Systematic review and meta-analysis of 18 studies (9,094 patients) asking whether structured orthogeriatric collaboration improves outcomes after hip fracture. Three care models are defined and analyzed separately: routine geriatric consultation, geriatric ward, and shared comanagement. Primary outcomes are in-hospital mortality, long-term mortality, and length of stay.
The default for most orthopedic services was an as-needed geriatrics consult — called only when something went wrong. This meta-analysis quantifies exactly how much that approach costs patients: a 40% higher in-hospital mortality and 17% higher 1-year mortality compared to structured collaboration.
When admitting an elderly hip fracture patient, involve geriatrics from day one through a structured model. Not a PRN page. The authors are explicit: consistently scheduled consults should replace as-needed consults for this population.
If your institution has a true comanagement service (shared care model), that structure offers the greatest length-of-stay benefit, though the evidence base is smaller and heterogeneity is high.
The 1-year mortality for hip fracture runs 20–30% even with good care. Structured orthogeriatric collaboration is one of the few interventions with pooled randomized and prospective data showing it moves that number.
Systematic review and meta-analysis of 18 studies (9,094 patients) asking whether structured orthogeriatric collaboration improves outcomes after hip fracture. Three care models are defined and analyzed separately: routine geriatric consultation, geriatric ward, and shared comanagement. Primary outcomes are in-hospital mortality, long-term mortality, and length of stay.
The default for most orthopedic services was an as-needed geriatrics consult — called only when something went wrong. This meta-analysis quantifies exactly how much that approach costs patients: a 40% higher in-hospital mortality and 17% higher 1-year mortality compared to structured collaboration.
When admitting an elderly hip fracture patient, involve geriatrics from day one through a structured model. Not a PRN page. The authors are explicit: consistently scheduled consults should replace as-needed consults for this population.
If your institution has a true comanagement service (shared care model), that structure offers the greatest length-of-stay benefit, though the evidence base is smaller and heterogeneity is high.
The 1-year mortality for hip fracture runs 20–30% even with good care. Structured orthogeriatric collaboration is one of the few interventions with pooled randomized and prospective data showing it moves that number.