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Rev Esp Geriatr Gerontol. 2015 Jul-Aug;50(4):161-7. doi: 10.1016/j.regg.2014.11.003. Epub 2015 Jan 2.

[Clinical pathway for hip fracture patients].

[Article in Spanish]

Author information

1
Unidad de Geriatría, Complejo Asistencial de Ávila, Ávila, España. Electronic address: pisalop@gmail.com.
2
Servicio de Cirugía Ortopédica y Traumatología, Complejo Asistencial de Ávila, Ávila, España.
3
Servicio de Medicina Preventiva, Hospital Río Hortega, Valladolid, España.
4
Servicio de Cardiología. Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España.

Abstract

INTRODUCTION:

Hip fracture in the elderly often occurs in patients with high co-morbidity. Effective management requires a comprehensive and multidisciplinary approach.

PURPOSE:

To evaluate the effect of a quality improvement intervention in the detection and treatment of complications in elderly patients admitted for hip fracture.

MATERIAL AND METHODS:

A comparative study was conducted between two groups of patients admitted for hip fracture prior to 2010, and after a quality improvement intervention in 2013. The intervention consisted of implementing improved multidisciplinary measures in accordance with recent scientific evidence. The degree of compliance of the implemented measures was quantified.

RESULTS:

Patients admitted due to hip fracture in 2010 (216 patients) and 2013 (196 patients) were similar in age, sex, Barthel Index, and a reduced Charlson Index, although there were more comorbidities in 2013. After implementation of the protocols, the detection of delirium, malnutrition, anemia, and electrolyte disturbances increased. A larger number of patients in 2013 were precribed intravenous iron (24% more) and osteoporosis treatment (61.3% more). The average stay was reduced by 45.3% and surgical delay by 29.4%, achieving better functional efficiency.

CONCLUSION:

The implementation of a clinical pathway in geriatric patients with hip fracture is useful to detect and treat complications at an early stage, and to reduce pre-operative and overall stay, all without a negative clinical or functional impact.

KEYWORDS:

Anciano; Asistencia hospitalaria; Complicaciones; Complications; Elderly; Fractura de cadera; Hip fracture; Hospital care

PMID:
25559411
DOI:
10.1016/j.regg.2014.11.003
[Indexed for MEDLINE]

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