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dc.date.accessioned2015-04-13T19:11:35Z
dc.date.available2015-04-13T19:11:35Z
dc.date.created2014-06-02T12:47:56Z
dc.date.issued2014
dc.identifier.citationWatne, Leiv Otto Torbergsen, Anne Cathrine Conroy, Simon Engedal, Knut Frihagen, Frede Hjorthaug, Geir Aasmund Juliebø, Vibeke Ræder, Johan Saltvedt, Ingvild Skovlund, Eva Wyller, Torgeir Bruun . The effect of a pre- and postoperative orthogeriatric service on cognitive function in patients with hip fracture: Randomized controlled trial (Oslo Orthogeriatric Trial). BMC Medicine. 2014, 12(1)
dc.identifier.urihttp://hdl.handle.net/10852/43557
dc.description.abstractBackground Delirium is a common complication in patients with hip fractures and is associated with an increased risk of subsequent dementia. The aim of this trial was to evaluate the effect of a pre- and postoperative orthogeriatric service on the prevention of delirium and longer-term cognitive decline. Methods This was a single-center, prospective, randomized controlled trial in which patients with hip fracture were randomized to treatment in an acute geriatric ward or standard orthopedic ward. Inclusion and randomization took place in the Emergency Department at Oslo University hospital. The key intervention in the acute geriatric ward was Comprehensive Geriatric Assessment including daily interdisciplinary meetings. Primary outcome was cognitive function four months after surgery measured using a composite outcome incorporating the Clinical Dementia Rating Scale (CDR) and the 10 words learning and recalls tasks from the Consortium to Establish a Registry for Alzheimer’s Disease battery (CERAD). Secondary outcomes were pre- and postoperative delirium, delirium severity and duration, mortality and mobility (measured by the Short Physical Performance Battery (SPPB)). Patients were assessed four and twelve months after surgery by evaluators blind to allocation. Results A total of 329 patients were included. There was no significant difference in cognitive function four months after surgery between patients treated in the acute geriatric and the orthopedic wards (mean 54.7 versus 52.9, 95% confidence interval for the difference -5.9 to 9.5; P = 0.65). There was also no significant difference in delirium rates (49% versus 53%, P = 0.51) or four month mortality (17% versus 15%, P = 0.50) between the intervention and the control group. In a pre-planned sub-group analysis, participants living in their own home at baseline who were randomized to orthogeriatric care had better mobility four months after surgery compared with patients randomized to the orthopedic ward, measured with SPPB (median 6 versus 4, 95% confidence interval for the median difference 0 to 2; P = 0.04). Conclusions Pre- and postoperative orthogeriatric care given in an acute geriatric ward was not effective in reducing delirium or long-term cognitive impairment in patients with hip fracture. The intervention had, however, a positive effect on mobility in patients not admitted from nursing homes.en_US
dc.languageEN
dc.language.isoenen_US
dc.publisherBioMed Central
dc.rightsAttribution 2.0 Generic
dc.rights.urihttp://creativecommons.org/licenses/by/2.0/
dc.titleThe effect of a pre- and postoperative orthogeriatric service on cognitive function in patients with hip fracture: Randomized controlled trial (Oslo Orthogeriatric Trial)en_US
dc.typeJournal articleen_US
dc.creator.authorWatne, Leiv Otto
dc.creator.authorTorbergsen, Anne Cathrine
dc.creator.authorConroy, Simon
dc.creator.authorEngedal, Knut
dc.creator.authorFrihagen, Frede
dc.creator.authorHjorthaug, Geir Aasmund
dc.creator.authorJuliebø, Vibeke
dc.creator.authorRæder, Johan
dc.creator.authorSaltvedt, Ingvild
dc.creator.authorSkovlund, Eva
dc.creator.authorWyller, Torgeir Bruun
cristin.unitcode185,53,11,15
cristin.unitnameGeriatrisk avdeling
cristin.ispublishedtrue
cristin.fulltextoriginal
cristin.qualitycode1
dc.identifier.cristin1135896
dc.identifier.bibliographiccitationinfo:ofi/fmt:kev:mtx:ctx&ctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=BMC Medicine&rft.volume=12&rft.spage=&rft.date=2014
dc.identifier.jtitleBMC Medicine
dc.identifier.volume12
dc.identifier.pagecount12
dc.identifier.doihttp://dx.doi.org/10.1186/1741-7015-12-63
dc.identifier.urnURN:NBN:no-47925
dc.type.documentTidsskriftartikkelen_US
dc.type.peerreviewedPeer reviewed
dc.source.issn1741-7015
dc.identifier.fulltextFulltext https://www.duo.uio.no/bitstream/handle/10852/43557/2/1741-7015-12-63-watne.pdf
dc.type.versionPublishedVersion
cristin.articleid63


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