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J Am Geriatr Soc. 2011 Jul;59(7):1299-308. doi: 10.1111/j.1532-5415.2011.03488.x. Epub 2011 Jun 30.

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

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  • 1Center for Health Services and Nursing Research, Katholieke Universiteit Leuven, Leuven, Belgium.

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.

© 2011, Copyright the Authors. Journal compilation © 2011, The American Geriatrics Society.

PMID:
21718273
[PubMed - indexed for MEDLINE]
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