138
· DOS Abstracts
Orthogeriatric collaborative improves 30 day mortal-
ity and quality of care after hip fracture in the elderly:
a nationwide cohort study
Pia Kjær Kristensen, Theis Muncholm Thillemann, Kjeld Søballe,
Søren Paaske Johnsen
Department of Orthopaedics , Hospital Horsens; Orthopaedic surgery ,
University Hospital Aarhus; Orthopaedics , University Hospital Aarhus;
Department of Clinical Epidemiology, University Hospital Aarhus
Background:
Orthogeriatric collaborative has been linked with better clinical
outcomes for hip fracture in clinical trials, however little is known about the im-
pact of orthogeriatrics on quality of care and clinical outcomes among patients
with hip fracture in a routine setting.
Purpose / Aim of Study:
We examined the association between orthogeri-
atrics and 30-day mortality, quality of care, surgical delay and length of stay
among patients with hip fracture.
Materials and Methods:
Using prospectively collected data from the Danish
Multidisciplinary Hip Fracture Registry, we identified 12,065 patients ≥65
years who were admitted with a hip fracture between 1. March 2010 to 30.
November 2011. The exposure was divided in two groups; Orthopaedic ward
with geriatric or medical consultant service on request and orthogeriatric col-
laborative where the geriatrician is integrated into the orthopaedic team with
nurses, physiotherapist and the orthopaedic surgeon. The primary outcome was
30-day mortality. Secondary outcome included quality of care assessed using
six process indicators, surgical delay and length of stay. Data was analyzed using
regression techniques while controlling for potential confounders.
Findings / Results:
The 30-day mortality was 9.4 % and 12.0 % for ortho-
geriatric and orthogeriatric ward. Admittance to an orthogeriatric ward was as-
sociated with decreased 30-day mortality (adjusted odds ratio = 0.69 (95%
CI: 0.54-0.88)). Furthermore, patients had higher relative risk for systematic
pain assessment, for receiving basic mobility assessment, for a post discharge
rehabilitation program, for anti-osteoporotic medication and for prevention fu-
ture fall accidents. Length of hospital stay and surgical delay were similar in the
groups.
Conclusions:
Admittance to an orthogeriatric ward was associated with de-
creased mortality rates and improved quality of care.
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