استعرض مصدر Effect of an Inpatient Geriatric Consultation Team on Functional Outcome, Mortality, Institutionalization, and Readmission Rate in Older Adults with Hip Fracture: A Controlled Trial


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 5 94) or usual care
(n 5 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 5.24). Complete adherence to IGCT recommendations
was 56.8%. A significant benefit of intervention on
functional status in univariate analyses (P 5.02) 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 5.03), 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. 

J Am Geriatr Soc 59:1299–1308, 2011.

Key words: geriatric consultation; inpatient; elderly; hip
fracture



https://lirias.kuleuven.be/bitstream/123456789/298224/2/Deschodt+et+al.+JAGS+2011.pdf

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