Geriatric Traumatology:The effectiviness of integrated orthogeriatric treatment on 1-year outcome in frail elderly with hip fracture

In an elderly person, a hip fracture can have severe consequences for the patient due to the risk of loss of mobility and early death. As the population ages, the number of patients with hip fractures will increase. The treatment is complex due to the occurrence of several disorders, malnutrition, memory issues, the use of various drugs, regular falls, bone decalcification and infirmity. The risk of complications and death is significant and is linked to high treatment costs. To improve the results of the treatment and efficacy, surgeons and orthopedists have developed various treatment models. In the Netherlands, the Center for Geriatric Traumatology (CvGT ), where the integrated orthogeriatric treatment model is used, was established in 2008. This model distinguishes itself from the joint treatment responsibility of the trauma surgeon/orthopedist and the geriatrician. Starting at the Emergency Ward, both specialties work together intensively with the support of a multidisciplinary team, and the emphasis is on preventing complications and loss of function.Since not much research has been conducted into the effectiveness of this treatment model so far, the recovery of elderly patients with a hip fracture was studied at the CvGT.Compared to the period before 2008, CvGT patients developed significantly fewer complications, and the duration of admission decreased with significantly fewer readmissions within 30 days. Significantly more patients with a hip fracture survived the first year. After integrated orthogeriatric treatment, there appears to be a connection to better short- and long-term treatment results for elderly patients with a hip fracture

Geriatric Traumatology:The effectiviness of integrated orthogeriatric treatment on 1-year outcome in frail elderly with hip fracture

In an elderly person, a hip fracture can have severe consequences for the patient due to the risk of loss of mobility and early death. As the population ages, the number of patients with hip fractures will increase. The treatment is complex due to the occurrence of several disorders, malnutrition, memory issues, the use of various drugs, regular falls, bone decalcification and infirmity. The risk of complications and death is significant and is linked to high treatment costs. To improve the results of the treatment and efficacy, surgeons and orthopedists have developed various treatment models. In the Netherlands, the Center for Geriatric Traumatology (CvGT ), where the integrated orthogeriatric treatment model is used, was established in 2008. This model distinguishes itself from the joint treatment responsibility of the trauma surgeon/orthopedist and the geriatrician. Starting at the Emergency Ward, both specialties work together intensively with the support of a multidisciplinary team, and the emphasis is on preventing complications and loss of function.Since not much research has been conducted into the effectiveness of this treatment model so far, the recovery of elderly patients with a hip fracture was studied at the CvGT.Compared to the period before 2008, CvGT patients developed significantly fewer complications, and the duration of admission decreased with significantly fewer readmissions within 30 days. Significantly more patients with a hip fracture survived the first year. After integrated orthogeriatric treatment, there appears to be a connection to better short- and long-term treatment results for elderly patients with a hip fracture

Praten met het publiek; ontwikkelingen op het terrein van publieksraadpleging in het levensmiddelenbeleid

Dit rapport stelt de vraag op welke wijze het Nederlandse publiek geraadpleegd kan worden in levensmiddelenbeleid en -wetgeving, waarbij voldaan moet worden aan de vereisten van openbaarheid, transparantie en effectiviteit. Het rapport formuleert in die zin aanbevelingen over de mogelijkheden om invulling te geven aan artikel 9 van de General Food Law. Geconcludeerd wordt dat het Ministerie van LNV met een versterking van de bestaande raadplegingsfora in het Regulier Overleg Warenwet en het Consumentenplatform goeddeels aan artikel 9 van de General Food Law zou kunnen voldoen

The consistency of care for older patients with a hip fracture:are the results of the integrated orthogeriatric treatment model of the Centre of Geriatric Traumatology consistent 10 years after implementation?

Summary: In the past 10 years after implementation, the orthogeriatric treatment model led in general to consistent outcomes for 1555 older adults in terms of most of the complications and mortality. Surgery was more often delayed to 24–48 h after arrival at the hospital, while the length of hospital stay shortened. Introduction: Since 1 April 2008, patients aged ≥ 70 years presenting themselves with a hip fracture at Ziekenhuisgroep Twente (ZGT) have been treated according to the orthogeriatric treatment model. The aim of this study was to investigate if outcomes of the orthogeriatric treatment model are consistent over the first 10 years after implementation. Methods: Between 1 April 2008 and 31 December 2016, patients aged ≥ 70 years who were surgically treated at ZGT for a hip fracture were included and divided into three periods equally distributed in time. Patient characteristics, in-hospital logistics, complications, and mortality data were compared between the three periods. Results: A total of 1555 patients were included. There was a shift in the surgical treatment for the fractured neck of femur from dynamic hip screw/cannulated screws to hemiarthroplasty (p < 0.001). Surgery within 24 h after arrival to the hospital decreased (p < 0.001), while surgery within 48 h stayed the same (p = 0.085). Length of hospital stay significantly decreased over time (p < 0.001). Complication rates were consistent except for the number of postoperative anemia, delirium, and urinary tract infections. Mortality rates did not change over the years. Conclusions: The orthogeriatric treatment model leads in general to consistent outcomes concerning mortality and most of the complications, except for postoperative anemia, delirium, and urinary tract infections. Inconsistent complication rates were influenced by altered diagnosis and treatment protocols. Length of hospital stay reduced, while time to surgery was more often delayed to 24–48 h. Monitoring clinical outcomes of the orthogeriatric treatment model over time is recommended in order to optimize and maintain the quality of care for this frail patient population