Preliminary results of orthogeriatric management in patients with hip fracture: Impact on functional recovery and survival

Abstract

IntroductionOrthogeriatric units have demonstrated improvements in functional recovery and survival in older adults hospitalised for hip fracture. The aim of this study is to present preliminary results of the interdisciplinary orthogeriatric activity at the Surgical Specialty Centre, Hamad Medical Corporation (Doha, Qatar). MethodsA prospective observational study was designed to evaluate the activity of the orthogeriatric unit in hip fracture patients between 2022 and 2024. Results100 patients were recruited with a mean age of 74.2 (SD 7.8) years, 57% were men, and a mean age-adjusted Charlson comorbidity index (CCI) of 4.4 (SD 1.7). Surgical delay was 1.8 (SD 3.4) days, with only 16% of the total undergoing surgery in more than 48h. The length of stay (LOS) of the enrolled sample was 15.8 (SD 23.1) days. In terms of functional recovery, the Barthel Index (BI) score increased significantly from 34.8 (SD 14.8) points on the first day of hospital admission to 55.7 (20.5) points at discharge, p<0.001; with a relative functional gain of 38.5 (SD 34.3) % and a rehabilitation efficiency (Heinemann Index above 50%) of 34.5%. The Heinemann Index calculated six months after discharge showed a rehabilitation efficiency of 60% of the total sample. Only one patient (1%) died in hospital and 3 (6%) had died at 6 months. Cox regression showed that CCI and LOS increased the risk of mortality, whereas BI score decreased it. ConclusionsThe introduction of an interdisciplinary orthogeriatric team in Qatar led to improvements in nutritional status, functional recovery and survival.