Hip fractures

Summary

Evidence from four randomized controlled studies comparing the effect of multidisciplinary care with usual care after surgery for hip fracture suggests that multidisciplinary care may facilitate walking recovery and improvement in activities of daily living (ADL). However, results were not statistically significant across studies or time frames. Differences in care protocols and outcome definitions across studies should be considered. In-hospital mortality was significantly lower for multidisciplinary care recipients, a 62% reduction in rate based on pooled estimates from two studies. No effect was seen on mortality at 1 year, however. There was no difference in readmission rates at any follow-up time and results for hospital length of stay were conflicting. Results should be interpreted cautiously given differences in care protocols as well as differences in the definitions, types and timing of outcomes measures. These factors may partially explain discrepancies across studies. Formal economic evaluation (eg, cost-effectiveness or cost-minimization analysis), may provide further perspective.