The management of elderly patients with femoral fractures A randomised controlled trial of early intervention versus standard care

The management of elderly patients with femoral fractures A randomised controlled trial of early intervention versus standard care

Objective To determine the effect of an early intervention program in an acute care setting on the length of stay in hospital of elderly patients with proximal femoral fractures. Setting Acute orthopaedic ward of a large teaching hospital. Design and participants A randomised controlled trial compar...

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Bibliographic Details
Published in:Medical journal of Australia Vol. 169; no. 10; pp. 515 - 518
Main Authors: Swanson, Cheryl E, Day, Gregory A, Yelland, Catherine E, Broome, Josiane R, Massey, Lorraine, Richardson, Helen R, Dimitri, Karel, Marsh, Alan
Format: Journal Article
Language:English
Published: Sydney Australasian Medical Publishing Company 16-11-1998
Subjects:
Aged
Aged, 80 and over
Biological and medical sciences
Female
Femoral Fractures - surgery
Femoral Fractures - therapy
Hospital Mortality
Humans
Injuries of the limb. Injuries of the spine
Length of Stay
Male
Medical sciences
Middle Aged
Social Support
Traumas. Diseases due to physical agents
Treatment Outcome
Human
Femoral neck
Program
Treatment efficiency
Diseases of the osteoarticular system
Duration
Fracture
Hospitalization
Operation
Trauma
Treatment
Surgery
Early
Elderly
Comparative study
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Summary:Objective To determine the effect of an early intervention program in an acute care setting on the length of stay in hospital of elderly patients with proximal femoral fractures. Setting Acute orthopaedic ward of a large teaching hospital. Design and participants A randomised controlled trial comparing 38 Intervention patients with 33 Standard Care patients. Intervention Early surgery, minimal narcotic analgesia, intense daily therapy and close monitoring of patient needs via a multidisciplinary approach versus routine hospital management. Main outcome measures Length of stay (LOS); deaths; level of independent functioning. Results Mean LOS was shorter in the Intervention group than in the Standard Care group (21 days v. 32.5 days; P <0.01). After adjusting for other factors that could affect LOS (eg, age, sex, pre‐trauma functional levels, pre‐trauma comorbidity and postsurgical complications), the Intervention program was significantly predictive of shorter LOS (P = 0.01). The Intervention group did not experience greater numbers of deaths, deterioration in function or need for social support than the Standard Care group. Conclusion This early intervention program in an acute care setting results in significantly shorter length of hospital stay for elderly patients with femoral fractures.
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ISSN:0025-729X
1326-5377
DOI:10.5694/j.1326-5377.1998.tb123397.x