This systematic review and meta-analysis of 37 studies (37,294 patients) evaluates whether orthogeriatric care improves outcomes for hip fracture patients. It compares three models — geriatric consultant service (GCS), geriatric ward (GW), and integrated care model (ICM) — against standard orthopedic care. Primary outcomes include length of stay, time to surgery, in-hospital and 1-year mortality, 30-day readmission, functional recovery, complications, and cost.
Hip fracture in an elderly patient is not just a surgical problem — it is a geriatric emergency. The 1-year mortality of 8–36% reflects the frailty of this population, and prior evidence on which care model best addresses that frailty was conflicting.
This meta-analysis gives you a practical framework: all three orthogeriatric models reduce mortality and delirium compared to standard care, so any model is better than none. When your institution is choosing or advocating for a specific model, the data favor ICM for in-hospital mortality reduction (the only model with a statistically significant subgroup result), while GCS offers the cleanest, lowest-heterogeneity data for both LOS and time-to-surgery improvements.
For daily practice: getting your hip fracture patient to the OR within 48 hours is supported by a 20% mortality reduction in the literature cited here. And orthogeriatric co-management, particularly GCS, is associated with meaningfully shorter time to surgery. Delirium prevention through systematic geriatric screening is the most robust complication benefit across all models.
The authors are explicit that no single model can be declared superior, and functional outcome data remain too heterogeneous to guide model selection on that basis alone. Match the model to your institution's available resources.
This systematic review and meta-analysis of 37 studies (37,294 patients) evaluates whether orthogeriatric care improves outcomes for hip fracture patients. It compares three models — geriatric consultant service (GCS), geriatric ward (GW), and integrated care model (ICM) — against standard orthopedic care. Primary outcomes include length of stay, time to surgery, in-hospital and 1-year mortality, 30-day readmission, functional recovery, complications, and cost.
Hip fracture in an elderly patient is not just a surgical problem — it is a geriatric emergency. The 1-year mortality of 8–36% reflects the frailty of this population, and prior evidence on which care model best addresses that frailty was conflicting.
This meta-analysis gives you a practical framework: all three orthogeriatric models reduce mortality and delirium compared to standard care, so any model is better than none. When your institution is choosing or advocating for a specific model, the data favor ICM for in-hospital mortality reduction (the only model with a statistically significant subgroup result), while GCS offers the cleanest, lowest-heterogeneity data for both LOS and time-to-surgery improvements.
For daily practice: getting your hip fracture patient to the OR within 48 hours is supported by a 20% mortality reduction in the literature cited here. And orthogeriatric co-management, particularly GCS, is associated with meaningfully shorter time to surgery. Delirium prevention through systematic geriatric screening is the most robust complication benefit across all models.
The authors are explicit that no single model can be declared superior, and functional outcome data remain too heterogeneous to guide model selection on that basis alone. Match the model to your institution's available resources.