Literature DB >> 21350887

Does a multidisciplinary team decrease complications in male patients with hip fractures?

Christopher J Dy1, Paul-Michel Dossous, Quang V Ton, James P Hollenberg, Dean G Lorich, Joseph M Lane.   

Abstract

BACKGROUND: Men with hip fractures are more likely to experience postoperative complications than women. The Medical Orthopaedic Trauma Service program at New York Presbyterian Hospital utilizes a multidisciplinary team approach to care for patients with hip fractures. The service is comanaged by an attending hospitalist and orthopaedic surgeon, with daily walking rounds attended by the hospitalist, orthopaedic resident, physical therapist, social worker, and a dedicated Medical Orthopaedic Trauma Service physician assistant. QUESTIONS/PURPOSES: We asked whether a multidisciplinary service for patients with hip fracture decreases (1) the incidence of inpatient complications in men, (2) the length of hospitalization, and (3) 90-day and 1-year mortality. PATIENTS AND METHODS: We retrospectively reviewed the charts of 74 men who had surgery for a nonperiprosthetic femoral neck, intertrochanteric, or subtrochanteric fracture for two 7-month periods before and after implementation of the Medical Orthopaedic Trauma Service. Age, ethnicity, comorbidity status, time to surgery, and postoperative complication data were collected. Regression modeling was used to evaluate the likelihood of postoperative complications, length of hospitalization, and 90-day and 1-year mortality while controlling for age, Charlson Comorbidity Index score, fracture type, and time from admission to surgery.
RESULTS: We observed a decrease in the likelihood of experiencing at least one inpatient complication in male patients after implementation of the Medical Orthopaedic Trauma Service (odds ratio = 0.264). There was no difference in length of hospitalization, 90-day mortality, or 1-year mortality.
CONCLUSIONS: Multidisciplinary collaboration for patients with hip fractures can decrease the likelihood of experiencing inpatient complications in male patients. LEVEL OF EVIDENCE: Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Year:  2011        PMID: 21350887      PMCID: PMC3111804          DOI: 10.1007/s11999-011-1825-y

Source DB:  PubMed          Journal:  Clin Orthop Relat Res        ISSN: 0009-921X            Impact factor:   4.176


  21 in total

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  5 in total

1.  [Co-management in geriatric traumatology].

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2.  Physician Perceptions of Patient Health: A Comparative Analysis between Urologist and Hospitalist Perceptions of Need for Inpatient Hospitalist Comanagement Following Radical Cystectomy.

Authors:  Jessica H Hannick; William Adams; Jasmin Sandhu; Stephanie Kliethermes; Daniel J Mazur; Joshua J Meeks; Sabine Sobek; Christopher L Coogan; Aliyah Sadaf; Marcus L Quek; Elizabeth Schulwolf
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3.  Does a Dedicated Unit for the Treatment of Hip Fractures Improve Acute Outcomes?

Authors:  Al-Achraf Khoriati; Wael Dandachli; Rupinderbir Deol; Nicholas de Roeck
Journal:  Int Sch Res Notices       Date:  2014-11-20

4.  An Orthopedic-Hospitalist Comanaged Hip Fracture Service Reduces Inpatient Length of Stay.

Authors:  Daniel N Bracey; Tunc C Kiymaz; David C Holst; Kamran S Hamid; Johannes F Plate; Erik C Summers; Cynthia L Emory; Riyaz H Jinnah
Journal:  Geriatr Orthop Surg Rehabil       Date:  2016-08-08

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Authors:  Jeremy Truntzer; Christopher Nacca; David Paller; Alan H Daniels
Journal:  Geriatr Orthop Surg Rehabil       Date:  2014-12
  5 in total

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