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Influence of Orthogeriatrics on the Morbidity and Mortality of Patients with Hip Fracture.


 BACKGROUND: Osteoporotic hip fractures often occur in fragile, elderly patients and are associated with a significant morbidity and mortality. The objective of this study is to evaluate the morbidity and mortality together with the length of hospital stay in patients with hip fracture in two non-consecutive years and to compare their evolution with the involvement of a specialist in orthogeriatric care.MATERIAL AND METHODS: Retrospective study that reviewed a total of 633 patients with an average age of 85.5 years who suffered a hip fracture and were treated in the same service of Trauma and Orthopaedics in two different years (2012 and 2017). We have analysed mortality, morbidity during their hospital stay, the length of hospital stays and the cost-benefit after the implication of a specialist in orthogeriatric care in 2017.RESULTS: Mortality during their hospital stay decreased significantly from 10% in 2012 to 3.6% in 2017. We have also observed a decrease in mortality at 30 days (10.5% versus 7%) and after one year (28.9% versus 24.9%) between both groups, although these differences were not statistically significant. The length of hospital stays decreased significantly between both periods observed. The average stay decreased by 4.8 days, the surgical delay decreased by 1.1 days and the postoperative hospital stay decreased by 3.4 days. The total annual economic savings estimated due to the involvement of a geriatrician in the follow-up of patients with hip fracture was 1,017.084.94€.CONCLUSIONS: The multidisciplinary approach of patients with hip fracture results in a more effective and more efficient care model. The quality of care and the clinical care optimisation of patients in the perioperative period improve and both hospital stay and mortality during hospital stay decrease significantly. A significant economic saving is also obtained in the treatment of this pathology.