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[The effectiveness of geriatric interconsultation in elderly patients admitted to traumatology]
A J Cruz Jentoft1, J A Serra Rexach, M Lázaro del Nogal
1Servicio de Geriatría, Hospital Universitario San Carlos, Madrid.
Objective:
To determine the effect of inpatient geriatric consultation in elderly orthopedic patients.
Design:
Before-after intervention trial.
Setting:
Tertiary care university hospital in Madrid (Spain).
Patients:
All patients older than 64 years admitted to the orthopedic department during one year before (481 patients) and six months after (283 patients) the establishment of geriatric consultation.
Intervention:
A geriatric consultation team (attending physician and fellow) evaluated, and actively treated when appropriate, most of the patients; follow-up ensued when need until clinical stability or death.
Main Outcome Measures:
In-hospital mortality, length of hospital stay and transfers to other departments.
Results:
There was no difference in sex (percent males 23% vs 24%), age (79.2 vs 79.1 years), or length of stay (27.7 vs 26.3 days). Lower in-hospital mortality (9.36% vs 4.95%, p = 0.017) and more transfers to other departments (4.99% vs 12.37%, p = 0.0007) occurred in the study group.
Conclusions:
This model of geriatric consultation achieved a lower mortality in orthopedic elderly patients. Length of stay did not change, but there was a higher rate of transfers to other departments. Further controlled studies are needed.
