Clinical effect of ‘Fast-track Management’ guided by ERAS concept under the multi-disciplinary cooperation mode of femoral intertrochanteric fracture in the elderly

Abstract

ABSTRACT The article was designed to explore the clinical efficacy of ‘Fast-track Management’ guided by ERAS concept under the multidisciplinary collaboration model for early operation of femoral intertrochanteric fracture in the elderly. The clinical data of 198 intertrochanteric fracture in the elderly were retrospectively analyzed. According to the diagnosis and treatment mode, they were divided into cooperative group and routine group. The preoperative waiting time, preoperative deep venous thrombosis, operation time, intraoperative bleeding, hospitalization time, Harris score, VAS score, intervention effect of eras concept, complication occurrence, and 1-year mortality were made a comparison. There were notable differences in the preoperative waiting time, the number of cases of preoperative deep vein thrombosis and the length of hospital stay between the cooperative group and routine group. The incidence of complications in the cooperative group was 9.38%, which was significantly lower than that in the conventional group, 54.90%. The 1-year mortality rate was clearly lower in the cooperative group than in the routine group. At 1 and 2 weeks after operation, VAS, HAMA and PSQI of the cooperative group were lower, but Harris and Barthel were higher than the routine group. At 1 month after operation, there was no clear difference in VAS and Harris between the cooperative group and routine group. The establishment of ‘Fast-track Management’ based on ERAS concept in the multidisciplinary collaboration model can effectively alleviate the pain of femoral intertrochanteric fracture in the elderly, shorten the hospital stay, reduce the occurrence of postoperative complications and the mortality within 1 year.