Geriatric care in hip fracture recovery: does it truly make a difference? A meta-analysis.

BACKGROUND

Hip fractures have a significant impact on morbidity and mortality in older adults, often leading to loss of function and an increased healthcare burden. The role of geriatric co-management in improving postoperative outcomes remains controversial. This meta-analysis evaluates the impact of geriatric care on functional recovery, complications, length of hospital stay, and one-year mortality in older patients with hip fractures.

METHODS

A meta-analysis was conducted according to PRISMA guidelines. Randomized controlled trials (RCTs) and prospective cohort studies comparing standard orthopedic care with geriatric co-management were included. The primary outcomes examined were one-year mortality, functional independence (Barthel ADL scores, independent walking), length of hospital stay and postoperative complications (delirium, infections, falls).

RESULTS

Six RCTs with 1,780 patients (894 geriatric care, 886 standard care) were analyzed. Geriatric care was associated with improved ADL scores (Cohen's d = 0.066, 95% CI 0.027-0.105) and a 19% higher rate of independent walking (RR = 1.19, 95% CI 1.092-1.288). The length of hospital stay was reduced by 1.39 days (95% CI - 1.98 to - 0.80). Complication rates decreased slightly (- 3.60%), but no significant reduction in one-year mortality was observed (- 2.26%). Heterogeneity was high for functional outcomes (I2 = 99.91%) and LOS (I2 = 99.99%).

CONCLUSIONS

Geriatric care improves short-term functional outcomes, reduces complications and shortens hospital stay in elderly patients with hip fractures. However, its impact on one-year mortality is limited. Standardized geriatric care models and further research on long-term recovery strategies are needed to optimize outcomes.