Role of comprehensive geriatric assessment in the management of osteoporotic hip fracture in the elderly: an overview.

PURPOSE: To highlight the advantages of comprehensive geriatric assessment (CGA) over usual care in the management of elderly patients with fragility hip fractures in terms of reducing the related mortality and disability.
METHOD: An overview of publications on the topic was conducted using the MEDLINE and EMBASE databases.
RESULTS: Several models of geriatric and orthopedic comanagement have been developed in recent years, all characterized by a variable degree of integration, and they have been shown to reduce complications, disability and mortality in elderly hip-fracture patients. Preoperatively, CGA should identify the comorbidities that need to be treated in view of surgery, so as to reduce the related risks. After surgery, CGA should deal with medical complications and assure patients an early mobilization in order to reduce short-term mortality and contain functional decline. Before discharge, the orthogeriatric team should draw up a tailored program to promote the patient's functional recovery and satisfactory quality of life, also covering the secondary prevention of fragility fractures by improving bone quality and reducing the risk of falls.
CONCLUSIONS: Fragility hip fractures in the elderly people need to be managed by different professionals working in close cooperation and adopting a CGA.