Key result
Multidisciplinary co-management linked to ~43% fewer postoperative complications versus traditional orthopedic care in elderly patients.
Why the study?
Intertrochanteric fractures have increased rapidly with an aging population, prompting the need to assess the efficacy of an MDT co-management program for elderly patients.
Does a multidisciplinary team co-management program improve time to surgery, length of stay, and postoperative complications in elderly patients with intertrochanteric fractures?
Cohort (n=490)
No
Does a multidisciplinary team co-management program improve time to surgery, length of stay, and postoperative complications in elderly patients with intertrochanteric fractures?
Absolute Event Rate: 25.3% vs 44.2%
p-value: p=<0.001
A multidisciplinary team co-management program significantly shortens time to surgery and length of stay, and reduces postoperative complications in elderly patients with intertrochanteric fractures.
MDT co-management was associated with fewer complications in elderly fracture patients; hypothesis-generating and requires RCTs to confirm benefits.
Background Intertrochanteric fractures increased quickly in past decades owing to the increasing number of aging population. Recently, geriatric co-management was rapidly emerging as a favored clinical care model for older patients with hip fractures. The purpose of this study was to assess the efficacy of a multidisciplinary team (MDT) co-management program in elderly patients with intertrochanteric fractures. Methods In this retrospective study, patients were divided into MDT group and traditional orthopedic care (TOC) group according to the healthcare model applied. 249 patients were included in the TOC group from January 2014 to December 2016 and 241 patients were included in the MDT group from January 2017 to December 2019. Baseline data, peri-operative data, and postoperative complications were collected and analyzed using SPSS 21.0. Results No significant differences were observed between the two groups in terms of patient baseline characteristics. Patients in the MDT group had significantly lower time from admission to surgery and length-of-stay (LOS) compared with those in the TOC group. Furthermore, the proportion of patients receiving surgery within 24 h (61.4 vs . 34.9%, p < 0.001) and 48 h (80.9 vs . 63.5%, p < 0.001) after admission to the ward was significantly higher in the MDT group compared with those in the TOC group. In addition, patients in the MDT group had significantly lower proportion of postoperative complications (25.3 vs . 44.2%, p < 0.001), deep vein thrombosis (7.9 vs . 12.9%, p = 0.049), pneumonia (3.8 vs . 8.0%, p = 0.045) and delirium (4.1 vs . 9.2%, p = 0.025) compared with those in the TOC group. However, no significant changes were found for in-hospital and 30-day mortality. Conclusion The MDT co-management could significantly shorten the time from admission to surgery, LOS, and reduce the postoperative complications for elderly patients with intertrochanteric fractures. Further research was needed to evaluate the impact of this model on patient health outcomes.
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Fan et al. (2022) conducted a cohort in Intertrochanteric fractures (n=490). Multidisciplinary team (MDT) co-management program vs. Traditional orthopedic care (TOC) was evaluated on Postoperative complications (p=<0.001). The multidisciplinary team co-management program significantly reduced postoperative complications (25.3% vs 44.2%) compared to traditional orthopedic care in elderly patients.
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