Applying a multidisciplinary program for managing hip fractures in the elderly: incidence of comorbidities and their impact on surgical opportunity

Abstract

Background: The percentage of elderly in the population has increased in recent decades; this population is often affected by medical conditions that predispose to falls and hip fractures that commonly lead to multidisciplinary hospital care. Hip fractures are associated with mortality within 30 days of the fracture between 1.6-10% and between 20-35% along the first year after the fracture. Early surgical treatment has been associated with a lower mortality rate. Perform subsequent surgical procedures after the first 48 to 72 hours increases mortality, the problem is that many of these patients have comorbidities that often delay the surgical procedure.
Materials and methods: To evaluate how a multidisciplinary program appropriately handles the pathologies associated in elderly patients with hip fracture without delay the optimal time for performing the surgical procedure, a prospective descriptive study was conducted including all patients over 60 years admitted with diagnosis of hip fracture between December 2012 and August 2014.
Results: 86 patients with hip fracture diagnosis entered the multidisciplinary management program with a mean age of 80 years (range 59-99), with an average body mass index of 24.6 (18-38). 84.8% (n = 73) were female gender patients. 80.2% (n = 69) of the patients underwent to operating room within the first 48 hours from the time of the fracture; 90.8% (n = 78) were operated within the first 48 hours from admission to the institution. The overall mortality rate was 10.4% (n = 9/86). Mean follow up time was 1 year.
Discussion: We believe that the institutional creation of multidisciplinary teams for managing elderly population with hip fracture promotes early rehabilitation and decreasing mortality.
Evidence level. IV.