Effectiveness of surgical green channel for senile hip fractures / 中华创伤骨科杂志

ABSTRACT

Objective To explore the short-term efficacy of green channel surgery for hip fractures in the elderly patients.Methods A retrospective study was conducted of the 128 elderly patients with hip fracture who had been operatively treated at Department of Orthopaedics,The First People's Hospital of Beijing Fangshan from January 2015 to September 2017.They were 44 men and 84 women,aged from 65 to 91 years (average,75.5 years).The interval from injury to surgery ranged from 24 to 48 hours for the green channel group of 63 cases but exceeded 48 hours for the non-green channel group of 65 cases.The 2 groups were compared in terms of complications during hospitalization,mortality 3 months after operation and good to excellent rate of hip function.Results The 2 groups were compatible due to insignificant differences in age,gender,internal disease upon admission or fracture type (P ＞ 0.05).All the patients were followed up for 0.5 to 3.0 months (average,2.7 months).The total incidence of complications during hospitalization,and incidences of hypostatic pneumonia,acute cardiac and cerebrovascular accidents and venous thromboembolism were all significantly lower in the green channel group than in the non-green channel group (P ＜0.05).There were no significant differences between the 2 groups in terms of in delirium,sudden death,pressure sore,postoperative urinary infection,or mortality 3 months after operation (P ＞ 0.05).No wound infection or pulmonary embolism was observed in either group.According to the scoring system for hip functions modified by Li Zirong,the good to excellent rate was 76.6％ in the green channel group (36/47) and 68.6％ (35/51) in the non-green channel group,showing no significant difference between the 2 groups (P ＞0.05).Conclusions Establishment of green channel surgery and multidisciplinary collaboration can significantly reduce incidence of postoperative complications.Its effect on the mid-and long-term mortality in these patients needs further observation.