Review of Two Approaches for the Care of Elderly Hip Fracture Patient

Introduction: Protocols for caring for elderly hip fracture patients vary among hospitals. The purpose of this study was to examine two different approaches of care for this patient population at our institution. Methods: Retrospective review of 389 consecutive patients 65 years and older with the diagnosis of a low- energy, hip fracture between January 2006 and May 2010. 227 consecutive patients for which a nonstandard method of admission (OP) to either medicine (133 patients) or orthopedic service (94 patients) were compared to a new plan of care (NP) that included 162 consecutive patients in which all patients were admitted to medicine. We evaluated perioperative complications rates, time to surgery (TTS), and length of hospital stay (LOS). Results: There were no significant differences in LOS, TTS, 30 day re-admission, rapid response codes, perioperative complications or death between either model of care. The NP did demonstrate a significant increase in patients being transfused (51.85% vs. 36.56%) and number of patients being diagnosed with Vitamin D deficiency (42.12% vs. 20.70%). Conclusion: While our change in protocol did not alter the rate of perioperative complications, nor did it provide quicker care or shorter hospital stays, it did provide more comprehensive osteoporosis care to our patients