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Effect of an inpatient geriatric consultation team on functional outcome, mortality, institutionalization, and readmission rate in older adults with hip fracture: A controlled trial

Authors

Deschodt, Mieke, Braes, Tom, Broos, Paul, Sermon, An, Boonen, Steven, Flamaing, Johan, Milisen, Koen

Journal

Journal of the American Geriatrics Society, Volume: 59, No.: 7, Pages.: 1299-1308

Year of Publication

2011

Abstract

Objectives: To evaluate the effect of an inpatient geriatric consultation team (IGCT) on end points of interest in people with hip fracture: length of stay, functional status, mortality, new nursing home admission, and hospital readmission. Design: Controlled trial based on assignment by convenience. Setting: Trauma ward in a university hospital. Participants: One hundred seventy-one people with hip fracture aged 65 and older. Intervention: Participants were assigned to a multidisciplinary geriatric intervention (n = 94) or usual care (n = 77) during hospitalization after hip fracture. Measurements: End points were functional status, length of stay, mortality, new nursing home admission, and hospital readmission 6 weeks, 4 months, and 12 months after surgery. Results: Mean length of stay was 11.1 ± 5.1 days in the intervention group and 12.4 ± 8.5 days in the control groups (P = .24). Complete adherence to IGCT recommendations was 56.8%. A significant benefit of intervention on functional status in univariate analyses (P = .02) 8 days after surgery disappeared in a linear mixed model. Participants with dementia had better functional status in a linear mixed model than those without (P = .03), but this effect was no longer significant after Bonferroni correction for multiple testing. After 6 weeks, 4 months, and 12 months, no between-group differences could be documented for mortality, new nursing home admission, or readmission rate. Conclusion: This trial could not document functional benefits of an IGCT intervention in people with hip fracture. More research is needed to investigate whether a more-intensive approach with more-direct control over patient management, more-specific recommendations, and more-intense education would be effective. (PsycINFO Database Record (c) 2014 APA, all rights reserved). (journal abstract)

Bibtex Citation

@article{Deschodt_2011, doi = {10.1111/j.1532-5415.2011.03488.x}, url = {http://dx.doi.org/10.1111/j.1532-5415.2011.03488.x}, year = 2011, month = {jun}, publisher = {Wiley-Blackwell}, volume = {59}, number = {7}, pages = {1299--1308}, author = {Mieke Deschodt and Tom Braes and Paul Broos and An Sermon and Steven Boonen and Johan Flamaing and Koen Milisen}, title = {Effect of an Inpatient Geriatric Consultation Team on Functional Outcome, Mortality, Institutionalization, and Readmission Rate in Older Adults with Hip Fracture: A Controlled Trial}, journal = {Journal of the American Geriatrics Society} }

Keywords

death and dying, fracture, geriatric patients, hip, hip fracture, hips, hospitalization, injuries, inpatient geriatrics consultation team, institutionalization, mortality, nursing homes

Countries of Study

Belgium

Types of Dementia

Dementia (general / unspecified)

Types of Study

Non randomised controlled trial

Type of Outcomes

Carer Burden (instruments measuring burden), Prevention and/or management of co-morbidities, Service use or cost reductions (incl. hospital use reduction, care home admission delay)

Settings

Hospital Inpatient Care

Type of Interventions

Treatment/prevention of co-morbidities or additional risks

Co-Morbidities

1

Workforce Interventions

Age discrimination training