Orthogeriatric co-management reduces incidence of delirium in hip fracture patients
| العنوان: | Orthogeriatric co-management reduces incidence of delirium in hip fracture patients |
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| المؤلفون: | Leiv Otto Watne, Truls Martin Straume-Næsheim, Marte Mellingsæter, Asbjørn Årøen, Bjørn Erik Neerland, Christian Thomas Pollmann |
| المصدر: | Osteoporosis International |
| بيانات النشر: | Springer Science and Business Media LLC, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | 0301 basic medicine, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, behavioral disciplines and activities, Hip fracture, Orthogeriatric co-management, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, mental disorders, medicine, Humans, Prospective Studies, Hip Fractures, business.industry, Incidence, Incidence (epidemiology), Delirium, Odds ratio, medicine.disease, Rheumatology, nervous system diseases, Logistic Models, Orthopedic surgery, Number needed to treat, Original Article, Observational study, 030101 anatomy & morphology, Subsyndromal delirium, medicine.symptom, business |
| الوصف: | Summary Hip fracture patients often display an acute confusional state (delirium) which is associated with worse outcomes. In this observational study, we found that co-management of hip fracture patients by a multidisciplinary team including a geriatrician and an orthopaedic surgeon could reduce the incidence of delirium. Introduction Delirium after hip fracture is common and is associated with negative outcomes. We investigated if orthogeriatric co-management reduced the incidence of delirium in hip fracture patients. Methods In this single-centre, prospective observational study, we compared the incidence of delirium and subsyndromal delirium (SSD) before (usual care group, n = 94) and after (orthogeriatric group, n = 103) the introduction of orthogeriatric co-management as an integrated care model. The outcome measure ‘no delirium/SSD/delirium’ was treated as an ordinal variable and analysed using the chi-squared test and multivariable ordinal logistic regression. Results The groups had similar baseline characteristics except for a higher proportion of patients with pre-existing cognitive impairment in the usual care group (51% vs. 37%, p = 0.045). Fewer patients in the orthogeriatric group developed SSD or delirium (no delirium: 59% vs. 40%/SSD: 6% vs. 13%/delirium: 35% vs. 47%; p = 0.021). The number needed to treat (NNT) to avoid one case of SSD or delirium was 5.3 (95% CI: 3.1 to 19.7). In a multivariable analysis adjusted for age, sex, ASA class, pre-existing cognitive impairment, time to surgery, type of surgery, and medical or surgical complications, the odds ratio for the development of SSD/delirium was lower in the orthogeriatric group (OR = 0.46, 95% CI: 0.23–0.89, p = 0.023). Conclusion Orthogeriatric co-management as an integrated care model reduced the incidence of SSD/delirium in hip fracture patients. Supplementary Information The online version contains supplementary material available at 10.1007/s00198-021-05974-8. |
| تدمد: | 1433-2965 0937-941X |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::cc2cfe3e6c8791d577232925d4d6f380 https://doi.org/10.1007/s00198-021-05974-8 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....cc2cfe3e6c8791d577232925d4d6f380 |
| قاعدة البيانات: | OpenAIRE |
Find this article in full text from Springer Verlag. | تدمد: | 14332965 0937941X |
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