Clinical pathways for geriatric patients with proximal femoral fracture improve process and outcome.

OBJECTIVE

The objective of the current study was to evaluate the implementation of clinical pathways (CPs) in hip fracture management.

METHODS

Six hundred and five proximal femoral fractures were prospectively included into a hospital data-base. The effects of CPs were evaluated using a pre-during-post design. Different procedural (time to surgery, length of stay, discharge, etc.) and patient outcome parameters (mortality, complications, etc.) were evaluated.

RESULTS

In both categories significant changes could be detected during the three-year period. E.g. significant reduction of time to surgery, improvement of discharge management, reduction of internal complications. However, no significant changes could be demonstrated for mortality or revision rate.

CONCLUSION

We could show a relevant improvement with the implementation of clinical pathways for the treatment of proximal femoral fractures in elderly patients.

LEVEL OF EVIDENCE: III, prospective non-randomised cohort study.