Trial reportBMJ open2021
Geriatric fracture centre vs usual care after proximal femur fracture in older patients: what are the benefits? Results of a large international prospective multicentre study.
Trial report in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02297581 (A Prospective Multicenter Cohort Study to Evaluate the Benefit of the Geriatric Fracture Center), which is not on this map. Cited by 11 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Prospective Multicenter Cohort Study to Evaluate the Benefit of the Geriatric Fracture Center (GFC) Concept
Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 21 citations in OpenAlex.
- The effects of in-hospital orthogeriatric care on health-related quality of life: a systematic review and meta-analysis.Age and ageing · 2025Pooled it
- Evaluation of Systemwide Improvement Programs to Optimize Time to Surgery for Patients With Hip Fractures: A Systematic Review.JAMA network open · 2022Pooled it
- Time Is Bone: Missed Opportunities for Secondary Prevention After a Hip Fracture.Journal of clinical medicine · 2025Review
- Safety and complications of antimicrobial coated compared to conventional intramedullary femoral nails in proximal femoral fractures.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Observational
- Waiting for surgery after hip fracture-Health and/or economic risk?The International journal of health planning and management · 2025Article
- Exploring geriatric trauma unit experiences through patients' eyes: a qualitative study.BMC geriatrics · 2024Article
- Geriatric proximal femur fracture updates.OTA international : the open access journal of orthopaedic trauma · 2024Article
- Contextual Determinants of Time to Surgery for Patients With Hip Fracture.JAMA network open · 2023Article
- Cost-effectiveness analysis of the Geriatric Fracture Center (GFC) concept: a prospective multicentre cohort study.BMJ open · 2023Article
- Overview of fracture liaison services in the UK and Europe: standards, model of care, funding, and challenges.OTA international : the open access journal of orthopaedic trauma · 2022Article
- 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
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors at 14 institutions in 8 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe aim of this study was to determine the effect of treatment in geriatric fracture centres (GFC) on the incidence of major adverse events (MAEs) in patients with hip fractures compared with usual care centres (UCC). Secondary objectives included hospital-workflow and mobility-related outcomes.
designCohort study recruiting patients between June 2015 and January 2017. Follow-up was 1 year.
settingInternational (six countries, three continents) multicentre study.
participants281 patients aged ≥70 with operatively treated proximal femur fractures.
interventionsTreatment in UCCs (n=139) or GFCs (n=142), that is, interdisciplinary treatment including regular geriatric consultation and daily physiotherapy. OUTCOME MEASURES: Primary outcome was occurrence of prespecified MAEs, including delirium. Secondary outcomes included any other adverse events, time to surgery, time in acute ward, 1-year mortality, mobility, and quality of life.
resultsPatients treated in GFCs (n=142) had a mean age of 81.9 (SD, 6.6) years versus 83.9 (SD 6.9) years in patients (n=139) treated in UCCs (p=0.013) and a higher mean Charlson Comorbidity Index of 2.0 (SD, 2.1) versus 1.2 (SD, 1.5) in UCCs (p=0.001). More patients in GFCs (28.2%) experienced an MAE during the first year after surgery compared with UCCs (7.9%) with an OR of 4.56 (95% CI 2.23 to 9.34, p<0.001). Analysing individual MAEs, this was significant for pneumonia (GFC: 9.2%; UCC: 2.9%; OR, 3.40 (95% CI 1.08 to 10.70), p=0.027) and delirium (GFC: 11.3%; UCC: 2.2%, OR, 5.76 (95% CI 1.64 to 20.23), p=0.002).
conclusionsContrary to our study hypothesis, the rate of MAEs was higher in GFCs than in UCCs. Delirium was revealed as a main contributor. Most likely, this was based on improved detection rather than a truly elevated incidence, which we interpret as positive effect of geriatric comanagement. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov: NCT02297581.
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