Evidence map›Paper›PMID 41239506›Full record

ArticleJournal of orthopaedic surgery and research2025

Difference in discharge disposition, adherence to clinical care standards and functional outcomes of older hip fracture patients receiving an orthogeriatric model of care versus routine care.

Seraina Netzer, Christian Ruch, Silviya Ivanova, Andreas Limacher, Lisa Meyer, Anna K Eggimann

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of orthopaedic surgery and research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
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1 · What the graph read from 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.

2 · The registry

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3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

Seraina NetzerDepartment of Geriatrics, Bern University Hospital, Inselspital, and University of Bern, Bern, Switzerland. seraina.netzer@extern.insel.ch.
Christian RuchMedical Faculty, University of Bern, Bern, Switzerland.
Silviya IvanovaDepartment of Orthopedic Surgery and Traumatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Andreas LimacherDepartment of Clinical Research, University of Bern, Bern, Switzerland.
Lisa MeyerDepartment of Orthopedic Surgery and Traumatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Anna K EggimannDepartment of Geriatrics, Bern University Hospital, Inselspital, and University of Bern, Bern, Switzerland.

Funding

Inselspital, Universitätsspital Bern Forschungsfonds der Geriatrischen Universitätsklinik
6 · The paper itself

Abstract

backgroundHip fractures are a common injury among older adults, leading to higher morbidity and mortality. Effective treatment pathways are needed. We aimed to compare an orthogeriatric model of care (OMC) and routine care in older hip fracture patients regarding discharge disposition, adherence to clinical care standards and functional outcomes.

methodsWe performed a retrospective cohort study in patients aged ≥ 70 years with acute hip fracture consecutively admitted to a tertiary Swiss hospital between January 1, 2023 and December 31, 2023 (n = 100). Patients meeting eligibility criteria (≥ 3 geriatric syndromes, no severe dementia) received OMC (n = 46) including an intensive multiprofessional rehabilitation program (MRP) comprising 7 physical, 2 nutritional, and 1 occupational therapy sessions led by a geriatrician during the acute hospital stay. All other patients received routine care (n = 56) on the same acute ward led by an orthopedic surgeon. Discharge destination, adherence to nine pre-specified clinical care standards and functional outcomes (Barthel index [BI] and De Morton Mobility index [DEMMI]), were assessed.

resultsMean age was 83.6 years, 59% were female, and 66% frail (Clinical Frailty Scale ≥ 5). Overall, 30 patients (65.2%) in the OMC were discharged to inpatient geriatric rehabilitation compared to 15 patients (27.8%) in routine care. After post-acute rehabilitation, 23 patients (50%) in the OMC versus 16 patients (29.6%) in routine care were discharged home. Length of stay was similar in the OMC versus routine care (10.8 vs. 9.4 days). Mean adherence to nine clinical care standards was 87.9% in the OMC versus 58.7% in routine care. In OMC patients, adherence was lowest for pain management using a femoral nerve block (58.7%), and full-weight bearing (76.1%), while full adherence was observed for mobilization the first day after surgery. In the OMC, functional outcomes improved within 7 days (median increase BI 10 points, DEMMI 8 points).

conclusionsThe OMC including MRP resulted in higher numbers discharged to post-acute rehabilitation and to home afterwards, as well as improvement of adherence to clinical care standards and functional outcomes, suggesting that OMC is a promising care model. Refinement of OMC is needed to optimize adherence to full weight-bearing and femoral nerve block.

Indexed as

Hip FracturesPatient DischargeStandard of CareAgedAged, 80 and overCohort StudiesFemaleHumansLength of StayMaleRecovery of FunctionRetrospective StudiesTreatment OutcomeBarthel-indexNon-home dischargeOrthogeriatricsRehabilitationTrauma

Identifiers

PMID41239506
PMCPMC12619141

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.