The Application Of ERAS In The Treatment Of Elderly Intertrochanteric Fracture

Objective:Research the clinical effect of ERAS combined with early operation on the elderly patients with intertrochanteric fracture of femur.Methods:We selected 120 elderly patients with intertrochanteric fracture in our department from January 2017 to January 2019 Through retrospective analysis,including 60 patients who were treated by ERAS combined with early operation,other 60 patients who were treated by conventional treatment.There were 27 males and 33 females in the combination group,with an average age of(77.07±7.42)years.There were 29 males and 31 females in the conventional treatment group,with an average age of(77.45±8.10)years.Compare the diversity between the two groups of indicators that sex,age,waiting time before operation,incidence of postoperative complications,length of stay,postoperative hip function and one-year mortality.Analyze the risk factors of death within one year after operation.Results:There are 60 patients in the combination group that 7 patients died within one year after operation and the mortality rate was 11.67%.There are 53 patients were followed up for one year whose 38 patients had excellent Harris score of hip joint that the excellent and good rate was 71.69%finally.There are 9 patients died within one year in the conventional treatment group and the mortality rate was 15.00%.There are 51 patients were followed up for one year whose Harris score of hip joint was excellent in 35 cases that the excellent and good rate was 68.63%.There was no significant statistical difference between two groups in 1-year mortality and the excellent and good rate of hip joint(P>0.05);The average waiting time from admission to operation was(53.60±14.05)h in the combination group,and in the conventional treatment group was(114.17±21.06)h;the average length of stay in the combination group were(9.57±2.15)days,the conventional treatment group were(15.37±4.03)days;the complication rate postoperative about the combination group was 20.00%,the conventional treatment group was 38.33%,There was significant statistical difference between two groups(P<0.05).The study showed advanced age(age≥80 years old)and postoperative complications were the risk factors of one-year death by logistic dualistic regression analysis.Conclusions:This study showed that ERAS combined with early operation can effectively decreased the waiting time before operation,reduce the length of hospitalization,lower the postoperative complications,accelerate the recovery of patients.In addition,This study has clinical significance and reference value for the establishment of the Fast track management.