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European Journal of Trauma and Emergency Surgery

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Open Access 28-04-2022 | Original Article

Orthogeriatric co-management: differences in outcome between major and minor fractures

Authors: Andreas Wiedl, Stefan Förch, Annabel Fenwick, Leonard Lisitano, Timon Röttinger, Thilo Nachbaur, Alexander Otto, Edgar Mayr

Published in: European Journal of Trauma and Emergency Surgery | Issue 4/2022

Abstract

Purpose

Literature shows that orthogeriatric co-management improves the outcomes of patients with hip fractures. Corresponding research with more diverse fragility fracture groups is lacking.

Therefore, an examination was performed prospectively as a 2 year-follow-up on an orthogeriatric co-managed ward, comparing relevant outcome parameters for major and minor fragility fractures.

Methods

All patients treated on an orthogeriatric co-managed ward from February 2014 to January 2015 were included and their injuries, orthogeriatric parameters such as the Barthel Index (BI), Parker Mobility Score (PMS) and place of residence (POR). Patients were separated into two groups of either immobilizing major (MaF) or non-immobilizing minor (MiF) fractures. 2 years later, a follow-up was conducted via telephone calls and questionnaires mailed to patients and/or their relatives.

Results

740 (574 major vs. 166 minor injuries) patients were initially assessed, with a follow-up rate of 78.9%. The in-house, 1-year, and 2-year-mortality rates were 2.7, 27.4, and 39.2%, respectively. Mortality was significantly higher for MaF in the short term, but not after 2 years. On average, during the observation period, patients regained their BI by 36.7 points (95% CI: 33.80–39.63) and PMS was reduced by 1.4 points (95% CI: 1.16–1.68). No significant differences were found in the readmission rate, change in BI, PMS or POR between the MaF and MiF groups.

Conclusion

The relevance of orthogeriatric treatment to improving functional and socioeconomic outcomes was confirmed. The similarity of the results from both fracture groups emphasizes the need for a multidisciplinary approach also for minor fractures.

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Title: Orthogeriatric co-management: differences in outcome between major and minor fractures
Authors: Andreas Wiedl
Stefan Förch
Annabel Fenwick
Leonard Lisitano
Timon Röttinger
Thilo Nachbaur
Alexander Otto
Edgar Mayr
Publication date: 28-04-2022
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Trauma and Emergency Surgery / Issue 4/2022
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-022-01974-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Orthogeriatric co-management: differences in outcome between major and minor fractures

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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