Mortality and readmission following hip fracture surgery: a retrospective study comparing conventional and fast-track care
Objective To compare the efficacies of two pathways—conventional and fast-track care—in patients with hip fracture.Design Retrospective single-centre study.Setting University hospital in middle Norway.Participants 1820 patients aged ≥65 years with hip fracture (intracapsular, intertrochanteric or su...
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BMJ Publishing Group
2017-08-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/7/8/e015574.full |
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| author | Kristin Haugan Lars G Johnsen Trude Basso Olav A Foss |
| author_facet | Kristin Haugan Lars G Johnsen Trude Basso Olav A Foss |
| author_sort | Kristin Haugan |
| collection | DOAJ |
| description | Objective To compare the efficacies of two pathways—conventional and fast-track care—in patients with hip fracture.Design Retrospective single-centre study.Setting University hospital in middle Norway.Participants 1820 patients aged ≥65 years with hip fracture (intracapsular, intertrochanteric or subtrochanteric).Interventions 788 patients were treated according to conventional care from April 2008 to September 2011, and 1032 patients were treated according to fast-track care from October 2011 to December 2013.Primary and secondary outcome Primary: mortality and readmission to hospital, within 365 days follow-up. Secondary: length of stay.Results We found no statistically significant differences in mortality and readmission rate between patients in the fast-track and conventional care models within 365 days after the initial hospital admission. The conventional care group had a higher, no statistical significant mortality HR of 1.10 (95% CI 0.91 to 1.31, p=0.326) without and 1.16 (95% CI 0.96 to 1.40, p=0.118) with covariate adjustment. Regarding the readmission, the conventional care group sub-HR was 1.02 (95% CI 0.88 to 1.18, p=0.822) without and 0.97 (95% CI 0.83 to 1.12, p=0.644) with adjusting for covariates. Length of stay and time to surgery was statistically significant shorter for patients who received fast-track care, a mean difference of 3.4 days and 6 hours, respectively. There was no statistically significant difference in sex, type of fracture, age or Charlson Comorbidity Index score at baseline between patients in the two pathways.Conclusions There was insufficient evidence to show an impact of fast-track care on mortality and readmission. Length of stay and time to surgery were decreased.Trial registration number NCT00667914; results |
| format | Article |
| id | doaj-art-d5d11356ccfe436580540b14c9d1e08b |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2017-08-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-d5d11356ccfe436580540b14c9d1e08b2025-02-12T01:05:19ZengBMJ Publishing GroupBMJ Open2044-60552017-08-017810.1136/bmjopen-2016-015574Mortality and readmission following hip fracture surgery: a retrospective study comparing conventional and fast-track careKristin Haugan0Lars G Johnsen1Trude Basso2Olav A Foss31 Department of Orthopaedics, Orthopaedic Research Centre, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway1 Department of Orthopaedics, Orthopaedic Research Centre, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway1 Department of Orthopaedics, Orthopaedic Research Centre, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway1 Department of Orthopaedics, Orthopaedic Research Centre, St Olavs Hospital, Trondheim University Hospital, Trondheim, NorwayObjective To compare the efficacies of two pathways—conventional and fast-track care—in patients with hip fracture.Design Retrospective single-centre study.Setting University hospital in middle Norway.Participants 1820 patients aged ≥65 years with hip fracture (intracapsular, intertrochanteric or subtrochanteric).Interventions 788 patients were treated according to conventional care from April 2008 to September 2011, and 1032 patients were treated according to fast-track care from October 2011 to December 2013.Primary and secondary outcome Primary: mortality and readmission to hospital, within 365 days follow-up. Secondary: length of stay.Results We found no statistically significant differences in mortality and readmission rate between patients in the fast-track and conventional care models within 365 days after the initial hospital admission. The conventional care group had a higher, no statistical significant mortality HR of 1.10 (95% CI 0.91 to 1.31, p=0.326) without and 1.16 (95% CI 0.96 to 1.40, p=0.118) with covariate adjustment. Regarding the readmission, the conventional care group sub-HR was 1.02 (95% CI 0.88 to 1.18, p=0.822) without and 0.97 (95% CI 0.83 to 1.12, p=0.644) with adjusting for covariates. Length of stay and time to surgery was statistically significant shorter for patients who received fast-track care, a mean difference of 3.4 days and 6 hours, respectively. There was no statistically significant difference in sex, type of fracture, age or Charlson Comorbidity Index score at baseline between patients in the two pathways.Conclusions There was insufficient evidence to show an impact of fast-track care on mortality and readmission. Length of stay and time to surgery were decreased.Trial registration number NCT00667914; resultshttps://bmjopen.bmj.com/content/7/8/e015574.full |
| spellingShingle | Kristin Haugan Lars G Johnsen Trude Basso Olav A Foss Mortality and readmission following hip fracture surgery: a retrospective study comparing conventional and fast-track care BMJ Open |
| title | Mortality and readmission following hip fracture surgery: a retrospective study comparing conventional and fast-track care |
| title_full | Mortality and readmission following hip fracture surgery: a retrospective study comparing conventional and fast-track care |
| title_fullStr | Mortality and readmission following hip fracture surgery: a retrospective study comparing conventional and fast-track care |
| title_full_unstemmed | Mortality and readmission following hip fracture surgery: a retrospective study comparing conventional and fast-track care |
| title_short | Mortality and readmission following hip fracture surgery: a retrospective study comparing conventional and fast-track care |
| title_sort | mortality and readmission following hip fracture surgery a retrospective study comparing conventional and fast track care |
| url | https://bmjopen.bmj.com/content/7/8/e015574.full |
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