Putensen, Jennifer Marie (2025) What Do Higher Complication Rates in Elderly Hip Fracture Patients Reveal? Comparing Integrated Geriatric Care with Geriatric Consultancy Service. thesis, Medicine.
Full text available on request.Abstract
Objective This study aimed to compare the treatment protocols and care pathways in hip fracture patients at two Dutch hospitals with different geriatric care approaches, assessing the impact on complication rates, length of hospital stay (LOS) and mortality. Background Hip fractures predominantly affect elderly patients (>70 years), presenting with a greater number of comorbidities and polypharmacy, challenging the treatment and rehabilitation. While introducing geriatric care into treatment has evidently improved patient outcomes, variability in the effects of different care models, such as an Integrated Care Model (ICM) and Geriatric Consultancy Service (GCS), remains. Methods This retrospective study included patients aged 70 years or older admitted for hip fractures between January 2019 and December 2023 at Medisch Spectrum Twente (MST) in Enschede and Ziekenhuisgroep Twente (ZGT) in Almelo. Primary end-points were in-hospital complications, with secondary end-points including LOS, 30-day and 90-day mortality. Results The study included 2,814 patients, 1,342 from the MST and 1,472 from ZGT. Patients at ZGT were older, less mobile and at higher risk for delirium. MST employs a GCS model, while ZGT uses an ICM approach with more comprehensive monitoring. ZGT had a higher complication rate (36.9%) compared to MST (28.9%), (OR 1.52, p< 0.001) and a longer LOS (p<0.001), with no significant differences observed in 30-day and 90-day mortality rates between the hospitals. Conclusion Our study suggests that the higher rate of complications at ZGT, compared to MST, is most likely due to both a more frail patient population as well as comprehensive monitoring and documentation processes, rather than reflecting a true increase in complication occurrences.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Groot, MSc R. de and Hegeman, Prof. Dr. J.H. |
| Faculty: | Medical Sciences |
| Date Deposited: | 28 Apr 2026 13:56 |
| Last Modified: | 28 Apr 2026 13:56 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3934 |
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