Carsten Schoeneberg1, Matthias Knobe2,3, Reto Babst3, Thomas Friess4, Ruth Volland5, Erich Hartwig6, Wolfgang Schmidt7, Sven Lendemans8, Benjamin Buecking9,10. 1. Klinik für Orthopädie und Unfallchirurgie, Alfried Krupp Krankenhaus, Hellweg 100, 45276, Essen, Deutschland. carsten.schoeneberg@krupp-krankenhaus.de. 2. Klinik für Unfall- und Wiederherstellungschirurgie, Universitätsklinikum RWTH, Aachen, Deutschland. 3. Klinik für Orthopädie und Unfallchirurgie, Luzerner Kantonsspital, Luzern, Schweiz. 4. Projektkoordination AltersTraumaZentrum DGU®, Herne, Deutschland. 5. AUC, Akademie der Unfallchirurgie GmbH, München, Deutschland. 6. Klinik für Orthopädie und Unfallchirurgie, ViDia Kliniken Karlsruhe Standort Diakonissenkrankenhaus, Karlsruhe, Deutschland. 7. Klinik für Unfallchirurgie, Sportorthopädie und Kindertraumatologie, Klinikum Garmisch-Partenkirchen, Garmisch-Partenkirchen, Deutschland. 8. Klinik für Orthopädie und Unfallchirurgie, Alfried Krupp Krankenhaus, Hellweg 100, 45276, Essen, Deutschland. 9. Zentrum für Orthopädie und Unfallchirurgie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg, Marburg, Deutschland. 10. DRK-Kliniken Nordhessen, Klinik für Orthopädie, Unfallchirurgie und Alterstraumatologie, Kassel, Deutschland.
Abstract
BACKGROUND: Geriatric trauma centers which are certified to the status of a Geriatic Trauma Center DGU® based on the criteria catalogue as outlined by the German Trauma Society (DGU), are required to participate in the Geriatric Trauma Register (ATR-DGU) for quality management and outcome analyses. The evaluation is pseudoanonymous and includes data on all treated hip fracture patients over 70 years old. This has been in regular use since 2016. This study analyzed the postoperative evaluation of gait, mortality, quality of life, hospital readmission and treatment of osteoporosis after 120 days. METHODS: A voluntary retrospective data evaluation of the ATR-DGU 120-day follow-up from 2017 was carried out. Written consent for the analysis and publication of the data was obtained from six clinics that already participated in the follow-up. The primary target parameters were mortality rate, readmission and revision rates, gait quality, osteoporosis treatment and quality of life according to EQ-5D-3L. The patient data were completely pseudonymized and a descriptive analysis was carried out. RESULTS: In this study 957 patients from the 6 hospitals were included. The average age was 84.5 years (±6.8 years). The mortality rate during the acute treatment phase was 5%. The 120-day follow-up could be evaluated in 412 patients, 10% of these required hospital readmission due to complications oft he same fracture and of these 6% required revision surgery. The mortality rate at 120 days was 12%. In 54% of the patients the fracture led to deterioration of mobility and 49% of patients received osteoporosis treatment after 120 days. The results of the EQ-5D-3L at 120 days revealed improvement as compared to the values on postoperative day 7; however, the preoperative status with respect to mobility and quality of life could not be regained. CONCLUSION: Despite the clear advantages of interdisciplinary treatment, the results are still limited concerning mobilization and quality of life. Further analysis of causative and influencing factors is necessary.
BACKGROUND:Geriatric trauma centers which are certified to the status of a Geriatic Trauma Center DGU® based on the criteria catalogue as outlined by the German Trauma Society (DGU), are required to participate in the Geriatric Trauma Register (ATR-DGU) for quality management and outcome analyses. The evaluation is pseudoanonymous and includes data on all treated hip fracturepatients over 70 years old. This has been in regular use since 2016. This study analyzed the postoperative evaluation of gait, mortality, quality of life, hospital readmission and treatment of osteoporosis after 120 days. METHODS: A voluntary retrospective data evaluation of the ATR-DGU 120-day follow-up from 2017 was carried out. Written consent for the analysis and publication of the data was obtained from six clinics that already participated in the follow-up. The primary target parameters were mortality rate, readmission and revision rates, gait quality, osteoporosis treatment and quality of life according to EQ-5D-3L. The patient data were completely pseudonymized and a descriptive analysis was carried out. RESULTS: In this study 957 patients from the 6 hospitals were included. The average age was 84.5 years (±6.8 years). The mortality rate during the acute treatment phase was 5%. The 120-day follow-up could be evaluated in 412 patients, 10% of these required hospital readmission due to complications oft he same fracture and of these 6% required revision surgery. The mortality rate at 120 days was 12%. In 54% of the patients the fracture led to deterioration of mobility and 49% of patients received osteoporosis treatment after 120 days. The results of the EQ-5D-3L at 120 days revealed improvement as compared to the values on postoperative day 7; however, the preoperative status with respect to mobility and quality of life could not be regained. CONCLUSION: Despite the clear advantages of interdisciplinary treatment, the results are still limited concerning mobilization and quality of life. Further analysis of causative and influencing factors is necessary.
Authors: Johannes Gleich; Evi Fleischhacker; Katherine Rascher; Thomas Friess; Christian Kammerlander; Wolfgang Böcker; Benjamin Bücking; Ulrich Liener; Michael Drey; Christine Höfer; Carl Neuerburg Journal: J Clin Med Date: 2021-11-23 Impact factor: 4.241