Research ExplorerPublicationsThe association between orthogeriatric co-management and mor...

The association between orthogeriatric co-management and mortality following hip fracture

Standard

The association between orthogeriatric co-management and mortality following hip fracture : an observational study of 58 000 patients from 828 hospitals. / Rapp, Kilian; Becker, Clemens; Todd, Chris; Rothenbacher, Dietrich; Schulz, Claudia; König, Hans-Helmut; Liener, Ulrich; Hartwig, Erich; Büchele, Gisela.

In: DTSCH ARZTEBL INT, Vol. 117, No. 4, 24.01.2020, p. 53-59.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Rapp, K, Becker, C, Todd, C, Rothenbacher, D, Schulz, C, König, H-H, Liener, U, Hartwig, E & Büchele, G 2020, 'The association between orthogeriatric co-management and mortality following hip fracture: an observational study of 58 000 patients from 828 hospitals', DTSCH ARZTEBL INT, vol. 117, no. 4, pp. 53-59. https://doi.org/10.3238/arztebl.2020.0053

APA

Rapp, K., Becker, C., Todd, C., Rothenbacher, D., Schulz, C., König, H-H., Liener, U., Hartwig, E., & Büchele, G. (2020). The association between orthogeriatric co-management and mortality following hip fracture: an observational study of 58 000 patients from 828 hospitals. DTSCH ARZTEBL INT, 117(4), 53-59. https://doi.org/10.3238/arztebl.2020.0053

Vancouver

Rapp K, Becker C, Todd C, Rothenbacher D, Schulz C, König H-H et al. The association between orthogeriatric co-management and mortality following hip fracture: an observational study of 58 000 patients from 828 hospitals. DTSCH ARZTEBL INT. 2020 Jan 24;117(4):53-59. https://doi.org/10.3238/arztebl.2020.0053

Bibtex

@article{e8dcad5891d94880afc03af705858c79,
title = "The association between orthogeriatric co-management and mortality following hip fracture: an observational study of 58 000 patients from 828 hospitals",
abstract = "BACKGROUND: To meet the special needs of older patients with fragility fractures, models for collaborative orthogeriatric care have been developed. The objective of our study was to analyze the association of orthogeriatric co-management with mortality following hip fracture in older patients in Germany.METHODS: This observational study was based on health insurance claims data from 58 001 patients (79.4% women) aged ≥80 years admitted to the hospital with hip fracture between January 2014 and March 2016. They were treated in 828 German hospitals with or without orthogeriatric co-management. The outcome measure was cumulative mortality with adjustment of the regression analyses.RESULTS: The crude 30-day mortality was 10.3% for patients from hospitals with orthogeriatric co-management and 13.4% for patients from hospitals without orthogeriatric co-management. The adjusted 30-day mortality was 22% lower for patients in hospitals with orthogeriatric co-management (rate ratio 0.78; 95% CI [0.74; 0.82]; adjusted absolute difference -2.48%; 95% CI [-2.98; -1.98]). The difference in 30-day mortality remained nearly unchanged over the first 6 months. The risk reduction with orthogeriatric co-management was consistently observed in both women and men, across age groups, and in patients with and without care needs. The mean length of the index stay was 19.8 days in hospitals with orthogeriatric co-management and 14.4 days in hospitals without orthogeriatric co-management.CONCLUSION: A multidisciplinary orthogeriatric approach is associated with lower mortality and a longer index stay in hospital after hip fracture.",
keywords = "Aged, 80 and over, Female, Germany/epidemiology, Hip Fractures/mortality, Humans, Male, Treatment Outcome",
author = "Kilian Rapp and Clemens Becker and Chris Todd and Dietrich Rothenbacher and Claudia Schulz and Hans-Helmut K{\"o}nig and Ulrich Liener and Erich Hartwig and Gisela B{\"u}chele",
year = "2020",
month = jan,
day = "24",
doi = "10.3238/arztebl.2020.0053",
language = "English",
volume = "117",
pages = "53--59",
journal = "DTSCH ARZTEBL INT",
issn = "1866-0452",
publisher = "Deutscher Arzte-Verlag",
number = "4",

}

RIS

TY - JOUR

T1 - The association between orthogeriatric co-management and mortality following hip fracture

T2 - an observational study of 58 000 patients from 828 hospitals

AU - Rapp, Kilian

AU - Becker, Clemens

AU - Todd, Chris

AU - Rothenbacher, Dietrich

AU - Schulz, Claudia

AU - König, Hans-Helmut

AU - Liener, Ulrich

AU - Hartwig, Erich

AU - Büchele, Gisela

PY - 2020/1/24

Y1 - 2020/1/24

N2 - BACKGROUND: To meet the special needs of older patients with fragility fractures, models for collaborative orthogeriatric care have been developed. The objective of our study was to analyze the association of orthogeriatric co-management with mortality following hip fracture in older patients in Germany.METHODS: This observational study was based on health insurance claims data from 58 001 patients (79.4% women) aged ≥80 years admitted to the hospital with hip fracture between January 2014 and March 2016. They were treated in 828 German hospitals with or without orthogeriatric co-management. The outcome measure was cumulative mortality with adjustment of the regression analyses.RESULTS: The crude 30-day mortality was 10.3% for patients from hospitals with orthogeriatric co-management and 13.4% for patients from hospitals without orthogeriatric co-management. The adjusted 30-day mortality was 22% lower for patients in hospitals with orthogeriatric co-management (rate ratio 0.78; 95% CI [0.74; 0.82]; adjusted absolute difference -2.48%; 95% CI [-2.98; -1.98]). The difference in 30-day mortality remained nearly unchanged over the first 6 months. The risk reduction with orthogeriatric co-management was consistently observed in both women and men, across age groups, and in patients with and without care needs. The mean length of the index stay was 19.8 days in hospitals with orthogeriatric co-management and 14.4 days in hospitals without orthogeriatric co-management.CONCLUSION: A multidisciplinary orthogeriatric approach is associated with lower mortality and a longer index stay in hospital after hip fracture.

AB - BACKGROUND: To meet the special needs of older patients with fragility fractures, models for collaborative orthogeriatric care have been developed. The objective of our study was to analyze the association of orthogeriatric co-management with mortality following hip fracture in older patients in Germany.METHODS: This observational study was based on health insurance claims data from 58 001 patients (79.4% women) aged ≥80 years admitted to the hospital with hip fracture between January 2014 and March 2016. They were treated in 828 German hospitals with or without orthogeriatric co-management. The outcome measure was cumulative mortality with adjustment of the regression analyses.RESULTS: The crude 30-day mortality was 10.3% for patients from hospitals with orthogeriatric co-management and 13.4% for patients from hospitals without orthogeriatric co-management. The adjusted 30-day mortality was 22% lower for patients in hospitals with orthogeriatric co-management (rate ratio 0.78; 95% CI [0.74; 0.82]; adjusted absolute difference -2.48%; 95% CI [-2.98; -1.98]). The difference in 30-day mortality remained nearly unchanged over the first 6 months. The risk reduction with orthogeriatric co-management was consistently observed in both women and men, across age groups, and in patients with and without care needs. The mean length of the index stay was 19.8 days in hospitals with orthogeriatric co-management and 14.4 days in hospitals without orthogeriatric co-management.CONCLUSION: A multidisciplinary orthogeriatric approach is associated with lower mortality and a longer index stay in hospital after hip fracture.

KW - Aged, 80 and over

KW - Female

KW - Germany/epidemiology

KW - Hip Fractures/mortality

KW - Humans

KW - Male

KW - Treatment Outcome

U2 - 10.3238/arztebl.2020.0053

DO - 10.3238/arztebl.2020.0053

M3 - SCORING: Journal article

C2 - 32036854

VL - 117

SP - 53

EP - 59

JO - DTSCH ARZTEBL INT

JF - DTSCH ARZTEBL INT

SN - 1866-0452

IS - 4

ER -