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Orthogeriatric care: improving patient outcomes

Authors Tarazona-Santabalbina FJ, Belenguer-Varea Á, Rovira E, Cuesta-Peredo D

Received 27 February 2016

Accepted for publication 23 April 2016

Published 24 June 2016 Volume 2016:11 Pages 843—856

DOI https://doi.org/10.2147/CIA.S72436

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Lucy Goodman

Peer reviewer comments 2

Editor who approved publication: Dr Richard Walker

Video abstract presented by Francisco José Tarazona-Santabalbina

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Francisco José Tarazona-Santabalbina,1,2 Ángel Belenguer-Varea,1,2 Eduardo Rovira,1,2 David Cuesta-Peredó1,2

1Geriatric Medicine Unit, Internal Medicine Department, Hospital Universitario de la Ribera, 2Medical School, Universidad Católica de Valencia San vicente Mártir, Valencia, Spain

Abstract: Hip fractures are a very serious socio-economic problem in western countries. Since the 1950s, orthogeriatric units have introduced improvements in the care of geriatric patients admitted to hospital because of hip fractures. During this period, these units have reduced mean hospital stays, number of complications, and both in-hospital mortality and mortality over the middle term after hospital discharge, along with improvements in the quality of care and a reduction in costs. Likewise, a recent clinical trial has reported greater functional gains among the affected patients. Studies in this field have identified the prognostic factors present upon admission or manifesting themselves during admission and that increase the risk of patient mortality or disability. In addition, improved care afforded by orthogeriatric units has proved to reduce costs. Nevertheless, a number of management issues remain to be clarified, such as the optimum anesthetic, analgesic, and thromboprophylactic protocols; the type of diagnostic and therapeutic approach best suited to patients with cognitive problems; or the efficiency of the programs used in convalescence units or in home rehabilitation care. Randomized clinical trials are needed to consolidate the evidence in this regard.

Keywords: hip fractures, geriatric assessment, orthogeriatric care, recovery of function, mortality

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