Internal Medicine-Led Multidisciplinary Co-Management is Associated with Improved Perioperative Outcomes in Elderly Patients with Hip Fracture: A Propensity Score Matched Study
- 1Department of Orthopedic Surgery, Beijing Jishuitan Hospital Guizhou Hospital, Guiyang, Guizhou, People’s Republic of China
- 2Department of Orthopedic Surgery, Beijing Jishuitan Hospital, Capital Medical University, Beijing, People’s Republic of China
Abstract
Background: Hip fractures in the elderly are associated with substantial morbidity and mortality. We compared perioperative outcomes between an internal medicine-led multidisciplinary co-management (IM) model and the traditional orthopedic-led consultation (OC) model in elderly hip fracture patients.
Methods: This retrospective cohort study was conducted at Beijing Jishuitan Hospital Guizhou Hospital from March 2023 to June 2025, enrolling 1095 patients aged ≥65 years with hip fractures (IM, n=872; OC, n=223). Propensity score matching (2:1 optimal maximum matching; caliper 0.45 on the logit of the propensity score) balanced 13 covariates, with exact matching for sex, fracture type, and renal insufficiency. Multivariate regression evaluated associations between the care model and perioperative outcomes.
Results: After matching, all 223 OC patients were successfully matched (final cohort 668: 445 IM, 223 OC), with all covariates achieving SMD < 0.1 (maximum 0.078). The IM group showed shorter hospital stay (10.0 vs 14.3 days), shorter time to surgery (42.3 vs 110.1 hours), less blood loss, and lower costs (all p < 0.001). Surgery within 48 hours was more frequent (70.3% vs 8.5%, p < 0.001), and allogeneic transfusion (49.4% vs 68.2%, p < 0.001) and one-year mortality (7.0% vs 12.6%, p = 0.016) were lower in the IM group. Multivariate analysis confirmed an independent association with lower mortality (OR 0.492, 95% CI 0.280–0.863, p = 0.013).
Conclusion: Internal medicine-led multidisciplinary co-management may be associated with shorter preoperative waiting time and hospital stay, reduced blood loss, allogeneic transfusion, one-year mortality, and medical costs. This model may serve as a reference strategy for perioperative management of geriatric hip fracture where multidisciplinary internal medicine resources are available; multicenter prospective studies are warranted.
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BibTeX
@article{pan2026internal,
title = {{Internal Medicine-Led Multidisciplinary Co-Management is Associated with Improved Perioperative Outcomes in Elderly Patients with Hip Fracture: A Propensity Score Matched Study}},
author = {Yuan Pan and Tao Wang and Min An and Yingying Deng and Yabo Liu and Chao Feng},
journal = {International Journal of General Medicine},
year = {2026},
month = nov,
doi = {10.2147/ijgm.s651287},
url = {https://doi.org/10.2147/ijgm.s651287},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Internal Medicine-Led Multidisciplinary Co-Management is Associated with Improved Perioperative Outcomes in Elderly Patients with Hip Fracture: A Propensity Score Matched Study
AU - Yuan Pan
AU - Tao Wang
AU - Min An
AU - Yingying Deng
AU - Yabo Liu
AU - Chao Feng
PY - 2026
DA - 2026/11/02
JO - International Journal of General Medicine
DO - 10.2147/ijgm.s651287
UR - https://doi.org/10.2147/ijgm.s651287
AB - Background: Hip fractures in the elderly are associated with substantial morbidity and mortality. We compared perioperative outcomes between an internal medicine-led multidisciplinary co-management (IM) model and the traditional orthopedic-led consultation (OC) model in elderly hip fracture patients. Methods: This retrospective cohort study was conducted at Beijing Jishuitan Hospital Guizhou Hospital from March 2023 to June 2025, enrolling 1095 patients aged ≥65 years with hip fractures (IM, n=872; OC, n=223). Propensity score matching (2:1 optimal maximum matching; caliper 0.45 on the logit of the propensity score) balanced 13 covariates, with exact matching for sex, fracture type, and renal insufficiency. Multivariate regression evaluated associations between the care model and perioperative outcomes. Results: After matching, all 223 OC patients were successfully matched (final cohort 668: 445 IM, 223 OC), with all covariates achieving SMD < 0.1 (maximum 0.078). The IM group showed shorter hospital stay (10.0 vs 14.3 days), shorter time to surgery (42.3 vs 110.1 hours), less blood loss, and lower costs (all p < 0.001). Surgery within 48 hours was more frequent (70.3% vs 8.5%, p < 0.001), and allogeneic transfusion (49.4% vs 68.2%, p < 0.001) and one-year mortality (7.0% vs 12.6%, p = 0.016) were lower in the IM group. Multivariate analysis confirmed an independent association with lower mortality (OR 0.492, 95% CI 0.280–0.863, p = 0.013). Conclusion: Internal medicine-led multidisciplinary co-management may be associated with shorter preoperative waiting time and hospital stay, reduced blood loss, allogeneic transfusion, one-year mortality, and medical costs. This model may serve as a reference strategy for perioperative management of geriatric hip fracture where multidisciplinary internal medicine resources are available; multicenter prospective studies are warranted.
SN - 1178-7074
ER -