Enhancing Elderly Hip Fracture Care: Reducing the Length of Stay Through Guidelines Implementation

Hip fractures are a significant concern for the elderly population due to their impact on health and well-being. Surgical interventions, including hip arthroplasty and osteosynthesis, play a crucial role in the management of these fractures. In 2015, a hospital-based protocol was introduced to expedite surgical interventions within 48 hours of admission for elderly patients with hip fractures, aiming to enhance preoperative care and minimize delays.

This retrospective observational study aimed to evaluate the effects of protocol implementation on elderly patients (aged >60 years) undergoing osteosynthesis for hip fractures. Primary objectives included assessing postoperative complications, 30-day and one-year mortality rates, functional recovery, and length of hospital stay. The secondary objective was to explore the impact of early surgical intervention (within 48 hours of admission) on these outcomes.

Electronic medical records of hip fracture patients treated at Braga Public Hospital from 2013 to 2016 were retrospectively reviewed.

We included a total of 744 patients, with 391 in the pre-protocol group and 353 in the post-protocol group. Protocol implementation led to a significant increase in surgeries performed within 48 hours of admission (36% versus 53%). While post-protocol patients were older and had higher comorbidity scores, they experienced more postoperative complications. However, their hospital stay was shorter, with no significant changes in mortality rates or time to assisted ambulation.

This study highlights the benefits of protocol implementation in expediting surgical interventions for elderly hip fracture patients. Despite increased complications, the protocol reduced hospital stay without affecting mortality rates. Early surgical intervention was associated with faster postoperative mobilization.