Presented in part at the American Association of Orthopedic Surgeons Annual Conference, Chicago, Illinois, March 22–26, 2006 and the American Geriatrics Society 2007 Annual Scientific Meeting, Seattle, Washington, May 2–6, 2007.
Article first published online: 7 AUG 2007
Copyright © 2007 Society of Hospital Medicine
Journal of Hospital Medicine
Volume 2, Issue 4, pages 219–225, July/August 2007
How to Cite
Batsis, J. A., Phy, M. P., Joseph Melton, L., Schleck, C. D., Larson, D. R., Huddleston, P. M. and Huddleston, J. M. (2007), Effects of a hospitalist care model on mortality of elderly patients with hip fractures. J. Hosp. Med., 2: 219–225. doi: 10.1002/jhm.207
Accepted for presentation to the American Geriatrics Society 2007 Annual Scientific Meeting, Seattle, Washington, May 2-6, 2007.
- Issue published online: 7 AUG 2007
- Article first published online: 7 AUG 2007
- Manuscript Accepted: 28 FEB 2007
- Manuscript Revised: 2 FEB 2007
- Manuscript Received: 24 NOV 2006
- Hospital Medicine Fellowship Program, Mayo Clinic, Rochester, MN
- hospitalist as consultant;
- geriatric patient;
- post-operative evaluation
We previously demonstrated that a hospitalist service created to medically manage patients with hip fracture reduced time to surgery and length of hospital stay, with no difference in inpatient mortality, compared with patients who received standard care. Whether this improved efficiency affects long-term mortality is unknown.
This study examined the effects of this hospitalist service versus standard care on mortality up to 1 year and identified predictors of mortality in patients with hip fracture.
Retrospective cohort study.
Tertiary care center.
Four hundred and sixty-six consecutive patients admitted for surgical repair of a hip fracture in 2000–2002 with 93% 1-year follow-up.
There was no significant difference in survival of the patients between those on the hospitalist care service and those on the standard care service (70.5% [CI: 64.8%, 76.7%] vs. 70.6% [CI: 64.9%, 76.8%]; P = .36), despite the shortened time to surgery and decreased length of stay in the hospitalist group. Predictors of mortality included: admission from a nursing home (hazard ratio [HR] 2.24, [CI: 1.73, 2.90]); age at admission (HR 1.17 [CI: 0.99, 1.38]); inpatient complications, including ICU admission, myocardial infarction, or acute renal failure (HR 1.85 [CI: 1.45, 2.35]); and ASA class III or IV compared with ASA class II (HR 4.20 [CI: 2.21, 7.99]).
The improved efficiency in reducing length of stay and time to surgery in the hospitalist group did not adversely affect long-term mortality of this patient population. Journal of Hospital Medicine 2007;2:219–225. © 2007 Society of Hospital Medicine.