The Efficacy of Multidisciplinary Team Co-Management Program for Elderly Patients With Intertrochanteric Fractures: A Retrospective Study

Jixing Fan; Yang Lv; Xiangyu Xu; Fang Zhou; Zhishan Zhang; Yun Tian; Hongquan Ji; Yan Guo; Zhongwei Yang; Guojin Hou

doi:10.3389/fsurg.2021.816763

The Efficacy of Multidisciplinary Team Co-Management Program for Elderly Patients With Intertrochanteric Fractures: A Retrospective Study

Front Surg. 2022 Feb 24:8:816763. doi: 10.3389/fsurg.2021.816763. eCollection 2021.

Authors

Jixing Fan^{1

2}, Yang Lv^{1

2}, Xiangyu Xu^{1

2}, Fang Zhou^{1

2}, Zhishan Zhang^{1

2}, Yun Tian^{1

2}, Hongquan Ji^{1

2}, Yan Guo^{1

2}, Zhongwei Yang^{1

2}, Guojin Hou^{1

2}

Affiliations

¹ Department of Orthopedics, Peking University Third Hospital, Beijing, China.
² Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China.

Abstract

Background: Intertrochanteric fractures increased quickly in past decades owing to the increasing number of aging population. Recently, geriatric co-management was rapidly emerging as a favored clinical care model for older patients with hip fractures. The purpose of this study was to assess the efficacy of a multidisciplinary team (MDT) co-management program in elderly patients with intertrochanteric fractures.

Methods: In this retrospective study, patients were divided into MDT group and traditional orthopedic care (TOC) group according to the healthcare model applied. 249 patients were included in the TOC group from January 2014 to December 2016 and 241 patients were included in the MDT group from January 2017 to December 2019. Baseline data, peri-operative data, and postoperative complications were collected and analyzed using SPSS 21.0.

Results: No significant differences were observed between the two groups in terms of patient baseline characteristics. Patients in the MDT group had significantly lower time from admission to surgery and length-of-stay (LOS) compared with those in the TOC group. Furthermore, the proportion of patients receiving surgery within 24 h (61.4 vs. 34.9%, p < 0.001) and 48 h (80.9 vs. 63.5%, p < 0.001) after admission to the ward was significantly higher in the MDT group compared with those in the TOC group. In addition, patients in the MDT group had significantly lower proportion of postoperative complications (25.3 vs. 44.2%, p < 0.001), deep vein thrombosis (7.9 vs. 12.9%, p = 0.049), pneumonia (3.8 vs. 8.0%, p = 0.045) and delirium (4.1 vs. 9.2%, p = 0.025) compared with those in the TOC group. However, no significant changes were found for in-hospital and 30-day mortality.

Conclusion: The MDT co-management could significantly shorten the time from admission to surgery, LOS, and reduce the postoperative complications for elderly patients with intertrochanteric fractures. Further research was needed to evaluate the impact of this model on patient health outcomes.

Keywords: China; elderly; intertrochanteric fractures; multidisciplinary team; traditional orthopedic care.