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  • 584 The effects of a co-management care model on older hip fracture patients with psychological disorders: a post-hoc exploratory subgroup analysis of a non-randomised controlled trial

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India Towards Zero Drowning
584 The effects of a co-management care model on older hip fracture patients with psychological disorders: a post-hoc exploratory subgroup analysis of a non-randomised controlled trial
  1. Jinyu Liang1,
  2. Jing Zhang1,
  3. Maomao Xi2,
  4. Pengpeng Ye3,
  5. Tingzhuo Liu1,
  6. Wei Tian4,
  7. Xinyi Zhang1,
  8. Junyi Peng1,
  9. Ke Peng5,
  10. Xinyan Liu1,
  11. Ning Tang1,
  12. Jiusheng He6,
  13. Liangyuan Wen7,
  14. Xianhai Wang8,
  15. Zongxin Shi9,
  16. Sanbao Hu10,
  17. Fengpo Sun7,
  18. Zishun Gong9,
  19. Mingyao Sun10,
  20. Ruofei Ma11,
  21. Shiwen Zhu11,12,
  22. Xinbao Wu11,
  23. Rebecca Ivers14,
  24. Minghui Yang11,12,13,
  25. Maoyi Tian1
  1. 1School of Public Health, Harbin Medical University, Harbin, China
  2. 2Wuhan Institute of Burns, Wuhan Third Hospital (Tongren Hospital of Wuhan University), Wuhan, China
  3. 3National Centre for Non-Communicable Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, China
  4. 4Department of Cell Biology, School of Basic Medicine, Harbin Medical University, Harbin, China
  5. 5National Clinical Research Centre for Cardiovascular Diseases, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, China
  6. 6Department of Orthopaedics, Beijing Shunyi District Hospital, Beijing, China
  7. 7Department of Orthopaedics, Beijing Hospital, National Centre of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
  8. 8Department of Orthopaedics, Beijing Changping District Hospital, Beijing, China
  9. 9Department of Orthopaedics, Beijing Liangxiang Hospital, Beijing, China
  10. 10Department of Orthopaedics, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
  11. 11Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
  12. 12Peking University Fourth School of Clinical Medicine, Beijing, China
  13. 14National Center of Orthopaedics, Beijing, China
  14. 15School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia

Abstract

Backgroud Psychological disorders, including depression, fear of falling, and cognitive disorders, are common among elderly patients with hip fractures. The effectiveness of a co-management care model in elderly hip fracture patients has been established, but its impact on those with psychological disorders remains unclear.

Objective This study aims to investigate the effects of a co-management care model on elderly hip fracture patients with psychological disorders.

Methods This study conducted a post-hoc analysis of a quasi-experiemental trial. The intervention group received collaborative care from orthopedic and geriatric departments in Beijing hospital, while the control group received standard orthopedic-led management in five other hospitals. The primary outcomes included three follow-up assessments within one year, focusing on changes in quality of life from admission. Repeated measurement linear regression models were used to compare differences between the groups, adjusting for potential confounding factors.

Results The study included 2,071 patients with hip fractures: 1,110 in the intervention group and 961 in the control group. Over half of the patients experienced one or more psychological disorders, primarily fear of falling and cognitive disorders. The intervention had no significant effect on patients with depressive states. Patients with cognitive disorder can benefit from a co-management care model. The co-management care model may have a unfavorable effect on patients with high fear of falling. Additionally, it did not impact the quality of life in patients with concurrent depression, higher fear of falling, and cognitive disorder.

Conclusion The co-management care model can improve quality of life for elderly hip fracture patients with cognitive disorder. Long-term health education for elderly hip patients should be strengthened, especially those with high fear of falling.

  • Hip fracture
  • Depression
  • Fear of fall
  • Cognitive disorder
  • Orthogeriatric care.

https://doi.org/10.1136/injuryprev-2024-SAFETY.292

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