Efficacy of a multidisciplinary approach on postoperative morbidity and mortality of elderly patients with hip fracture.

Efficacy of a multidisciplinary approach on postoperative morbidity and mortality of elderly patients with hip fracture.

Reguant, F;Arnau, A;Lorente, J V;Maestro, L;Bosch, J;
journal of clinical anesthesia 2019 Vol. 53 pp. 11-19
344
reguant2019efficacyjournal

Abstract

We evaluated the efficacy of a multidisciplinary approach to reduce postoperative complications and 1-year mortality in patients, undergoing hip fracture surgery and the impact of surgical delay on mortality.A non-randomized intervention study with a historical control group (CG).During the hospital stay of patients undergoing hip fracture surgery and subsequent follow-up during 12 months post-discharge.240 patients undergoing hip fracture surgery were included in the CG. 272 patients were included in the intervention group (IG).CG patients received the standard care given at our hospital. Patients in the IG received a new model of multidisciplinary approach to care.The following variables were collected: study group, age, gender, ASA physical status, comorbidity, type of fracture, type of anaesthesia, surgical delay, postoperative complications, hospital stay, destination after discharge and postoperative mortality.512 patients (CG = 240; IG = 272). Mean age was 83.8 years in CG and 84.9 years in IG. Patients in the IG had a worse health status according to ASA (III-IV: 68.8% vs 51.7%; p < 0.001) and took more drugs (p < 0.001). Surgery was performed within 48 h of admission in 55.1% of patients of the IG (38.3% CG; p < 0.001). Incidence of postoperative complications (67.3% IG vs 76.2% CG p = 0.025) and hospital stay was shorter in the IG (p < 0.001). A surgical delay of >48 h (HR = 0.61; CI95%: 0.42-0.88) and allocation to the IG (HR = 0.64; CI95%: 0.44-0.93) were the protective factors for mortality.The multidisciplinary approach could be associated with a decrease in postoperative complications, hospital stay and mortality. Surgical delay may not increase the risk of mortality. The main objective in the management of these patients should be the optimization of their general health status before surgery rather than surgical delay.

Citation

ID: 47182
Ref Key: reguant2019efficacyjournal
Use this key to autocite in SciMatic or Thesis Manager

References

Blockchain Verification

Account:
NFT Contract Address:
0x95644003c57E6F55A65596E3D9Eac6813e3566dA
Article ID:
47182
Unique Identifier:
S0952-8180(18)30762-1
Network:
Scimatic Chain (ID: 481)
Loading...
Blockchain Readiness Checklist
Authors
Abstract
Journal Name
Year
Title
5/5
Creates 1,000,000 NFT tokens for this article
Token Features:
  • ERC-1155 Standard NFT
  • 1 Million Supply per Article
  • Transferable via MetaMask
  • Permanent Blockchain Record
Blockchain QR Code
Scan with Saymatik Web3.0 Wallet

Saymatik Web3.0 Wallet