Impact of multidisciplinary diagnosis and treatment on postoperative 30-day mortality and complications in elderly patients with hip fracture / 中华创伤骨科杂志

ABSTRACT

Objective:To investigate the impact of multidisciplinary diagnosis and treatment on postoperative 30-day mortality and complications in elderly patients with hip fracture.Methods:A retrospective analysis was conducted of the 260 elderly patients with hip fracture who had been treated by the mode of multidisciplinary diagnosis and treatment at Department of Orthopedics, Shenzhen Second People's Hospital from June 2018 to October 2019. The multidisciplinary group consisted of 66 males and 194 females with an age of 78.7 years ± 5.1 years, and 141 femoral neck fractures, 114 intertrochanteric fractures and 5 subtrochanteric fractures. They were compared with the 242 elderly patients with hip fracture (traditional group) who had been treated by the traditional mode from January 2017 to May 2018. The 2 groups were compared in terms of preoperative waiting time, 48-hour operation rate, 30-day mortality, and incidences of postoperative pneumonia and pressure ulcer.Results:There were no statistically significant differences in the preoperative general data or operative procedures between the 2 groups, showing comparability ( P>0.05). For the multidisciplinary group, preoperative waiting time was 41.9 h ± 36.5 h, significantly shorter than that for the traditional group (71.4 h ± 13.9 h), 48-hour operation rate 66.5% (173/260), significantly higher than that for the traditional group(8.7%, 21/242), incidence of postoperative pneumonia 3.1%(8/260), significantly lower than that for the traditional group(9.9%, 24/242), incidence of postoperative pressure ulcer (5.4%, 14/260), significantly lower than that for the traditional group(11.2%, 27/242), and 30-day mortality(2.3%, 6/260), significantly lower than that for the traditional group(5.8%, 14/242) (all P<0.05). Conclusions:Establishment of a mode of multidisciplinary diagnosis and treatment can significantly reduce the prolonged preoperative waiting time for elderly patients with hip fracture, thereby greatly reducing postoperative complications and postoperative 30-day mortality.