Should hospital managers read the orthopedic literature before surgeons? The example of femur fracture management

Journal of Orthopaedics and Traumatology

Original Article

Alessandro Aprato¹  Gabriele Agati¹  Matteo Giachino²  Alessandro Massè²  Denis Longo² 

[1] San Luigi Hospital of Orbassano, University of Turin, Regione Gonzole 10, Orbassano, Turin, Italy;University of Turin, C.so Massimo d’Azeglio 60, Turin, Italy;

关键词: Hip fractures;    Elderly;    Early treatment;    Public healthcare;   

DOI  :  10.1007/s10195-016-0427-6

 received in 2015-12-24, accepted in 2016-08-06,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundEarly surgical intervention in the treatment of proximal femur fractures has been shown to significantly reduce mortality and complications. Our study intends to evaluate early surgery rates in a single-center analysis before the clinical advantages of early surgical intervention were demonstrated in the literature (G1), after the orthopedic team aimed to treat those fractures within 48 h (G2), and after early intervention became a primary objective for hospital management (G3).Materials and methodsThe hospital charts of 894 proximal femur fractures in patients aged >65 years between 2008 and 2015 were analyzed in a single teaching hospital. The patients were allocated to three groups according to admission date, relative to the introduction of the different targets for early intervention. Our primary aim was to evaluate the differences in the rate of surgical treatment within 48 h in the three groups, and our secondary aim was to see if those differences influenced clinical outcomes.ResultsThe rate of treatment before 48 h was 23, 49 and 72 % in groups 1, 2 and 3, respectively (p < 0.001). There were no statistically significant differences between the three groups regarding time from surgery to discharge and perioperative mortality. The length of hospitalization was different only between groups 1 and 2.ConclusionsThe adoption of an early treatment goal for proximal femur fractures by the orthopedic team significantly improved the results. However, it was only by introducing this goal into primary hospital management objectives that significantly increased the performance.Level of evidence Level IV (retrospective case−control study).

【 授权许可】

CC BY   
© The Author(s) 2016