ArticleDer Unfallchirurg2019
[Geriatric Trauma Center DGU®: Evaluation of clinical and economic parameters : A pilot study in a german university hospital].
Article in Der Unfallchirurg, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled it.
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Who cites it
29 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Association of orthogeriatric care models with evaluation and treatment of osteoporosis: a systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020Pooled it
- [Osteosynthesis for tibial plateau fractures in geriatric patients].Unfallchirurgie (Heidelberg, Germany) · 2026Review
- Characterization of orthogeriatric care models and association with mortality and health-economic outcomes in patients with hip fractures: a retrospective cohort study from Germany.BMC geriatrics · 2026Article
- Observational study on the comparability of the clinical profiles of older adults with hip fractures and pelvic fractures in Germany.Zeitschrift fur Gerontologie und Geriatrie · 2026Article
- Validation of the Geriatrics at Risk Score (GeRi-Score) on 120-day follow-up, the influence of preoperative geriatric visits, and the time to surgery on the outcome of hip fracture patients: an analysis from the Registry for Geriatric Trauma (ATR-DGU).Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2024Article
- First year report of the IMSS Multicenter Hip Fracture Registry.Archives of osteoporosis · 2024Observational
- Health-economic evaluation of orthogeriatric co-management for patients with pelvic or vertebral fragility fractures.BMC geriatrics · 2024Article
- Health-economic evaluation of orthogeriatric co-management for patients with forearm or humerus fractures: an analysis of insurance claims data from Germany.BMC health services research · 2024Article
- Evaluation of costs, osteoporosis treatment, and re-fractures in German collaborative orthogeriatric care after fragility fractures.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2024Article
- The Geriatrics at Risk Score (GeRi-Score) for mortality prediction in geriatric patients with proximal femur fracture - a development and validation study from the Registry for Geriatric Trauma (ATR-DGU).Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2023Article
- Orthogeriatric co-management: differences in outcome between major and minor fractures.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Article
- Geriatric patients with dementia show increased mortality and lack of functional recovery after hip fracture treated with hemiprosthesis.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Article
- Differences of hemiarthroplasty and total hip replacement in orthogeriatric treated elderly patients: a retrospective analysis of the Registry for Geriatric Trauma DGUEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Article
- The Predictive Value of the "Identification of Seniors at Risk" Score on Mortality, Length of Stay, Mobility and the Destination of Discharge of Geriatric Hip Fracture Patients.Clinical interventions in aging · 2022Article
- [Influence of timing of surgery on complication rates after cemented hemiarthroplasty for treatment of medial femoral neck fractures].Der Unfallchirurg · 2021Article
- In-Hospital Clinical Outcomes in Patients with Fragility Fractures of the Lumbar Spine, Thoracic Spine, and Pelvic Ring: A Comparison of Data before and after Certification as a DGUMedicina (Kaunas, Lithuania) · 2021Observational
- Fragility Fractures: Risk Factors and Management in the Elderly.Medicina (Kaunas, Lithuania) · 2021Review
- Health-economic evaluation of collaborative orthogeriatric care for patients with a hip fracture in Germany: a retrospective cohort study using health and long-term care insurance claims data.The European journal of health economics : HEPAC : health economics in prevention and care · 2021Article
- Intracapsular Femoral Neck Fractures-A Surgical Management Algorithm.Medicina (Kaunas, Lithuania) · 2021Review
- Care of Geriatric Patients with Lumbar Spine, Pelvic, and Acetabular Fractures before and after Certification as a Geriatric Trauma Center DGUMedicina (Kaunas, Lithuania) · 2021Article
Corrections and comments
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPrevious studies on orthogeriatric models of care suggest that there is substantial variability in how geriatric care is integrated in the patient management and the necessary intensity of geriatric involvement is questionable.
objectiveThe aim of the current prospective cohort study was the clinical and economic evaluation of fragility fracture treatment pathways before and after the implementation of a geriatric trauma center in conformity with the guidelines of the German Trauma Society (DGU).
methodsA comparison of three different treatment models (6 months each) was performed: A: Standard treatment in Orthopaedic Trauma; B: Special care pathways with improvement of the quality management system and implementation of standard operating procedures; C: Interdisciplinary treatment with care pathways and collaboration with geriatricians (ward round model).
resultsIn the 151 examined patients (m/w 47/104; 83.5 (70-100) years; A: n = 64, B: n = 44, C: n = 43) pathways with orthogeriatric comanagement (C) improved frequency of postoperative mobilization (p = 0.021), frequency of osteoporosis prophylaxis (p = 0.001) and the discharge procedure (p = 0.024). In comparison to standard treatment (A), orthogeriatric comanagement (C) was associated with lower rates of mortality (9% vs. 2%; p = 0.147) and cardio-respiratory complications (39% vs. 28%; p = 0.235) by trend. In this context, there were low rates of myocardial infarction (6% vs. 0%), dehydration (6% vs. 0%), cardiac dysrhythmia (8% vs. 0%), pulmonary decompensation (28% vs. 16%), electrolyt dysbalance (34% vs. 19%) and pulmonary edema (11% vs. 2%). Duration of stay in an intensive care unit was 29 h (A) and 18 h (C) respectively (p = 0.205), with consecutive reduction in costs. A sole establishment of a special care pathway for older hip fracture patients (B) showed a lower rate of myocardial infarction (A: 11%, B: 0%, C: 0%; p = 0.035).
conclusionThere was a clear tendency to a better overall result in patients receiving multidisciplinary orthogeriatric treatment using a ward visit model of orthogeriatric comanagement, with lower rates of cardiorespiratory complications and mortality. While special care pathways could reduce the rate of myocardial infarction in hip fracture patients, costs and revenues showed no difference between all care models evaluated. However, patients with hip fracture or periprosthetic fracture represent cohorts at clinical and economic risk as well.
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