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Review
. 2021 Sep;33(9):2405-2443.
doi: 10.1007/s40520-021-01898-9. Epub 2021 Jul 21.

Orthogeriatric co-management for the care of older subjects with hip fracture: recommendations from an Italian intersociety consensus

Antonio De Vincentis  1 , Astrid Ursula Behr  2 , Giuseppe Bellelli  3   4 , Marco Bravi  5 , Anna Castaldo  6 , Lucia Galluzzo  7 , Giovanni Iolascon  8 , Stefania Maggi  9 , Emilio Martini  10 , Alberto Momoli  11 , Graziano Onder  7 , Marco Paoletta  8 , Luca Pietrogrande  12 , Mauro Roselli  13 , Mauro Ruggeri  14 , Carmelinda Ruggiero  15 , Fabio Santacaterina  5 , Luigi Tritapepe  16 , Amedeo Zurlo  17 , Raffaele Antonelli Incalzi  18 ; Società Italiana Geriatria e Gerontologia (SIGG),; Associazione Italiana di Psicogeriatria (AIP),; Società Italiana di Geriatria Ospedale e Territorio (SIGOT),; Società Italiana di Medicina Generale (SIMG),; Società Italiana di Anestesia Analgesia Rianimazione e Terapia Intensiva (SIAARTI),; Società Italiana di Ortopedia e Traumatologia (SIOT),; Fragility Fracture Network-Italia (FFN-I),; Società Italiana di Medicina Fisica e Riabilitativa (SIMFER),; Società Italiana di Fisioterapia (SIF),; Consiglio Nazionale delle Ricerche (CNR),; Associazione Italiana di Fisioterapia (AIFI),; Istituto Superiore Sanità (ISS)
Affiliations
Review

Orthogeriatric co-management for the care of older subjects with hip fracture: recommendations from an Italian intersociety consensus

Antonio De Vincentis et al. Aging Clin Exp Res. 2021 Sep.

Abstract

Background: Health outcomes of older subjects with hip fracture (HF) may be negatively influenced by multiple comorbidities and frailty. An integrated multidisciplinary approach (i.e. the orthogeriatric model) is, therefore, highly recommended, but its implementation in clinical practice suffers from the lack of shared management protocols and poor awareness of the problem. The present consensus document has been implemented to address these issues.

Aim: To develop evidence-based recommendations for the orthogeriatric co-management of older subjects with HF.

Methods: A 20-member Expert Task Force of geriatricians, orthopaedics, anaesthesiologists, physiatrists, physiotherapists and general practitioners was established to develop evidence-based recommendations for the pre-, peri-, intra- and postoperative care of older in-patients (≥ 65 years) with HF. A modified Delphi approach was used to achieve consensus, and the U.S. Preventive Services Task Force system was used to rate the strength of recommendations and the quality of evidence.

Results: A total of 120 recommendations were proposed, covering 32 clinical topics and concerning preoperative evaluation (11 topics), perioperative (8 topics) and intraoperative (3 topics) management, and postoperative care (10 topics).

Conclusion: These recommendations should ease and promote the multidisciplinary management of older subjects with HF by integrating the expertise of different specialists. By providing a convenient list of topics of interest, they might assist in identifying unmet needs and research priorities.

Keywords: Consensus; Femur fracture; Hip fracture; Older; Orthogeriatric management.

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References

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