Impact of Preoperative Specialty Consults on Hospitalist Comanagement of Hip Fracture Patients.

Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine
Nicholas BellasMandeep Kumar

Abstract

Hip fractures typically occur in frail elderly patients. Preoperative specialty consults, in addition to hospitalist comanagement, are often requested for preoperative risk assessment. Determine if preoperative specialty consults meaningfully influence management and outcomes in hip fracture patients, while being comanaged by hospitalists DESIGN: Retrospective cohort study SETTING: Tertiary care hospital in Connecticut PATIENTS: 491 patients aged 50 years and older who underwent surgery for an isolated fragility hip fracture, defined as one occurring from a fall of a height of standing or less. Presence or absence of a preoperative specialty consult MEASUREMENTS: Time to surgery (TTS), length of hospital stay (LOS), and postoperative complications RESULTS: 177 patients had a preoperative specialty consult. Patients with consults were older and had more comorbidities. Most consult recommendations were minor (72.8%); there was a major recommendation only for eight patients (4.5%). Multivariate analysis demonstrates that consults are more likely to be associated with a TTS beyond 24 hours (Odds Ratio [OR] 4.28 [2.79-6.56]) and 48 hours (OR 2.59 [1.52-4.43]), an extended LOS (OR 2.67 [1.78-4.03]), and a higher 30-day readmission ra...Continue Reading

References

Dec 1, 1996·Journal of Clinical Epidemiology·P PeduzziA R Feinstein
Aug 5, 2000·Journal of Orthopaedic Trauma·T YoumK J Koval
Feb 27, 2014·Archives of Orthopaedic and Trauma Surgery·Philip J BelmontAndrew J Schoenfeld
Sep 5, 2014·Journal of Orthopaedic Trauma·William M RicciMichael J Gardner
Nov 29, 2017·JAMA : the Journal of the American Medical Association·Daniel PincusWalter P Wodchis
Aug 9, 2018·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Boris SobolevUNKNOWN Canadian Collaborative Study of Hip Fractures

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Citations

Dec 24, 2019·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·James Anstey, Brian P Lucas
May 11, 2020·Irish Journal of Medical Science·Karthik GonuguntlaPeter Robinson
Mar 3, 2021·Archives of Orthopaedic and Trauma Surgery·Heather J RobertsUtku Kandemir
Jul 11, 2021·Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·R M AminD F Amanatullah
Nov 5, 2021·Hospital Pediatrics·Andrew S Kern-GoldbergerChristopher P Bonafide

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