Long-term Patient-reported Quality of Life and Pain After a Multidisciplinary Clinical Pathway for Elderly Patients With Hip Fracture: A Retrospective Comparative Cohort Study.

Autor:	Kalmet PHS; Department of Trauma Surgery, Maastricht University Medical Center, Maastricht, The Netherlands., de Joode SGCJ; Department of Trauma Surgery, Maastricht University Medical Center, Maastricht, The Netherlands., Fiddelers AAA; Department of Trauma Surgery, Maastricht University Medical Center, Maastricht, The Netherlands., Ten Broeke RHM; Department of Trauma Surgery, Maastricht University Medical Center, Maastricht, The Netherlands., Poeze M; Department of Trauma Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.; Nutrim School for Nutrition, Toxicology and Metabolism, Maastricht University, Maastricht, The Netherlands., Blokhuis T; Department of Trauma Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
Jazyk:	angličtina
Zdroj:	Geriatric orthopaedic surgery & rehabilitation [Geriatr Orthop Surg Rehabil] 2019 Jun 06; Vol. 10, pp. 2151459319841743. Date of Electronic Publication: 2019 Jun 06 (Print Publication: 2019).
DOI:	10.1177/2151459319841743
Abstrakt:	Introduction: There is an increase in incidence of hip fractures in the ageing population. The implementation of multidisciplinary clinical pathways (MCP) has proven to be effective in improving the care for these frail patients, and MCP tends to be more effective than usual care (UC). The aim of this study was to analyze potential differences in patient-reported outcome among elderly patients with hip fractures who followed MCP versus those who followed UC. Materials and Methods: This retrospective cohort study included patients aged 65 years or older with a low-energy hip fracture, who underwent surgery in the Maastricht University Medical Center, Maastricht, the Netherlands. Two cohorts were analyzed; the first one had patients who underwent UC in 2012 and the second one contained patients who followed MCP in 2015. Collected data regarded demographics, patient-reported outcomes (Short Form 12 [SF-12] and the Numeric Rating Scale [NRS] to measure pain), and patient outcome. Results: This cohort study included 398 patients, 182 of them were included in the MCP group and 216 were in the UC group. No differences in gender, age, or American Society of Anesthesiologists classification were found between the groups. No significant differences were found in SF-12 and the NRS data between the MCP group and UC group. In the MCP group, significantly lower rates of postoperative complications were found than in the UC group, but mortality within 30 days and one year after the hip fracture was similar in both groups. Discussion: Although the effects of hip fractures in the elderly on patient-reported outcome, pain and quality of life have been addressed in several recent studies, the effects of MCP on long-term outcome was unclear. Conclusion: A multidisciplinary clinical pathway approach for elderly patients with a hip fracture is associated with a reduced time to surgery and reduced postoperative complications, while no differences were found in quality of life, pain, or mortality. Competing Interests: Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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