A Comparative Study of Rehabilitation Outcomes of Elderly Hip Fracture Patients: The Advantage of a Comprehensive Orthogeriatric Approach

Background. The optimal setting and design of a comprehensive treatment for elderly hip fracture patients is unknown. The aims of this study were to compare the functional outcomes associated with an innovative comprehensive single-step (geriatric-based) and classic double-step (orthopedic-based) treatment of such patients. Methods. This is a partially concurrent prospective study, taking place in the orthogeriatric unit of a department of geriatric rehabilitation, in a large urban academic freestanding hospital. The participants were 336 consecutive elderly people, admitted for surgry of extracapsular or intracapsular hip fracture. 204 patients were admitted to the department of orthopedic surgery and transferred, shortly after surgery, to the orthogeriatric ward for ongoing rehabilitation (ORT group). Another 116 patients were admitted directly to a geriatric-based orthogeriatric ward, and they received surgical, medical, and rehabilitation treatment within the same facility (ORTGER group). The main outcome measures were length of stay, absolute functional gains of the motor functional independence measure (FIM), and relative functional motor gains according to the Montebello rehabilitation factor score. Succesful rehabilitation was defined as relative functional gain >.5. Results. 320 patients were included in the final analysis. The two groups were similar, yet ORT-group patients were somewhat younger (p