A Primary Research For The Foundation Of Fast-track Care With Senile Hip Fractures

Objective To compare the differences of many indictors with setting up senile hip fracture fast-track before and after to provide theoretical support and clinical evdiences for founding this system.Methods Between January 2014 to December 2014(before the foundation of fast-track)and January 2015 to December 2015(after the foundation of fast-track),277 patients whose age was over 65 yeras were performed surgical treatment and divided into two groups that signed A and B.Some indictors are compared,including age,gender,time for injury to operation,fracture type,comorbidities,postoperative mortality,postoperative compications and the rate of good function of hip joint.Menmile group B was admitted to preoperative evaluation system that including age,ASA classification and SPMSQ scores were assigned.At the end of this follow-up period.To demonstrate the effectiveness of this system,SF-36 scores and preoperative evaluation scores were collected to establish abscissa and ordinate that compare their correlation.Results The average duration of follow-up was 10.9 months for 120 patients and11.3months for 129 patients,respectively in two groups.Age,gender,comorbidites and the rate of good function of hip joint(84.7% in group A and 85.3% in group B)resulted in insignificant difference(P > 0.05).The average duration from injury to surgery was67.3h and 47.6h respectively.The postoperative mortality respecrively was 16.9% and8.5% within one year.Postoperative complications occurance rate respectively was39.8% and 20.2%.These indictors result in significant difference(P < 0.05).Male,femoral intertrochanteric fracture and comorbidites were risk factors for the one-year mortality after surgery.As well as,there were significant corralation betweenpreoperative evaluation system scores and SF-36 scores(level of P=0.01).Conclusions Setting up senile hip fracture fast-track can effectively shorten time from injury to surgery,decrease postoperative mortality and complications as well.It is a synthetical subject that improve the diagnosis level of seile hip fracture.Meanwhile,the effectiveness preoperative evaluation system was proved in the fast-track.