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.
Orthogeriatric Care Models and Outcomes in Hip Fracture Patients: a Systematic Review and Meta-Analysis
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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.