[Orthogeriatrics: supportive evidence for the process]
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1Service de Gériatrie, Hôpital Erasme, Bruxelles. thierry.pepersack@erasme.ulb.ac.be
Abstract:
Incidence of hip fractures increases dramatically in the aging population leading to increased admissions of frail old patients. The proof of concept of the efficacy of comprehensive geriatric assessment exists for non orthopaedic old subjects. This review identifies innovative models of care for the management of older adults with hip fracture, distinguished mainly on the basis of the role of the healthcare professionals involved in the care and their responsabilities. The managements are heterogeneous and the models are often combined. The choice to implement a model should depend of his level of evidence, the existing resources, and the willingness of both orthopaedic, and geriatric teams. The heterogeneity of the models, of the nature of interventions, of the populations and of the outcomes is challenging to undertake meta-analysis in order to choice one "universal" model. However there is a tendency to better overall outcomes in patient receiving co managed care: subjects admitted for hip fracture are often frail adults requiring a comprehensive management in order to identify and treat geriatric syndromes.
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