385. https://doi.org/10.1007/s00113-019-00730-4
doi: 10.1007/s00113-019-00730-4
pubmed: 31598740
Goh EL, Lerner RG, Achten J, Parsons N, Griffin XL, Costa PML (2020) Complications following hip fracture: results from the World Hip Trauma Evaluation cohort study. Injury 51:1331–1336. https://doi.org/10.1016/j.injury.2020.03.031
doi: 10.1016/j.injury.2020.03.031
pubmed: 32268962
pmcid: 7322551
Greve K, Modig K, Talbäck M, Bartha E, Hedström M (2020) No association between waiting time to surgery and mortality for healthier patients with hip fracture: a nationwide Swedish cohort of 59,675 patients. Acta Orthop 91:1–6. https://doi.org/10.1080/17453674.2020.1754645
doi: 10.1080/17453674.2020.1754645
Gjertsen J-E, Engesaeter LB, Furnes O et al (2008) The Norwegian Hip Fracture Register: experiences after the first 2 years and 15,576 reported operations. Acta Orthop 79:583–593. https://doi.org/10.1080/17453670810016588
doi: 10.1080/17453670810016588
pubmed: 18839363
Prieto-Alhambra D, Reyes C, Sainz MS, González-Macías J, Delgado LG, Bouzón CA, Gañan SM, Miedes DM, Vaquero-Cervino E, Bardaji MFB, Herrando LE, Baztán FB, Ferrer BL, Perez-Coto I, Bueno GA, Mora-Fernandez J, Doñate TE, Blasco JMI, Aguado-Maestro I, Sáez-López P, Doménech MS, Climent-Peris V, Rodríguez ÁD, Sardiñas HK, Gómez ÓT, Serra JT, Caeiro-Rey JR, Cano IA, Carsi MB, Etxebarria-Foronda I, Hernández JDA, Solis JR, Suau OT, Nogués X, Herrera A, Díez-Perez A (2018) In-hospital care, complications, and 4-month mortality following a hip or proximal femur fracture: the Spanish registry of osteoporotic femur fractures prospective cohort study. Arch Osteoporos 13:96. https://doi.org/10.1007/s11657-018-0515-8
doi: 10.1007/s11657-018-0515-8
pubmed: 30218380
pmcid: 6153683
Tsang STJ, Aitken SA, Golay SK, Silverwood RK, Biant LC (2014) When does hip fracture surgery fail? Injury 45:1059–1065. https://doi.org/10.1016/j.injury.2014.03.019
doi: 10.1016/j.injury.2014.03.019
pubmed: 24794618
Inacio MCS, Weiss JM, Miric A et al (2015) A community-based hip fracture registry: population, methods, and outcomes. Perm J 19:29–36. https://doi.org/10.7812/TPP/14-231
doi: 10.7812/TPP/14-231
pubmed: 26057682
pmcid: 4500478
Ellanti P, Cushen B, Galbraith A, Brent L, Hurson C, Ahern E (2014) Improving hip fracture care in Ireland: a preliminary report of the Irish hip fracture database. J Osteoporos 2014:656357–656357. https://doi.org/10.1155/2014/656357
doi: 10.1155/2014/656357
pubmed: 25548713
pmcid: 4274861
Svedbom A, Hernlund E, Ivergård M et al (2013) Osteoporosis in the European Union: a compendium of country-specific reports. Arch Osteoporos 8:137. https://doi.org/10.1007/s11657-013-0137-0
doi: 10.1007/s11657-013-0137-0
pubmed: 3880492
pmcid: 3880492
Munson JC, Bynum JPW, Bell J-E, Cantu R, McDonough C, Wang Q, Tosteson TD, Tosteson ANA (2016) Patterns of prescription drug use before and after fragility fracture. JAMA Intern Med 176:1531–1538. https://doi.org/10.1001/jamainternmed.2016.4814
doi: 10.1001/jamainternmed.2016.4814
pubmed: 27548843
pmcid: 5048505
Wang X, Li C, He Y, Wang T, Zhang H, Ma Z, Ma H, Zhao H (2020) Anti-osteoporosis medication treatment pattern after osteoporotic fracture during 2010-2016 in Fujian, China. Arch Osteoporos 15:134. https://doi.org/10.1007/s11657-020-00798-1
doi: 10.1007/s11657-020-00798-1
pubmed: 32820451
Gonnelli S, Caffarelli C, Iolascon G, Bertoldo F, Letizia Mauro G, Patti A, Nuti R (2017) Prescription of anti-osteoporosis medications after hospitalization for hip fracture: a multicentre Italian survey. Aging Clin Exp Res 29:1031–1037. https://doi.org/10.1007/s40520-016-0681-8
doi: 10.1007/s40520-016-0681-8
pubmed: 27943127
Kim SC, Kim M-S, Sanfélix-Gimeno G et al (2015) Use of osteoporosis medications after hospitalization for hip fracture: a cross-national study. Am J Med 128:519–26.e1. https://doi.org/10.1016/j.amjmed.2015.01.014
doi: 10.1016/j.amjmed.2015.01.014
pubmed: 25660252
pmcid: 4414898
Dyer SM, Crotty M, Fairhall N et al (2016) A critical review of the long-term disability outcomes following hip fracture. BMC Geriatr 16:158. https://doi.org/10.1186/s12877-016-0332-0
doi: 10.1186/s12877-016-0332-0
pubmed: 5010762
pmcid: 5010762
Tang VL, Sudore R, Cenzer IS, Boscardin WJ, Smith A, Ritchie C, Wallhagen M, Finlayson E, Petrillo L, Covinsky K (2017) Rates of recovery to pre-fracture function in older persons with hip fracture: an observational study. J Gen Intern Med 32:153–158. https://doi.org/10.1007/s11606-016-3848-2
doi: 10.1007/s11606-016-3848-2
pubmed: 27605004
Rapp K, Rothenbacher D, Magaziner J et al (2015) Risk of nursing home admission after femoral fracture compared with stroke, myocardial infarction, and pneumonia. J Am Med Dir Assoc 16:715.e7–715.e12. https://doi.org/10.1016/j.jamda.2015.05.013
doi: 10.1016/j.jamda.2015.05.013
Muhm M, Walendowski M, Danko T, Weiss C, Ruffing T, Winkler H (2016) Length of hospital stay for patients with proximal femoral fractures: influencing factors. Unfallchirurg 119:560–569. https://doi.org/10.1007/s00113-014-2649-5
doi: 10.1007/s00113-014-2649-5
pubmed: 25169887
Szende A, Janssen B, Cabases J (2014) Self-reported population health: an international perspective based on EQ-5D. Springer, Netherlands
doi: 10.1007/978-94-007-7596-1
Svedbom A, Borgström F, Hernlund E, Ström O, Alekna V, Bianchi ML, Clark P, Curiel MD, Dimai HP, Jürisson M, Uusküla A, Lember M, Kallikorm R, Lesnyak O, McCloskey E, Ershova O, Sanders KM, Silverman S, Tamulaitiene M, Thomas T, Tosteson ANA, Jönsson B, Kanis JA (2018) Quality of life after hip, vertebral, and distal forearm fragility fractures measured using the EQ-5D-3L, EQ-VAS, and time-trade-off: results from the ICUROS. Qual Life Res 27:707–716. https://doi.org/10.1007/s11136-017-1748-5
doi: 10.1007/s11136-017-1748-5
Prieto-Alhambra D, Moral-Cuesta D, Palmer A, Aguado-Maestro I, Bardaji MFB, Brañas F, Bueno GA, Caeiro-Rey JR, Cano IA, Barres-Carsi M, Delgado LG, Salomó-Domènech M, Etxebarria-Foronda I, Ferrer BL, Mills S, Herrando LE, Mifsut D, Evangelista LDR, Nogués X, Perez-Coto I, Blasco JMI, Martín-Hernández C, Kessel H, Serra JT, Solis JR, Suau OT, Vaquero-Cervino E, Hernández CP, Mañas LR, Herrera A, Díez-Perez A (2019) The impact of hip fracture on health-related quality of life and activities of daily living: the SPARE-HIP prospective cohort study. Arch Osteoporos 14:14. https://doi.org/10.1007/s11657-019-0607-0
doi: 10.1007/s11657-019-0607-0
Gjertsen J-E, Baste V, Fevang JM, Furnes O, Engesæter LB (2016) Quality of life following hip fractures: results from the Norwegian hip fracture register. BMC Musculoskelet Disord 17:265. https://doi.org/10.1186/s12891-016-1111-y
doi: 10.1186/s12891-016-1111-y
pubmed: 4936302
pmcid: 4936302
Griffin XL, Parsons N, Achten J, Fernandez M, Costa ML (2015) Recovery of health-related quality of life in a United Kingdom hip fracture population. The Warwick Hip Trauma Evaluation—a prospective cohort study. Bone Joint J 97-B:372–382. https://doi.org/10.1302/0301-620X.97B3.35738
doi: 10.1302/0301-620X.97B3.35738
pubmed: 25737522
Marques A, Lourenço Ó, da Silva JAP (2015) The burden of osteoporotic hip fractures in Portugal: costs, health related quality of life and mortality. Osteoporos Int 26:2623–2630. https://doi.org/10.1007/s00198-015-3171-5
doi: 10.1007/s00198-015-3171-5
pubmed: 25986386