Postoperative Management Using a Critical Care Pathway of Community Medical Coordination in Patients with Hip Fracture

Abstract

Objective: To assess the effects of a postoperative critical care pathway of community medical coordination in patients with hip fracture.
Methods: Retrospective chart reviews were conducted for patients with hip fractures operated from December 2008 to May 2012, inclusive. We commenced using a postoperative critical care pathway from September 2010. The patients were divided into two groups between pre-introduction (group B; 67 women and 25 men; mean age, 80.4 years) and post-introduction (group A; 144 women and 24 men; mean age, 82.2 years) of the critical care pathway. The analysis consisted of gender, age, operative procedure, length of time between injury and surgical intervention, duration of hospitalization, mobility on discharge from our hospital compared to the final observation, and return rate to our hospital.
Results: Group A had a significantly shorter length of hospital stay compared to group B (27.1 versus 39.4 days, respectively; P < 0.01). Although both groups regained mobility at the final observation, group A had improved ability compared to group B (72.7 and 56.5%, respectively; P < 0.01). Return rate to our hospital was significantly increased in group A compared to group B (85.2 and 53.2%, respectively; P < 0.01).
Conclusion: The critical care pathway shortened the length of hospitalization, and contributed to improved walking ability. We have been able to continue the treatment of osteoporosis and fracture prevention therapy during follow-up visits to our hospital.