[Clinical pathway for hip fracture patients].

Autor:	Sáez López P; Unidad de Geriatría, Complejo Asistencial de Ávila, Ávila, España. Electronic address: pisalop@gmail.com., Sánchez Hernández N; Servicio de Cirugía Ortopédica y Traumatología, Complejo Asistencial de Ávila, Ávila, España., Paniagua Tejo S; Servicio de Medicina Preventiva, Hospital Río Hortega, Valladolid, España., Valverde García JA; Servicio de Cirugía Ortopédica y Traumatología, Complejo Asistencial de Ávila, Ávila, España., Montero Díaz M; Servicio de Cirugía Ortopédica y Traumatología, Complejo Asistencial de Ávila, Ávila, España., Alonso García N; Servicio de Cirugía Ortopédica y Traumatología, Complejo Asistencial de Ávila, Ávila, España., Freites Esteve A; Servicio de Cardiología. Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España.
Jazyk:	Spanish; Castilian
Zdroj:	Revista espanola de geriatria y gerontologia [Rev Esp Geriatr Gerontol] 2015 Jul-Aug; Vol. 50 (4), pp. 161-7. Date of Electronic Publication: 2015 Jan 02.
DOI:	10.1016/j.regg.2014.11.003
Abstrakt:	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. (Copyright © 2014 SEGG. Published by Elsevier Espana. All rights reserved.)
Databáze:	MEDLINE
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