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Preventing complications in elderly hip fractures

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“An older individual with a hip fracture needs immediate surgery,” explains Gerald Hayken, MD, orthopaedic surgeon and co-medical director of the Fracture Care Center at Virtua Memorial, one of the country’s few fracture centers. “These individuals often have co-morbidities and decondition faster than younger people while in the hospital.”

National statistics paint a bleak picture: 35 percent of elderly patients die within the first year after their hip fracture; 25 percent require permanent long-term care placement; and 60 percent need an assistive device for the rest of their lives.

“Reducing morbidity and mortality associated with elderly fragility fractures is Virtua’s mission,” says Fracture Care Center co-medical director, Greg Busch, DO. “Our approach is interdisciplinary with all patients managed by a team of specially certified nurses, an orthopaedic surgeon, geriatrician, physical therapist, case manager and a social worker.”

“For example, the literature shows improved outcomes for patients operated on within 24 hours after their ED arrival; we’ve built that into the program,” says Dr. Hayken. “We also have created specialized order sets to counteract common in-hospital problems such as delirium and bed sores.”

Dr. Busch: “We start thinking about a healthy discharge on day zero – based on a constructive evidence-based plan to keep patients on the right track throughout their stay.”