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Characteristics and Outcomes of Hip Fracture Patients Hospitalized in an Orthogeriatric Unit Versus an Orthopedic Department: A Retrospective Cohort Study

INTRODUCTION: Hip fractures are a significant health risk in older adults and a major cause of morbidity, functional decline and mortality. Our aim was to compare clinical outcomes of older patients hospitalized in an ortho-geriatric (OG) unit to those hospitalized in an orthopedic department (OD) f...

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Autores principales: Bugaevsky, Yulia, Levy, Yochai, Hershkovitz, Avital, Ocheretny, Irena, Nissenholtz, Adaya, Cooper, Lisa, Weissman, Yaara Leibovici, Weiss, Avraham, Velkes, Steven, Beloosesky, Yichayaou
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7804357/
https://www.ncbi.nlm.nih.gov/pubmed/33489431
http://dx.doi.org/10.1177/2151459320986299
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author Bugaevsky, Yulia
Levy, Yochai
Hershkovitz, Avital
Ocheretny, Irena
Nissenholtz, Adaya
Cooper, Lisa
Weissman, Yaara Leibovici
Weiss, Avraham
Velkes, Steven
Beloosesky, Yichayaou
author_facet Bugaevsky, Yulia
Levy, Yochai
Hershkovitz, Avital
Ocheretny, Irena
Nissenholtz, Adaya
Cooper, Lisa
Weissman, Yaara Leibovici
Weiss, Avraham
Velkes, Steven
Beloosesky, Yichayaou
author_sort Bugaevsky, Yulia
collection PubMed
description INTRODUCTION: Hip fractures are a significant health risk in older adults and a major cause of morbidity, functional decline and mortality. Our aim was to compare clinical outcomes of older patients hospitalized in an ortho-geriatric (OG) unit to those hospitalized in an orthopedic department (OD) for surgical treatment of a hip fracture. METHODS: A retrospective cohort study of hip fractured patients hospitalized between 2015-2016 in a single tertiary university-affiliated medical center. Included were patients aged 65 and older who had undergone hip fracture surgery and were admitted to either a geriatric or orthopedic ward. RESULTS: 441 patients met the inclusion criteria (195 in the OG unit, 246 in the OD); 257 were transferred to an affiliated geriatric center hospital (107 from the OG unit and 127 from the OD) for rehabilitation. Patients in the OG unit were older, more cognitively and functionally impaired and with more comorbidities. The 1-year mortality rate was significantly lower in the OD group (OR 0.32, CI 95% 0.19-0.53, p < 0.001), however, after propensity matching, the 30-day and 1 year mortality rates were similar in both groups. No difference was found in the rehabilitation length of stay between the groups. The functional independence measure improvement was similar in both groups, with a non-significant trend toward better functional improvement among OG unit patients. CONCLUSIONS: Despite the higher complexity of patients, worse baseline functional capacity in the OG unit, improvement after rehabilitation was similar in both groups. These results demonstrate the advantages of the OG unit in treating and stabilizing frail older adults, thus maximizing their chances for a successful recovery after hip fractures. LEVEL OF EVIDENCE: Level IV
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spelling pubmed-78043572021-01-21 Characteristics and Outcomes of Hip Fracture Patients Hospitalized in an Orthogeriatric Unit Versus an Orthopedic Department: A Retrospective Cohort Study Bugaevsky, Yulia Levy, Yochai Hershkovitz, Avital Ocheretny, Irena Nissenholtz, Adaya Cooper, Lisa Weissman, Yaara Leibovici Weiss, Avraham Velkes, Steven Beloosesky, Yichayaou Geriatr Orthop Surg Rehabil Original Manuscript INTRODUCTION: Hip fractures are a significant health risk in older adults and a major cause of morbidity, functional decline and mortality. Our aim was to compare clinical outcomes of older patients hospitalized in an ortho-geriatric (OG) unit to those hospitalized in an orthopedic department (OD) for surgical treatment of a hip fracture. METHODS: A retrospective cohort study of hip fractured patients hospitalized between 2015-2016 in a single tertiary university-affiliated medical center. Included were patients aged 65 and older who had undergone hip fracture surgery and were admitted to either a geriatric or orthopedic ward. RESULTS: 441 patients met the inclusion criteria (195 in the OG unit, 246 in the OD); 257 were transferred to an affiliated geriatric center hospital (107 from the OG unit and 127 from the OD) for rehabilitation. Patients in the OG unit were older, more cognitively and functionally impaired and with more comorbidities. The 1-year mortality rate was significantly lower in the OD group (OR 0.32, CI 95% 0.19-0.53, p < 0.001), however, after propensity matching, the 30-day and 1 year mortality rates were similar in both groups. No difference was found in the rehabilitation length of stay between the groups. The functional independence measure improvement was similar in both groups, with a non-significant trend toward better functional improvement among OG unit patients. CONCLUSIONS: Despite the higher complexity of patients, worse baseline functional capacity in the OG unit, improvement after rehabilitation was similar in both groups. These results demonstrate the advantages of the OG unit in treating and stabilizing frail older adults, thus maximizing their chances for a successful recovery after hip fractures. LEVEL OF EVIDENCE: Level IV SAGE Publications 2021-01-10 /pmc/articles/PMC7804357/ /pubmed/33489431 http://dx.doi.org/10.1177/2151459320986299 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Manuscript
Bugaevsky, Yulia
Levy, Yochai
Hershkovitz, Avital
Ocheretny, Irena
Nissenholtz, Adaya
Cooper, Lisa
Weissman, Yaara Leibovici
Weiss, Avraham
Velkes, Steven
Beloosesky, Yichayaou
Characteristics and Outcomes of Hip Fracture Patients Hospitalized in an Orthogeriatric Unit Versus an Orthopedic Department: A Retrospective Cohort Study
title Characteristics and Outcomes of Hip Fracture Patients Hospitalized in an Orthogeriatric Unit Versus an Orthopedic Department: A Retrospective Cohort Study
title_full Characteristics and Outcomes of Hip Fracture Patients Hospitalized in an Orthogeriatric Unit Versus an Orthopedic Department: A Retrospective Cohort Study
title_fullStr Characteristics and Outcomes of Hip Fracture Patients Hospitalized in an Orthogeriatric Unit Versus an Orthopedic Department: A Retrospective Cohort Study
title_full_unstemmed Characteristics and Outcomes of Hip Fracture Patients Hospitalized in an Orthogeriatric Unit Versus an Orthopedic Department: A Retrospective Cohort Study
title_short Characteristics and Outcomes of Hip Fracture Patients Hospitalized in an Orthogeriatric Unit Versus an Orthopedic Department: A Retrospective Cohort Study
title_sort characteristics and outcomes of hip fracture patients hospitalized in an orthogeriatric unit versus an orthopedic department: a retrospective cohort study
topic Original Manuscript
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7804357/
https://www.ncbi.nlm.nih.gov/pubmed/33489431
http://dx.doi.org/10.1177/2151459320986299
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