The effectiveness of a co-management care model on older hip fracture patients in China – A multicentre non-randomised controlled study

作者：Jing Zhang, Minghui Yang, Xinyi Zhang, Jiusheng He, Liangyuan Wen, Xianhai Wang, Zongxin Shi, Sanbao Hu, Fengpo Sun, Zishun Gong, Mingyao Sun, Qiang Li, Ke Peng, Pengpeng Ye, Ruofei Ma, Shiwen Zhu, Xinbao Wu, Ruth Webster, Rebecca Ivers, Maoyi Tian · 发表于：The Lancet Regional Health - Western Pacific · 年份：2021 · DOI：10.1016/j.lanwpc.2021.100348 · 被引用次数：51 · 研究领域：Hip and Femur Fractures、Total Knee Arthroplasty Outcomes、Trauma and Emergency Care Studies

BACKGROUND: Clinical guidelines recommend orthogeriatric care to improve older hip fracture patients' outcomes, but few studies have been conducted in China. This study evaluated the effects of an orthogeriatric co-management care model in six Chinese hospitals. METHODS: This non-randomised controlled study was designed as an exploratory trial and was conducted in 3 urban and 3 suburban hospitals. Eligible patients were aged ≥ 65 years with X-ray confirmed hip fracture and admitted to hospital within 21 days of injury. All patients received three times follow-ups within one year (1-month, 4-month and 12-month post admission). Co-management care was implemented in 1 urban hospital, while usual care continued in 5 urban and suburban hospitals. Patient demographics, pre-, peri- and post-operative information, complications and mortality were collected at baseline and follow-ups. The primary outcome was proportion of patients receiving surgery within 48 hours from ward arrival. Secondary outcomes included osteoporosis assessment, in-hospital rehabilitation, length of hospital stay, in-hospital mortality and one-year cumulative mortality. FINDINGS: There were 2,071 eligible patients enrolled (1,110 intervention, 961 control). Compared to usual care, a significantly higher proportion of intervention patients received surgery within 48 hours (75% vs 27%, p<0.0001), osteoporosis assessment (99.9% vs 60.6%, p<0.0001), rehabilitation (99.1% vs 3.9%, p<0.0001) and shorter length of hosp...