[Geriatric complex treatment of proximal femoral fractures? Who profits the most?].

BACKGROUND

Geriatric complex treatment (GCT) is a new type of early rehabilitative care. The main goal is to maintain personal autonomy. GCT includes 21 treatments by physio-, occupational and speech therapists, accompanied by specialized nurses. The aim of this study was to investigate how elderly patients benefit from the GCT after hip fractures (HF).

PATIENTS AND METHODS

In all, 124 patients [≥70 years; 50 patients underwent GCT, 74 underwent standard traumatologic care (STC)] after operative treatment for HF were included. Cognitive impairment was diagnosed in 46% of GCT patients and 70% were classified as ASA III. In the STC group, 23% were cognitively impaired and 50% were classified ASA III.

RESULTS

Significantly more patients of the GCT group were both cognitively impaired and classified as ASA III. Among the cognitively impaired, the STC group reached a median of 20 points on the Barthel index, while the GCT group reached 60 points.

CONCLUSION

The GCT patients in our study were more likely to be dependent on care and have cognitive deficits. Only cognitively impaired patients were shown to benefit from GCT. In the remaining patients no difference was found, thus, only cognitively impaired patients currently undergo GCT at our clinic.