Study Summary

Five hundred and fifty-five patients from 7 trials were included in this meta-analysis comparing enhanced care and rehabilitation models and standard post-operative rehabilitation in elderly dementia patients undergoing surgery for proximal hip fractures. The primary outcomes of interest were health-related quality of life, activities of daily living and functional performance measures. Secondary outcomes of interest included measures of cognitive function, behaviour, pain, mortality, adverse events, and health and social resources. Insufficient evidence of health-related quality of life, activities of daily living, functional performance, cognitive function, behaviour and pain outcomes were available, preventing the pooling and meta-analysis of data. Pooled results for risk of all-cause mortality during hospitalization, 3 months and 12 months post-operation were not significant different between the enhanced care and usual care groups. Pooled results for length of stay were not significantly different between groups. Pooled results for post-operative delirium at discharge were significantly in favour of the enhanced care group compared to the usual care group. The sub-group analysis of delirium during hospitalization was not significantly different between the geriatrician-led in-patient management sub-group and the orthopaedic-led in-patient management sub-group.