[The effectiveness of geriatric interconsultation in elderly patients admitted to traumatology]. / La eficacia de la interconsulta geriátrica en pacientes ancianos ingresados en traumatología.

ABSTRACT

OBJECTIVE: To determine the effect of inpatient geriatric consultation in elderly orthopedic patients. DESIGN: Before-after intervention trial. SETTING: Tertiary care university hospital in Madrid (Spain). PATIENTS All patients older than 64 years admitted to the orthopedic department during one year before (481 patients) and six months after (283 patients) the establishment of geriatric consultation. INTERVENTION A geriatric consultation team (attending physician and fellow) evaluated, and actively treated when appropriate, most of the patients; follow-up ensued when need until clinical stability or death. MAIN OUTCOME MEASURES: In-hospital mortality, length of hospital stay and transfers to other departments. RESULTS: There was no difference in sex (percent males 23% vs 24%), age (79.2 vs 79.1 years), or length of stay (27.7 vs 26.3 days). Lower in-hospital mortality (9.36% vs 4.95%, p = 0.017) and more transfers to other departments (4.99% vs 12.37%, p = 0.0007) occurred in the study group. CONCLUSIONS: This model of geriatric consultation achieved a lower mortality in orthopedic elderly patients. Length of stay did not change, but there was a higher rate of transfers to other departments. Further controlled studies are needed.