Intervention Helps Older Patients with Broken Hip

NEW YORK (Reuters Health) - An intervention designed to prevent medical complications and delivered by a geriatric team can reduce the risk of death and complications in older patients hospitalized with hip fracture, according to researchers.

"The geriatric team contributes to the prevention and treatment of medical problems associated with the fracture and its surgery, and designs an individual rehabilitation plan according to the medical situation and the social support for each patient," lead author Dr. Maite Vidan, of Hospital General Universitario "Gregorio Maranon" in Madrid, Spain, told Reuters Health.

In a study published in the Journal of the American Geriatric Society, the investigators examined whether an early multidisciplinary geriatric intervention in 319 patients at least 65 years old with hip fracture reduced the length of stay, complications and death rate.

The patients were randomly assigned to a daily multidisciplinary geriatric intervention or usual care soon after breaking their hip.

Patients in the intervention group were hospitalized for around 16 days, 2 days less than patients in the usual care group. The risk of death while hospitalized was 0.6 percent for subjects in the intervention group versus 5.5 percent for those in the usual care group. The rate of major medical complications was 45.2 and 61.7 percent for the intervention and usual care groups, respectively.

Further analysis showed that the geriatric intervention cut the risk of death or major complications by 45 percent. The most common major complications were delirium and bedsores.

"This model of collaborative care is associated with lower rates of major medical complications and mortality during hospitalization than the usual care," the author said. "Also, the proportion of patients who begin rehabilitation before discharge is higher with this model of care, without an increase in the length of stay."

SOURCE: Journal of the American Geriatric Society, September 2005.