Fragility in orthopedics and fracture co-management
Keywords:
fragility, orthogeriatrics, co-management.Abstract
Introduction: Orthogeriatric care has evolved in the last fifteen years. Unsatisfactory results have been recognized in cohort studies of geriatric patients with orthopedic frailty trauma.
Objective: To explain the use of the clinical frailty scale to identify patients with the greatest need for care, taking into account current health resources and geriatric frailty over age.
Methods: PubMed was searched for English-language publications from 2010-2020 using the terms: “geriatric orthopedic patients,” “geriatric patients and frailty,” and “frailty in orthogeriatrics.”
Conclusions: Population aging forces hospitals to provide high-quality care to older adults. Frailty is a better indicator for specialized care needs.
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References
Rogers M, Brown R, Stanger S. Frailty in orthopaedics: is age relevant? Injury. 2020;5(11):2402-6. DOI: http://doi.org/doi.org/10.1016/j.injury.2020.07.031
Bonafede M, Shi N, Barron R, Li X, Crittenden DB, Chandler D. Predicting imminent risk for fracture in patients aged 50 or older with osteoporosis using US claims data. Arch Osteoporos. 2016;11(1):26. DOI: http://doi.org/10.1007/s11657-016-0280-5
Kanis JA, Harvey NC, McCloskey E, Bruyère O, Veronese N, Lorentzon M, et al. Algorithm for the management of patients at low/middle/high risk of osteoporotic fracture. Osteopor Int. 2019;31:1-12. DOI: http://doi.org/10.1007/s00198-019-05176-3
Borgström F, Karlsson L, Gustav Ortsäter G, Norton N, Halbout Ph, Cooper C, et al. Fragility fractures in Europe: burden, management and opportunities. Arch of Osteopor. 2020;15:59. DOI: https://doi.org/10.1007/s11657-020-0706-y
Leal J, Gray AM, Hawley S, Prieto-Alhambra D, Delmestri A, Arden NK, et al. Costeffectiveness of orthogeriatric and fracture liaison service models of care for hip fracture patients: a population-based study. J Bone Miner Res. 2017;32(2):203-11. DOI: https://doi.org/10.1002/jbmr.2995
British Orthopaedic Association Trauma Committee. British Orthopaedic Association's Standards for Trauma (BOAST): Care of the older or frail patient with orthopaedic injuries. Injury. 2020;51(7):1419-21. DOI: https://doi.org/10.1016/j.injury.2020.06.005
Nice Institute for Health and Care Excellence (2020) COVID-19 rapid guideline: Critical care in adults. 2020 [acceso 05/04/2020]. Disponible en: https://www.nice.org.uk/guidance/ng159
British Orthopaedic Association. Blue book on fragility fracture care. 2007 [acceso 25/11/2019]. Disponible en: https://www.bgs.org.uk/sites/default/files/content/attachment/2018-05-02/Blue%20Book%20on%20fragility%20fracture%20care.pdf
Turner, G. Introduction to frailty. British geriatrics society. 2020 [acceso 13/11/2020]. Disponible en: https://www.bgs.org.uk/resources/introduction-to-frailty>
British geriatrics society. Work force and the BGS. 2019 [acceso 11/11/2019] https://www.bgs.org.uk/resources/workforce-and-the-bgs#anchor-nav-how-manygeriatricians-do-we-need-per-head-of-population-
Fried L, Ferruci L, Darer J, Williamson J, AndersonG. Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. J Gerontol Ser A. 2004;59(3):255-63. DOI: https://doi.org/10.1093/gerona/59.3.m255
Rockwood clinical frailty scale. 2018 [acceso 05/04/2020]. Disponible en: https://www.bgs.org.uk/sites/default/files/content/attachment/2018-07-05/rockwood_cfs.pdf
Rockwood K, Song X, MacKnight Ch, Bergman H, Hogan DB, McDowell, et al. A global clinical measure of fitness and frailty in elderly people. Can Med Asso J. 2005;173(5):489-95. DOI: https://doi.org/10.1503/cmaj.050051
Hilmer SN, Perera V, Mitchell S, Murnion BP, Dent J, Bajorek B, et al. The assessment of frailty in older people in acute care. Australas J Ageing. 2009;28(4):182-8. DOI: https://doi.org/10.1111/j.1741-6612.2009.00367.x.
Gregorevic K. The clinical frailty scale predicts functional decline and mortality when used by junior medical staff: a prospective cohort study. BMC Geriatr. 2016;16. DOI: https://doi.org/10.1186/s12877-016-0292-4
Major trauma in older people. 2017 [acceso 29/11/2020]. Disponible en: https://www.tarn.ac.uk/content/downloads/3793/Major%20Trauma%20in%20Older%20People%202017.pdf
Next steps on the five year forward view. 2019 [acceso 25/11/2019]. Disponible en: https://www.england.nhs.uk/wp-content/uploads/2017/03/NEXT-STEPS-ON-THE-NHS-FIVE-YEAR-FORWARD-VIEW.pdf
Curtis EM, Moon RJ, Harvey NC, Cooper C. The impact of fragility fracture and approaches to osteoporosis risk assessment worldwide. Bone. 2017;104:29-38. DOI: https://doi.org/10.1016/j.bone.2017.01.024
Recommendations. Hip fracture: management guidance. 2017 [acceso 25/11/2019]. Disponible en: https://www.nice.org.uk/guidance/cg124/chapter/Recommendations
Middleton M. Orthogeriatrics and hip fracture care in the UK: factors driving change to more integrated models of care. Geriatrics. 2018;3(3):55. DOI: https://doi.org/10.3390/geriatrics3030055
The NHS long term plan. 2019 [acceso 25/11/2019]. Disponible en: https://www.longtermplan.nhs.uk/wp-content/uploads/2019/08/nhs-long-term-plan-version-1.2.pdf
Nordström P, Gustafson Y, Michaëlsson K, Nordström A. Length of hospital stay after hip fracture and short term risk of death after discharge: a total cohort study in Sweden. BMJ. 2015;350:h696. DOI: https://doi.org/10.1136/bmj.h696
Caeiro JR, Bartra A, Mesa M, Etxebarria I, Montejo J, Carpintero P, et al. Coste de la fractura de cadera osteoporótica en España por comunidad autónoma. Rev Esp de Cir Ort y Traum. 2019;63(1):56-68. DOI: https://doi.org/10.1016/j.recot.2018.03.005
Svedbom A, Borgstom F, Hernlund E, Strom O, Alekna V, Bianchi ML, et al. Quality of life for up to 18 months after low-energy hip, vertebral, and distal forearm fractures-results from the ICUROS. Osteopor Int. 2018;29:557-66. DOI: https://doi.org/10.1007/s00198-017-4317-4
Leal J, Gray A, Prieto-Alhambra D, Arden NK, Cooper C, Javaid M, et al. Impact of hip fracture on hospital care costs: a population-based study. Osteopor Int. 2016;27(2):549-58. DOI: https://doi.org/10.1007/s00198-015-3277-9
McCloskey E, Ershova O, Sanders KM, Silverman S, Tamulaitiene M, Thomas T, et al. Quality of life after hip, vertebral, and distal forearm fragility fractures measured using the EQ-5D-3L, EQ-VAS, and time-trade-off: results from the ICUROS. Qual Life Res. 2017;27:707-16. DOI: https://doi.org/10.1007/s11136-017-1748-5
Royal College Physicians. National hip fracture database (NHFD) annual report september 2018. 2019 [acceso 25/11/2019]. https://nhfd.co.uk/files/2018ReportFiles/NHFD-2018-Annual-Report-v100.pdf
