Key result
Orthogeriatric co-management linked to ~93% lower in-hospital mortality in high-risk hip fracture patients.
Why the study?
The study was conducted to evaluate the effect of orthogeriatric co-management care on geriatric hip fracture patients with high ASA scores.
Does orthogeriatric co-management care reduce mortality in geriatric hip fracture patients with high ASA scores?
Cohort (n=628)
Yes
Does orthogeriatric co-management care reduce mortality in geriatric hip fracture patients with high ASA scores?
Odds Ratio: 0.07 (95% CI 0.008–0.597)
Absolute Event Rate: 0.26% vs 4.39%
p-value: p=0.015
Orthogeriatric co-management significantly reduces early mortality and improves early mobility and quality of life in geriatric hip fracture patients with high ASA scores compared to traditional orthopedic care.
Supports orthogeriatric co-management in high-ASA hip fracture patients; hypothesis-generating pending randomized confirmation.
Purpose: To assess the effect of orthogeriatric co-management care on the geriatric hip fracture patients with high ASA score. Patients and Methods: A post-hoc analysis of a prospective multicenter study was done. Patients with an ASA score of 3 or 4 were selected from the database for analysis. Patients were divided into the orthogeriatric co-management group (CM group) and traditional consultation mode group (TC group) depending on the management mode. With mortality as the primary outcome, multivariate regression analyses were performed to adjust for confounders. Mobility and quality of life were compared between groups. Results: A total of 628 patients were included, 593 of whom completed follow-up (388 in CM group, 205 in TC group). The in-hospital mortality, 30-day mortality, 120-day mortality in CM group were significantly lower than those in TC group after adjustment ( P < 0.05). The difference of 1-year mortality in the two groups was not statistically significant after adjustment ( P > 0.05). The surgical intervention rate, the early surgery rate, preoperative waiting time, hospital length of stay (LOS), 30-day mobility, 30-day EuroQol-5 Dimensions (EQ-5D) index, 30-day EuroQol-Visual Analog Scale (EQ-VAS), 120-day EQ-5D index, the total incidence of clinical adverse events, as well as deep vein thrombosis (DVT) and cardiac complication between the two groups were statistically significantly different after adjustment ( P < 0.05). The difference of 120-day mobility was not statistically significant after adjustment ( P < 0.05). There was no significant difference in the in-hospital total cost, the incidence of other clinical adverse events, 120-day EQ-VAS, 1-year reoperation rate, 1-year mobility, 1-year EQ-5D index, 1-year EQ-VAS between the two groups ( P > 0.05). Conclusion: Compared with the traditional consultation mode, orthogeriatric co-management care significantly reduced early mortality and enhanced early mobility and quality of life in geriatric hip fracture patients with high ASA score.
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Gao et al. (2025) conducted a cohort in Geriatric hip fracture with high ASA score (n=628). Orthogeriatric co-management care vs. Traditional consultation mode was evaluated on In-hospital mortality (OR 0.070, 95% CI 0.008-0.597, p=0.015). Orthogeriatric co-management care significantly reduced in-hospital mortality (OR 0.070) and 30-day mortality compared to traditional consultation in geriatric hip fracture patients with high ASA scores.
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