Revista espanola de cirugia ortopedica y traumatologia · 2025
How does multidisciplinary collaboration with an internal medicine physician influence mortality in hip fracture patients?
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Cano-Obando L, Gómez-Palomo J M, Galán-Romero A, González-García C, Zamora-Navas P
Аннотация
INTRODUCTION: The increase in life expectancy and the aging population have led to a higher incidence of hip fractures, especially in women over 60 years old. This study analyzes the influence of a multidisciplinary team with the collaboration of a specialist in internal medicine (IM) with the trauma department on mortality, perioperative complications and hospital stay in patients with hip fractures.
MATERIAL Y METHODS: An analytical observational study of historical cohorts was conducted in patients over 65 years admitted for hip fracture and treated with arthroplasty or intramedullary nailing. Two cohorts were established: one before and one after the IM assignment. Patients with metabolic bone diseases different from osteoporosis and those who were operated in other centers were excluded. The minimum follow-up was 12 months.
RESULTS: A total of 190 patients (50 men, 140 women) were included, with a mean age of 82.0 years and a BMI of 27.5. Mortality, which was the main objective of our study, during the first 12 months was higher in the non-IM (27.1 vs. 13.5%; P=.035). In addition, we included systemic complications and hospital stay as secondary objectives. Systemic complications were also higher in the non-IM cohort (43.2 vs. 27.1%; P=.031). Overall hospital stay was shorter in the IM cohort (7.3 vs. 9.9 days; P=.001). "Preoperative stays shorter than 72 hours" were more frequent in the IM group (53.0 vs. 33.2%; P=.009).
CONCLUSIONS: Multidisciplinary collaboration with a specialist in internal medicine significantly reduces first-year mortality, systemic complications, and hospital stay in hip fracture patients, allowing earlier interventions and hospital discharge.
MATERIAL Y METHODS: An analytical observational study of historical cohorts was conducted in patients over 65 years admitted for hip fracture and treated with arthroplasty or intramedullary nailing. Two cohorts were established: one before and one after the IM assignment. Patients with metabolic bone diseases different from osteoporosis and those who were operated in other centers were excluded. The minimum follow-up was 12 months.
RESULTS: A total of 190 patients (50 men, 140 women) were included, with a mean age of 82.0 years and a BMI of 27.5. Mortality, which was the main objective of our study, during the first 12 months was higher in the non-IM (27.1 vs. 13.5%; P=.035). In addition, we included systemic complications and hospital stay as secondary objectives. Systemic complications were also higher in the non-IM cohort (43.2 vs. 27.1%; P=.031). Overall hospital stay was shorter in the IM cohort (7.3 vs. 9.9 days; P=.001). "Preoperative stays shorter than 72 hours" were more frequent in the IM group (53.0 vs. 33.2%; P=.009).
CONCLUSIONS: Multidisciplinary collaboration with a specialist in internal medicine significantly reduces first-year mortality, systemic complications, and hospital stay in hip fracture patients, allowing earlier interventions and hospital discharge.