Geriatric and Gerontology Department, Campus Bio-Medico University of Rome, via Alvaro del Portillo, 200, 00128, Rome, Italy.
Operative Unit of Anesthesia and Resuscitation, Hospital of Camposampiero, Padua, Italy.
Aging Clin Exp Res. 2020 Jul;32(7):1393-1399. doi: 10.1007/s40520-020-01574-4. Epub 2020 May 1.
Hip fracture (HF) is a burdening health problem in older people. The orthogeriatric approach has been shown to favour functional recovery and reduce mortality, but its implementation in clinical practice cannot rely upon shared management protocols and greatly varies among different healthcare systems. Here, we present the rationale and design of the Italian consensus document on the management of HF in older people.
A panel of multidisciplinary experts from ten Italian scientific societies involved in the care of HF and including geriatricians, orthopaedics, anaesthesiologists, physiatrists and general practitioners, will join to establish the content validity of a list of statements. A Delphi consensus methodology will be applied to obtain the opinions of the panel and to provide the final recommendations.
The document will include indications on the following relevant topics: (1) optimal care path of older subjects with HF; (2) management of comorbidities and pre-operative alteration of physiological parameters; (3) management of selected categories of patients at expected increased risk of adverse outcomes; (4) continuity of care out of hospital; (5) screening and correction of risk factors for HF in older subjects; (6) information and divulgation of shared management strategies. The objective of the consensus will be to inform clinicians, patients, researchers, and health policy makers about the best management strategies for HF in older people and their inherent limitations, thus facilitating communication between stakeholders and promoting the most cost/effective models of care.
髋部骨折（HF）是老年人面临的重大健康问题。矫形骨科方法已被证明有利于功能恢复和降低死亡率，但在临床实践中的实施不能仅依赖于共同管理方案，并且在不同的医疗保健系统中差异很大。在这里，我们提出了意大利老年人髋部骨折管理共识文件的基本原理和设计。
来自十个意大利科学协会的多学科专家小组参与了 HF 的护理，包括老年病学家、矫形外科医生、麻醉师、物理治疗师和全科医生，他们将共同确定一份声明清单的内容有效性。将应用德尔菲共识方法征求小组的意见并提供最终建议。
该文件将包括以下相关主题的指示：（1）老年 HF 患者的最佳护理路径；（2）共病和术前生理参数改变的管理；（3）预期不良结果风险增加的特定类别的患者管理；（4）医院外的连续护理；（5）老年患者 HF 风险因素的筛查和纠正；（6）共同管理策略的信息和传播。共识的目标是为临床医生、患者、研究人员和卫生政策制定者提供有关老年人 HF 的最佳管理策略及其内在局限性的信息，从而促进利益相关者之间的沟通，并促进最具成本效益的护理模式。
