Evaluation of the liaison critical pathway with classification of the hip fractured patients by the condition of walking ability and lucidity before injury

Abstract

The objective of this study is to evaluate the outcomes and the variance of the liaison critical pathway in an unselected population of patients operated for displaced hip fractures. It is characteristic of the liaison pathway to classify the patients into three groups by assessing the condition of walking ability and lucidity before injury. These groups are Classification A：able to walk independently outside, Classification B：able to walk with a walking device outdoors and Classification C：unable to walk outdoors alone, or is suffering from various levels of dementia. Records of 86 hips procedures in 22 men and 64 women, aged 28 to 96 (mean, 77) years were studied by variant analysis. The variant proportion of the classification of this study group were：Classification A 47%,Classification B 60% and Classification C 22%. The cause of variance was mainly due to patients' pre-existing conditions such as limited weight-bearing or having pre-existing illness. At discharge, 65% in Classification A acquired walking ability outside, 40% in B and 7% in C. 88% in Classification A were able to go into home care, 84% in B and 63% in C, respectively. This latter number of home care return suggested that people who were unable to acquire walking ability outside can still go home. The importance of social circumstances at the time of discharge in influencing the condition of elderly patients with hip fractures in C pathway has been also shown. Outcomes of hospital stay and walking ability were not sufficient, but the classification with the condition of walking ability and lucidity before injury was useful for medical staff, patients and their families.