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[Translated article] How does multidisciplinary collaboration with an internal medicine physician influence mortality
L Cano-Obando1, J M Gómez-Palomo1, A Galán-Romero1
1Unidad de Cirugía Ortopédica y Traumatología, Hospital Universitario Virgen de la Victoria, Málaga, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.
Introduction:
The increase in life expectancy and the ageing 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.
Material And Methods:
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 centres were excluded. The minimum follow-up was 12 months.
Results:
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 72h were more frequent in the IM group (53.0 vs. 33.2%; p=.009).
Conclusions:
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.
