Gulistan Bahat1, Nezahat Muge Catikkas2, Mehmet Akif Karan2, Jean Yves Reginster3. 1. Division of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University, Capa, 34093, Istanbul, Turkey. gbahatozturk@yahoo.com. 2. Division of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University, Capa, 34093, Istanbul, Turkey. 3. Department of Public Health, Epidemiology and Health Economics, Liège Medical School, University of Liège, Liège, Belgium.
Abstract
PURPOSE: Orthogeriatrics is a team approach that aims to provide adequate and timely intervention for individuals suffering from fragility fractures, particularly hip fractures. These patients are mostly the frailest older adults. The aim of orthogeriatrics is to re-gain functionality as early as possible and to decrease disability and mortality. Some developed countries have established orthogeriatric services, while many others, including Turkey, have so far not. Here, to identify areas for improvement, we outline the status of the orthogeriatrics in older adults in Turkey. METHODS: We present clear calls for action, emphasizing possible and noteworthy areas for improvement. RESULTS: Our proposals include the need for an easily applied, short version of comprehensive geriatric assessment; appropriate laboratory testing on admission; paracetamol with a special emphasis in its dosings and clues for state-of-the-art analgesic management; the essential need to introduce oral nutritional supplementation, irrespective of nutritional status; the need for vitamin D commencement, in almost all patients; and starting osteoporosis treatment in fracture hospitalization, whenever appropriate. Last but not least, the ever-increasing prerequisite to establish "fracture liaison services" is stipulated. CONCLUSION: We suggest that our recommendations offer great potential in Turkey, for the improvement of frail fracture patients' care. We call the other countries that do not have established orthogeriatric lines to model our approach to improve the management of fracture patients globally.
PURPOSE: Orthogeriatrics is a team approach that aims to provide adequate and timely intervention for individuals suffering from fragility fractures, particularly hip fractures. These patients are mostly the frailest older adults. The aim of orthogeriatrics is to re-gain functionality as early as possible and to decrease disability and mortality. Some developed countries have established orthogeriatric services, while many others, including Turkey, have so far not. Here, to identify areas for improvement, we outline the status of the orthogeriatrics in older adults in Turkey. METHODS: We present clear calls for action, emphasizing possible and noteworthy areas for improvement. RESULTS: Our proposals include the need for an easily applied, short version of comprehensive geriatric assessment; appropriate laboratory testing on admission; paracetamol with a special emphasis in its dosings and clues for state-of-the-art analgesic management; the essential need to introduce oral nutritional supplementation, irrespective of nutritional status; the need for vitamin D commencement, in almost all patients; and starting osteoporosis treatment in fracture hospitalization, whenever appropriate. Last but not least, the ever-increasing prerequisite to establish "fracture liaison services" is stipulated. CONCLUSION: We suggest that our recommendations offer great potential in Turkey, for the improvement of frail fracture patients' care. We call the other countries that do not have established orthogeriatric lines to model our approach to improve the management of fracture patients globally.
Authors: Dimitrios A Flevas; Panayiotis D Megaloikonomos; Leonidas Dimopoulos; Evanthia Mitsiokapa; Panayiotis Koulouvaris; Andreas F Mavrogenis Journal: EFORT Open Rev Date: 2018-04-27