Multidisciplinary Approach to Hip Fracture in Elderly Patients: A New Clinical Organizative Model
Carlo Rostagno1, Marco Mannucci, Alessandro Cartei, Gian Luca Polidori, Roberto Buzzi, Ferdinando Landi, Gian Franco Gensini
ABSTRACT: Due to the high number of elderly patients, most frequently admitted for hip fracture and often suffering from multiple co-morbidities, the clinical approach is significantly more complex than in patients undergoing elective surgery. Establishing a trauma area with 75 beds managed by a team with the key figure of the internal medicine specialist as coordinator of a Multidisciplinary Working Group that will include several specialists such as Anesthesiologists Geriatricians, Orthopaedics, Radiologist, nursing Service Managers, Nurses, Physiotherapists , Social Service Staff , Health Care and Social Agency staff may allow an integrated evaluation at hospital arrival with careful clinical investigation , identification and stabilization of concomitant clinical problems, to decrease the time to surgery, in particular for frail subjects. Moreover, clinical management by internal medicine specialists and geriatricians, other than orthopedics, should improve the ultimate outcome in patients with hip fractures.