Mortality and readmission following hip fracture surgery: a retrospective study comparing conventional and fast-track care.
Mortality and readmission following hip fracture surgery: a retrospective study comparing conventional and fast-track care.
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DOI：
10.1136/bmjopen-2016-015574
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发表时间：
2017-08-29
期刊：
影响因子：
2.9
通讯作者：
Foss OA
中科院分区：
文献类型：
--
作者：
Haugan K;Johnsen LG;Basso T;Foss OA
比较髋部骨折患者常规护理和快速康复护理两种路径的疗效。回顾性单中心研究。在挪威中部的大学医院。1820例年龄≥65岁的髋部骨折（囊内、转子间或转子下）患者。2008年4月至2011年9月，788例患者按照常规护理进行治疗，2011年10月至2013年12月，1032例患者按照快速通道护理进行治疗。主要：365天随访内的死亡率和再入院率。次要：停留时间。我们发现，在首次入院后365天内，快速通道和传统护理模式患者的死亡率和再入院率无统计学显著差异。常规治疗组的死亡率较高，无统计学显著性，HR为1.10（95% CI 0.91至1.31，p=0.326），无协变量调整，HR为1.16（95% CI 0.96至1.40，p=0.118）。关于再入院，常规护理组sub-HR为1.02（95% CI 0.88至1.18，p=0.822），未调整协变量，调整协变量后为0.97（95% CI 0.83至1.12，p=0.644）。接受快速通道护理的患者的住院时间和手术时间在统计学上显著缩短，平均差异分别为3.4天和6小时。两种途径患者的性别、骨折类型、年龄或基线Charlson Comorbid指数评分无统计学显著差异。没有足够的证据表明快速通道护理对死亡率和再入院率的影响。住院时间和手术时间缩短。NCT 00667914;结果
To compare the efficacies of two pathways—conventional and fast-track care—in patients with hip fracture. Retrospective single-centre study. University hospital in middle Norway. 1820 patients aged ≥65 years with hip fracture (intracapsular, intertrochanteric or subtrochanteric). 788 patients were treated according to conventional care from April 2008 to September 2011, and 1032 patients were treated according to fast-track care from October 2011 to December 2013. Primary: mortality and readmission to hospital, within 365 days follow-up. Secondary: length of stay. We found no statistically significant differences in mortality and readmission rate between patients in the fast-track and conventional care models within 365 days after the initial hospital admission. The conventional care group had a higher, no statistical significant mortality HR of 1.10 (95% CI 0.91 to 1.31, p=0.326) without and 1.16 (95% CI 0.96 to 1.40, p=0.118) with covariate adjustment. Regarding the readmission, the conventional care group sub-HR was 1.02 (95% CI 0.88 to 1.18, p=0.822) without and 0.97 (95% CI 0.83 to 1.12, p=0.644) with adjusting for covariates. Length of stay and time to surgery was statistically significant shorter for patients who received fast-track care, a mean difference of 3.4 days and 6 hours, respectively. There was no statistically significant difference in sex, type of fracture, age or Charlson Comorbidity Index score at baseline between patients in the two pathways. There was insufficient evidence to show an impact of fast-track care on mortality and readmission. Length of stay and time to surgery were decreased. NCT00667914; results
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影响因子：
3.7
作者：
Moja L;Piatti A;Pecoraro V;Ricci C;Virgili G;Salanti G;Germagnoli L;Liberati A;Banfi G
通讯作者：
Banfi G
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105.7
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作者：
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影响因子：
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作者：
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通讯作者：
de Vries, Frank