دورية أكاديمية
The effectiveness of a co-management care model on older hip fracture patients in China - A multicentre non-randomised controlled study.
| العنوان: | The effectiveness of a co-management care model on older hip fracture patients in China - A multicentre non-randomised controlled study. |
|---|---|
| المؤلفون: | Zhang J; School of Population Health, University of New South Wales, Sydney, New South Wales, Australia., Yang M; Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital, Peking University Fourth School of Clinical Medicine, Beijing, China., Zhang X; The George Institute for Global Health at Peking University Health Science Centre, Beijing, China., He J; Department of Orthopaedics, Beijing Shunyi District Hospital, Beijing, China., Wen L; Department of Orthopedics, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, P.R.China., Wang X; Department of Orthopaedics, Beijing Changping District Hospital, Beijing, China., Shi Z; Department of Orthopaedics, Beijing Liangxiang Hospital, Beijing, China., Hu S; Department of Orthopaedics, Beijing Anzhen Hospital, Capital Medical University, Beijing, China., Sun F; Department of Orthopedics, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, P.R.China., Gong Z; Department of Orthopaedics, Beijing Liangxiang Hospital, Beijing, China., Sun M; Department of Orthopaedics, Beijing Anzhen Hospital, Capital Medical University, Beijing, China., Li Q; The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia., Peng K; National Clinical Research Center for Cardiovascular Diseases, Shenzhen, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, Shenzhen, China., Ye P; The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.; National Centre for Non-Communicable Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, China., Ma R; Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital, Peking University Fourth School of Clinical Medicine, Beijing, China., Zhu S; Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital, Peking University Fourth School of Clinical Medicine, Beijing, China., Wu X; Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital, Peking University Fourth School of Clinical Medicine, Beijing, China., Webster RJ; The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.; Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, Australia., Ivers RQ; School of Population Health, University of New South Wales, Sydney, New South Wales, Australia.; The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia., Tian M; The George Institute for Global Health at Peking University Health Science Centre, Beijing, China.; The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.; School of Public Health, Harbin Medical University, Harbin, China. |
| المصدر: | The Lancet regional health. Western Pacific [Lancet Reg Health West Pac] 2021 Dec 31; Vol. 19, pp. 100348. Date of Electronic Publication: 2021 Dec 31 (Print Publication: 2022). |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Ltd Country of Publication: England NLM ID: 101774968 Publication Model: eCollection Cited Medium: Internet ISSN: 2666-6065 (Electronic) Linking ISSN: 26666065 NLM ISO Abbreviation: Lancet Reg Health West Pac Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Original Publication: [London] : Elsevier Ltd., [2020]- |
| مستخلص: | Background: Clinical guidelines recommend orthogeriatric care to improve older hip fracture patients' outcomes, but few studies have been conducted in China. This study evaluated the effects of an orthogeriatric co-management care model in six Chinese hospitals. Methods: This non-randomised controlled study was designed as an exploratory trial and was conducted in 3 urban and 3 suburban hospitals. Eligible patients were aged ≥ 65 years with X-ray confirmed hip fracture and admitted to hospital within 21 days of injury. All patients received three times follow-ups within one year (1-month, 4-month and 12-month post admission). Co-management care was implemented in 1 urban hospital, while usual care continued in 5 urban and suburban hospitals. Patient demographics, pre-, peri- and post-operative information, complications and mortality were collected at baseline and follow-ups. The primary outcome was proportion of patients receiving surgery within 48 hours from ward arrival. Secondary outcomes included osteoporosis assessment, in-hospital rehabilitation, length of hospital stay, in-hospital mortality and one-year cumulative mortality. Findings: There were 2,071 eligible patients enrolled (1,110 intervention, 961 control). Compared to usual care, a significantly higher proportion of intervention patients received surgery within 48 hours (75% vs 27%, p<0.0001), osteoporosis assessment (99.9% vs 60.6%, p<0.0001), rehabilitation (99.1% vs 3.9%, p<0.0001) and shorter length of hospital stay (6.1 days vs 12.0 days, p<0.0001). The intervention group saw a significant lower in-hospital mortality rate than the control group (adjusted relative risk 0.021, 95% CI 0.001 to 0.45, P=0.01). One-year cumulative mortality was also significantly reduced in the intervention group (hazard ratio 0.59, 95% CI 0.38 to 0.80, p=0.01). Interpretation: Co-management care of older hip fracture patients resulted in better outcomes, including decreased time to surgery, improved clinical management, and reduced one-year mortality. A randomised controlled trial is needed to provide definitive evidence. Funding: The study is supported by Capital's Funds for Health Improvement and Research (2018-1-2071). Competing Interests: All authors have not any conflict of interest to this study and have provided a conflict of interest statement. (© 2021 The Authors.) |
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| فهرسة مساهمة: | Keywords: China; Co-management care; Hip fracture; Older people; Orthogeriatric care |
| تواريخ الأحداث: | Date Created: 20220210 Latest Revision: 20220501 |
| رمز التحديث: | 20240628 |
| مُعرف محوري في PubMed: | PMC8814766 |
| DOI: | 10.1016/j.lanwpc.2021.100348 |
| PMID: | 35141666 |
| قاعدة البيانات: | MEDLINE |
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