ORIGINAL ARTICLE: EPIDEMIOLOGY,
CLINICAL PRACTICE AND HEALTH
Advantages of care for patients with hip fractures in the acute
geriatric unit: Hip study Anoia
Maria Teresa Salgado,
and Ramón Sellarès
Acute Geriatric Unit
Traumatology and Orthopedic Surgery Department,
Anesthesiology Department, Igualada
Physiotherapy Department, St. Joseph Health Foundation of Igualada, Igualada and
Geriatrics Program, Internal Medicine
Department, University Bellvitge Hospital. IDIBELL, L’Hospitalet de Llobregat, Spain
Aim: Hip fracture as a result of bone fragility is characterized by poor health outcomes in the medium and long
term. Our goal was to compare a new orthogeriatric model with the old trauma model and evaluate improvements in
Methods: We carried out a comparative unicentric study, a historical sample (trauma model) collected from 1 June
2007 to 31 May 2010, versus a prospective sample (orthogeriatric model) collected from 1 June 2010 until 31 May
2013. We included all patients aged >69 years with hip fracture as a result of bone fragility.
Results: A total of 792 patients were evaluated (mean age 84.3 years). The surgical waiting period went from
2.70 days in the trauma model to 1.86 days in the orthogeriatric model (P < 0.001); the average stay was 15.76 days
in the trauma model, and for the orthogeriatric model was reduced to 5.90 days (P < 0.001); mortality went from
4.5% to 1.3% (P ≤ 0.010); 1 month readmission for hip dislocation was reduced from 2.3% to 0.5% (P = 0.032).
After a 6-month follow up, we had 302 trauma model patients and 287 orthogeriatric model patients. After 1 year,
we had 288 patients in the trauma model and 264 patients in the orthogeriatric model. The main cause of abandon-
ment was death, 108 patients (27.3%) in the trauma model and 100 patients (27.5%) in the orthogeriatric model
(P = 0.951).
Conclusions: When we compared the two models, we found statistically signiﬁcant better results in the preopera-
tive waiting period, average stay, hospital mortality and 1 month readmission as a result of hip prosthesis luxation in
favor of the orthogeriatric model. Geriatr Gerontol Int 2018; 18: 407–414.
Keywords: acute geriatric unit, elderly, hip fracture, orthogeriatric model.
Hip fracture is a bone fragility fracture, and it has the
greatest impact on patients and are one of the most sig-
niﬁcant public health problems in western countries.
A total of 90% of cases occur in people aged >50 years,
with an average age of approximately 80 years.
Hospital mortality rises from 4% to 8%,
to 25% 1 year later and 40% in 2 years. Less than 40% of
patients regain their previous level of functionality at
3 months post-fracture and 80% patients regain their pre-
vious level of functionality after 12 months post-
and is the reason for new patient institutionali-
zation, causing high economic costs.
Currently, there is a great variability of the care
models to assist elderly patients with hip fracture; how-
ever, none are clearly superior to the others; all of them
have their advantages and limitations.
Heyburn et al.
identiﬁed four different models of
multidisciplinary orthogeriatric units: (i) the traditional
model, where the elderly patient is admitted to a trauma
ward with a fracture and subsequent care is given by
the trauma physician and the nursing staff; (ii) the sec-
ond model, a geriatrician or internist is partially incor-
porated into the traditional model; (iii) the third model
corresponds to the “Hastings model,”
acute treatment given by an orthopedic team, and sub-
sequent transfer of the more complex clinical and/or
functional patients to a geriatric rehabilitation unit; and
Accepted for publication 27 August 2017.
Correspondence: Dr Enric Duaso PhD, Department of Geriatrics,
Hospital de Igualada, Avenida Cataluña, 11, 08700 Igualada,
Barcelona, Spain. Email: firstname.lastname@example.org
doi: 10.1111/ggi.13191 |© 2017 Japan Geriatrics Society
Geriatr Gerontol Int 2018; 18: 407–414