The Importance of Fast-Track Projects for the Outcome of Elderly Patients with Femur and Hip Fractures in the Decrease of all Evaluated Parameters

Abstract

Background: Population aging is a worldwide phenomenon, and there are 37.7 million elderly people in Brazil. In the period between 2008-2012, showed that more than 181 thousand cases occurred, of hip and femur fractures in elderly patients. Through an Excel spreadsheet, designed in 2010, the objective of this study was to compare the results after the implementation of a fast-track project after femoral surgery in patients aged over 60 years, with predicted routine SUS Hospital. Methods: Patients were observed during two distinct periods: before implantation and after the implementation of the new project. Data evaluation was carried out in four stages of the study in both groups: before arrival to the operating room, during surgery, PACU and on the ward in the morning of day 1 postoperatively. The tests used for statistical analysis were the chi-square test, Fisher’s exact test, and the Kruskal-Wallis test. For all tests considered, the significance level is 0.05. Results: The implementation of the project significantly reduces from 8% to 99% of all parameters evaluated in the four stages of the study and increases the quality of postoperative analgesia by 30%. These data resulted in greater patient and family satisfaction, and probably lower cost. Conclusions: The Brazilian Public Health System (SUS) project has as its primordial objective the humanization of any medical treatment, and this study decreasing practically all the studied parameters and increasing analgesia (time and quality), should be the objective of the implantation of all SUS hospitals. Despite not having calculated the cost, these results probably contributed to its decrease.