Le cheminement clinique systématisé dans les fractures proximales fémorales du sujet âgé améliore les résultats cliniques

Abstract

ObjectiveThe objective of the current study was to evaluate the implementation of clinical pathways (CPs) in hip fracture management. MethodsIn total, 605 proximal femoral fractures were prospectively included into a hospital data-base. The effects of CPs were evaluated using a pre-during-post design. Different procedural (time to surgery, length of stay, discharge, etc.) and patient outcome parameters (mortality, complications, etc.) were evaluated. ResultsIn both categories, significant changes could be detected during the three-year period. E.g. significant reduction of time to surgery, improvement of discharge management, reduction of internal complications. However, no significant changes could be demonstrated for mortality or revision rate. ConclusionWe could show a relevant improvement with the implementation of clinical pathways for the treatment of proximal femoral fractures in elderly patients. Level of EvidenceIII, prospective non-randomized cohort study.