A Comparison of The Success Rate of Surgery in the First 48 Hours and Others Complications Between Conventional Process and Hip Fracture Fast Track Surgery in Chaophraya Yommarat Hospital
Abstract
Introduction : Sine 2019, Chaophraya Yommarat Hospital establish hip fracture fast track surgey. Aim to compare the success rate of surgery in the first 48 hours and others complications between conventional process and hip fracture fast track surgey in Chaophraya Yommarat Hospital.
Methods : A retrospective cohort study enrolled 312 patients over 50 years old with fragility hip fracture during October 2019 to September 2021. They were devided into two groups, conventional process(group 1, n=156) and hip fracture fast track surgery(group 2, n=156). Data were collected from medical records from admit to 6 months after discharge from hospital. Data including rate of surgery in the first 48 hours, complications, motality and 6-month refracture rate were analyzed by Chi-square test and unpaired t test.
Results: The rate of surgery in the first 48 hours of group 2 more than group 1(61.6% versus 38.4%, p<0.05), the mean length of stay of group 2 less than group 1(9.24 days versus 10.80 days, p<0.05) and group 2 significant reduce the incidence of urinary tract infection(2.56% to 0%) and delirium(3.84 to 0.64). The intrahospital mortality and 6-month mortality of group 1 more than group 2 (2.56% versus 1.28% and 1.92% versus 1.28%). The 6-month refracture rate of group 1 more than group 2 (1.28% versus 0%).
Conclusion: The hip fracture fast track surgery can increase the rate of surgery in the first 48 hours, decrease the length of stay and postoperative complications, reduce the mortality and 6-month refracture rate more than conventional process.
Keywords: conventional process, fragility hip fracture, hip fracture fast track surgey.
Downloads
References
2. Roberts K C, Brox W T, David S, et al., Management of hip fractures in the elderly. J Am Acad Orthop Surg, 2015. 23(2): p. 131-7.
3. Brox W T, Roberts K C, Sudeep T, et al. American Academy of orthopedic Surgeons. Management of Hip Fractures in the Elderly:Evidence-Based Clinical Practice Guideline [internet]. 2014 [cited 2020 Aug 20]; Available from: https://aaos.org/globalassets/quality-and-practice-resources/hip-fractures-in-the elderly/management_of_hip_fractures_in_the_elderly-7-24-19.pdf
4. Cheng S Y, Levy A R, Lefaivre K A, et al. Geographic trends in incidence of hip fractures: a comprehensive literature review. 2011. 22(10): p. 2575-2586.
5. Bhandari M and Swiontkowski M. Management of Acute Hip Fracture. 2017. 377(21): p. 2053-2062.
6. Kanis J A, Odén A, McCloskey E V, et al. A systematic review of hip fracture incidence and probability of fracture worldwide. Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2012. 23(9): p. 2239-2256.
7. Vaseenon T, Luevitoonvechkij S, Wongtriratanachai P, et al. Long-term mortality after osteoporotic hip fracture in Chiang Mai, Thailand. J Clin Densitom, 2010. 13(1): p. 63-67.
8. Sambrook P and Cooper C, Osteoporosis. The Lancet, 2006. 367(9527): p. 2010-2018.
9. Khan R, Fernandez C, Kashifl F, et al. Combined orthogeriatric care in the management of hip fractures: a prospective study. Ann R Coll Surg Engl, 2002. 84(2): p. 122-4.
10. Kammerlander C, Roth T, Friedman S M, et al. Ortho-geriatric service--a literature review comparing different models. Osteoporos Int, 2010. 21(Suppl 4): p. S637-46.
11. Ellis G, Gardner M, Tsiachristas A, et al. Comprehensive geriatric assessment for older adults admitted to hospital. Cochrane Database Syst Rev, 2011(7): p. Cd006211.
12. Gilchrist W J, Newman R J, Hamblen D L, et al. Prospective randomised study of an orthopaedic geriatric inpatient service. Bmj, 1988. 297(6656): p. 1116-8.
13. Brañas F, Ruiz-Pinto A, Fernández E, et al. Beyond orthogeriatric co-management model: benefits of implementing a process management system for hip fracture. International Osteoporosis Foundation and National Osteoporosis Foundation 2018.
14. Fisher A A, Davis M W, Rubenach S E, et al. Outcomes for older patients with hip fractures: the impact of orthopedic and geriatric medicine cocare. J Orthop Trauma, 2006. 20(3): p. 172-8; discussion 179-80.
15. Leung A H, Ping Lam T, Hoi Cheung W, et al. An orthogeriatric collaborative intervention program for fragility fractures: a retrospective cohort study. J Trauma, 2011. 71(5): p. 1390-4.
16. Deschodt M, Braes T, Flamaing J, et al. Preventing delirium in older adults with recent hip fracture through multidisciplinary geriatric consultation. J Am Geriatr Soc, 2012. 60(4): p. 733-9.
17. Shyu Y I, Liang J, Wu C C, et al. Interdisciplinary intervention for hip fracture in older Taiwanese: benefits last for 1 year. J Gerontol A Biol Sci Med Sci, 2008. 63(1): p. 92-7.
18. Muangpaisan W, Wongprikron A, Srinonprasert V, et al., Incidence and risk factors of acute delirium in older patients with hip fracture in Siriraj Hospital. J Med Assoc Thai, 2015. 98(4): p. 423-30.
19. Lundstrom M, Edlund A, Bucht G, et al. Dementia after delirium in patients with femoral neck fractures. J Am Geriatr Soc, 2003. 51(7): p. 1002-6.
20. Gruber-Baldini A L, Zimmerman S, Morrison R S, et al. Cognitive impairment in hip fracture patients: timing of detection and longitudinal follow-up. J Am Geriatr Soc, 2003. 51(9): p. 1227-36.
21. Vidan M, Serra J A, Moreno C,et al. Efficacy of a comprehensive geriatric intervention in older patients hospitalized for hip fracture: a randomized, controlled trial. J Am Geriatr Soc, 2005. 53(9): p. 1476-82.
22. Prestmo A, Hagen G, Sletvold O, et al. Comprehensive geriatric care for patients with hip fractures: a prospective, randomised, controlled trial. Lancet, 2015. 385(9978): p. 1623-33.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Singburi Hospital Journal
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
The published articles are copyrighted by Singburi Hospital.
The statements appearing in each article in this academic journal are the personal opinions of each author and are not related in any way to Singburi Hospital or other hospital personnel. Each author is solely responsible for all contents of their article. If there are any errors, each author alone will be responsible for their own article.
