Hutchinson K, Bretherton C B, Gmati A, Handley B
Croydon University Hospital, UK.
Queen Mary University, UK.
Ann R Coll Surg Engl. 2025 Mar;107(3):217-222. doi: 10.1308/rcsann.2024.0048. Epub 2024 Jul 31.
A multidisciplinary team (MDT) approach to polytrauma patients minimises morbidity and mortality. This project assesses the extent to which British Orthopaedic Association Standards for Trauma guidelines for the management of the frail Orthopaedic patient are currently being met.
A retrospective analysis was performed of all Trauma and Orthopaedic patients in multiple medical institutions over a 2-week capture period from 1 March 2022 until 14 March 2022 inclusive. Data collected included age, sex, injury, length of stay and dates of speciality input.
A total of 1,050 patients were included from 27 hospitals. The median age was 80 years, with 560 (53.3%) of all fractures being neck of femur fractures. Of the 1,050 patients, 870 (82.9%) were managed operatively. The median number of different speciality involvements was 3; 645 (61.4%) had an orthogeriatric (OG) review. In major trauma centres (MTC), 93.3% had OG input, compared with 66.3% in non-MTC. The speciality with the greatest input was Radiology, with Plastics having the lowest input.
A standardised MDT approach is needed to optimise care and recovery in orthopaedic trauma patients. The difference in results regarding speciality involvement is substantial and needs to be addressed to minimise disparities in care received by this vulnerable cohort of patients.
多学科团队（MDT）治疗多发伤患者可将发病率和死亡率降至最低。本项目评估了目前英国骨科协会创伤指南中关于老年骨科患者管理的标准在多大程度上得到了满足。
对2022年3月1日至2022年3月14日（含）为期2周的多家医疗机构中所有创伤和骨科患者进行回顾性分析。收集的数据包括年龄、性别、损伤情况、住院时间和专科介入日期。
共纳入了来自27家医院的1050例患者。中位年龄为80岁，所有骨折中560例（53.3%）为股骨颈骨折。在1050例患者中，870例（82.9%）接受了手术治疗。不同专科介入的中位数为3次；645例（61.4%）接受了骨科老年医学（OG）评估。在主要创伤中心（MTC），93.3%的患者有OG介入，而非MTC为66.3%。介入最多的专科是放射科，介入最少的是整形科。
需要一种标准化的MDT方法来优化骨科创伤患者的护理和康复。专科介入结果的差异很大，需要加以解决，以尽量减少这一脆弱患者群体所接受护理的差异。
