Implementing a clinical pathway for hip fractures; effects on hospital length of stay and complication rates in five hundred and twenty six patients

International Orthopaedics
Paul T P W BurgersPiet A R de Rijcke

Abstract

Modern management of the elderly with a hip fracture is complex and costly. The aim of this study was to compare the treatment-related hospital length of stay (HLOS) before and after implementing a clinical pathway for patients undergoing hip fracture surgery. This was a retrospective, before-and-after study. The first period ranged from June 21, 2008 to November 1, 2009 (N = 212), and the second was from January 7, 2010 to July 7, 2011 (N = 314). The electronic hospital system and patients records were reviewed for demographics, HLOS, mortality, complications and readmissions. In the first period 53 % had a femoral neck fracture, of which 57 % were treated with hemiarthroplasty. In the second period this was 46 % and 71 %. Pertrochanteric fractures were treated with a Gamma nail in 85 % in the first period, and in 92 % in the second period. The median HLOS decreased from nine to six days (p < 0.001). For the hemiarthroplasty group HLOS decreased from nine to seven days (p < 0.001); for internal fixation there was no significant difference (five versus six days, p = 0.557) and after Gamma nailing it decreased from ten to six days (p < 0.001). For mortality no statistically significant difference was found (6 % versus 5 %, p = 0...Continue Reading

References

Oct 19, 2000·Baillière's Best Practice & Research. Clinical Endocrinology & Metabolism·C E De Laet, H A Pols
Nov 21, 2002·Acta Orthopaedica Scandinavica·Romke van BalenJ Dik F Habbema
Dec 14, 2005·Archives of Physical Medicine and Rehabilitation·Lauren A BeaupreL Duncan Saunders
Nov 18, 2009·Acta Orthopaedica·Ulrica BergströmOlle Svensson
Apr 20, 2010·The Orthopedic Clinics of North America·Jason A LoweTania A Ferguson
Apr 6, 2012·Calcified Tissue International·Fabrizio LeighebMassimiliano Panella
Sep 7, 2012·BMJ : British Medical Journal·Susan Mayor
Apr 27, 2013·Zeitschrift für Orthopädie und Unfallchirurgie·C BliemelB Buecking
Jul 19, 2013·The Journal of Bone and Joint Surgery. American Volume·Blaine T ManningKhaled J Saleh

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Citations

Jun 14, 2015·Journal of Medical Systems·Hua-Qiong WangJing-Song Li
Dec 7, 2018·Archives of Orthopaedic and Trauma Surgery·Christina RollBernd Kinner

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