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Cracking the Hip: Does Protocol Matter? A Retrospective Cohort Study Investigating the Effect of Protocol
Amelia R Levi1, Marine Coste2, Ethan Warshowsky2
1Department of Surgery, SUNY Downstate Health & Sciences University, Kings County NYC Health & Hospitals, MedStar Georgetown University Hospital, Washington, DC, USA.
Geriatric Orthopaedic Surgery & Rehabilitation
|March 4, 2022
Summary
Implementing a hip fracture protocol reduced time to surgery and postoperative complications in elderly patients. This collaborative approach improved outcomes, though further enhancements may be beneficial.
Area of Science:
- Geriatric Trauma Surgery
- Orthopedic Surgery Outcomes
- Healthcare Protocol Implementation
Background:
- Hip fractures are a significant health issue in older adults, with approximately 300,000 cases annually in the USA.
- Early intervention is critical for reducing morbidity and mortality associated with hip fractures.
- Our institution developed a collaborative hip fracture protocol to streamline care and improve patient outcomes.
Purpose of the Study:
- To evaluate the effectiveness of a new collaborative hip fracture protocol.
- To determine if the protocol reduced time to operating room (TTO) and hospital length of stay (LOS).
- To assess the impact of the protocol on in-hospital mortality and postoperative complications.
Main Methods:
- A retrospective cohort study compared patients over 60 with isolated hip fractures before and after protocol implementation in May 2018.
- Data were extracted from a level-1 trauma center's trauma registry.
- Primary outcomes included TTO and in-hospital mortality; secondary outcomes were LOS and postoperative complications. Univariate analysis was performed.
Main Results:
- The study included 176 patients (107 pre-protocol, 69 post-protocol).
- Post-protocol, TTO decreased significantly (39 vs. 57 hours; P = .013), and postoperative complications were reduced (9% vs. 23%; P = .016).
- Despite a higher prevalence of comorbidities in the post-protocol group, LOS and in-hospital mortality also showed a decreasing trend.
Conclusions:
- The hip fracture protocol led to reduced TTO, LOS, and postoperative complications.
- The protocol demonstrated a positive trend in improving hip fracture patient outcomes.
- Further improvements and institution-wide education may further optimize the protocol's benefits.
Keywords:
geriatric hip fracturehip fracturehip fracture protocolisolated hip fracturelevel-1 trauma centerMore Related Videos
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