How does multidisciplinary collaboration with an internal medicine physician influence mortality in hip fracture...

The increase in life expectancy and the aging population have led to a higher incidence of hip fractures, especially in women over 60 years old. This study analyzes the influence of a multidisciplinary team with the collaboration of a specialist in internal medicine (IM) with the trauma department on mortality, perioperative complications and hospital stay in patients with hip fractures.

An analytical observational study of historical cohorts was conducted in patients over 65 years admitted for hip fracture and treated with arthroplasty or intramedullary nailing. Two cohorts were established: one before and one after the IM assignment. Patients with metabolic bone diseases different from osteoporosis and those who were operated in other centers were excluded. The minimum follow-up was 12 months.

A total of 190 patients (50 men, 140 women) were included, with a mean age of 82.0 years and a BMI of 27.5. Mortality, which was the main objective of our study, during the first 12 months was higher in the non-IM (27.1 vs. 13.5%; P=.035). In addition, we included systemic complications and hospital stay as secondary objectives. Systemic complications were also higher in the non-IM cohort (43.2 vs. 27.1%; P=.031). Overall hospital stay was shorter in the IM cohort (7.3 vs. 9.9 days; P=.001). "Preoperative stays shorter than 72 hours" were more frequent in the IM group (53.0 vs. 33.2%; P=.009).

Multidisciplinary collaboration with a specialist in internal medicine significantly reduces first-year mortality, systemic complications, and hospital stay in hip fracture patients, allowing earlier interventions and hospital discharge.