Australian journal of general practice · 2025
Impact of family physician-led hospitalist intervention methods in the multidisciplinary management of hip fracture: A retrospective cohort study.
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Ishimaru Naoto, Waki Takahiro, Shimokawa Toshio, Mizuki Shimpei, Kanzawa Yohei, Nakajima Takahiro, Ito Kenjiro, Kinami Saori
Аннотация
BACKGROUND AND OBJECTIVES: Hip fractures are associated with high morbidity and mortality. We compared the impacts of a hospitalist consultant model and hospitalist model on morbidity in patients with hip fractures with conventional orthopaedic surgeon-led care.
METHOD: This retrospective cohort study included patients who underwent surgery for hip fractures between April 2017 and March 2022. The primary outcome was the rate of perioperative complications. Multivariate analysis was adjusted for age, gender and any significant variables shown in univariate analysis.
RESULTS: Of the 982 patients, 329, 224 and 429 were treated within the orthopaedic department, the hospitalist consultant model and the hospitalist model, respectively. In adjusted analysis, time to surgery was shorter within the hospitalist model (odds ratio [OR]: -0.259; 95% confidence interval [CI]: -0.502 to -0.016), but there were no differences among groups in length of stay, complications or in-hospital mortality.
DISCUSSION: A family physician-led hospitalist model might facilitate earlier surgery for hip fractures than a conventional care model.
METHOD: This retrospective cohort study included patients who underwent surgery for hip fractures between April 2017 and March 2022. The primary outcome was the rate of perioperative complications. Multivariate analysis was adjusted for age, gender and any significant variables shown in univariate analysis.
RESULTS: Of the 982 patients, 329, 224 and 429 were treated within the orthopaedic department, the hospitalist consultant model and the hospitalist model, respectively. In adjusted analysis, time to surgery was shorter within the hospitalist model (odds ratio [OR]: -0.259; 95% confidence interval [CI]: -0.502 to -0.016), but there were no differences among groups in length of stay, complications or in-hospital mortality.
DISCUSSION: A family physician-led hospitalist model might facilitate earlier surgery for hip fractures than a conventional care model.