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Implementation of Orthogeriatrics in Portugal.

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Orthogeriatric units improve care for elderly patients with femur fractures, reducing in-hospital deaths. This specialized approach enhances outcomes for frail individuals with multiple health issues.

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Area of Science:

  • Geriatric Medicine
  • Orthopaedics
  • Internal Medicine

Background:

  • Orthogeriatrics focuses on elderly patients with fragility fractures.
  • Portugal's first Orthogeriatrics Unit was established in 2015 at Vila Nova de Gaia Hospital Centre.
  • The unit operates under a co-management model between internal medicine and orthopaedics.

Purpose of the Study:

  • To evaluate the effectiveness of an orthogeriatric unit in managing elderly patients with femur fractures.
  • To assess the impact of multidisciplinary care on patient outcomes, including mortality, functionality, and length of stay.

Main Methods:

  • Retrospective analysis of 444 patients over 65 with femur fractures admitted to the orthogeriatric unit.
  • Comprehensive geriatric assessment, postoperative monitoring, and functional rehabilitation.
  • Statistical analysis using Kaplan-Meier curves and Cox regression for mortality.

Main Results:

  • The typical patient was an 84-year-old female with multiple comorbidities (mean Charlson Index 4.85).
  • High rates of medical complications (86.3%) and geriatric syndromes were observed.
  • Reduced in-hospital mortality (2.65%), with 73% returning home and 75% achieving a modified Rankin Scale score < 3 at discharge.

Conclusions:

  • Orthogeriatric units effectively reduce in-hospital mortality in frail elderly patients with femur fractures.
  • Co-management between internal medicine and orthopaedics is crucial for successful outcomes.
  • The model demonstrates significant benefits for patients with fragility fractures.