Early surgical treatment using regional clinical pathways to reduce the length of postoperative hospital stay in hip fracture patients: A retrospective analysis using the Japanese Diagnosis Procedure Combination database
Hip fracture is a common injury in older adults; however, the optimal timing of surgical treatment remains undetermined in Japan. Therefore, this retrospective study aimed to ascertain the rate of early surgery among hip fracture patients and investigate its effectiveness, along with "regional...
Gespeichert in:
| Veröffentlicht in: | PloS one 2024-07, Vol.19 (7), p.e0282766 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | |
|---|---|
| container_issue | 7 |
| container_start_page | e0282766 |
| container_title | PloS one |
| container_volume | 19 |
| creator | Nishimura, Haruki Suzuki, Hitoshi Tokutsu, Kei Muramatsu, Keiji Kawasaki, Makoto Yamanaka, Yoshiaki Uchida, Soshi Nakamura, Eiichiro Fushimi, Kiyohide Matsuda, Shinya Sakai, Akinori |
| description | Hip fracture is a common injury in older adults; however, the optimal timing of surgical treatment remains undetermined in Japan. Therefore, this retrospective study aimed to ascertain the rate of early surgery among hip fracture patients and investigate its effectiveness, along with "regional clinical pathways" (patient plan of care devised by Japanese clinicians), in reducing the length of hospital stay (LOS) postoperatively. We hypothesized that performing early surgery along with a regional clinical pathway is effective to reduce the postoperative LOS and complications among hip fracture patients. We examined the data of patients diagnosed with femoral neck and peritrochanteric fractures retrieved from the Japanese Diagnosis Procedure Combination database between April 2016 and March 2018. Patients were divided into the early (43,928, 34%; surgery within 2 days of admission) and delayed (84,237, 66%; surgery after 2 days of admission) surgery groups. The difference in postoperative LOS between the two groups was 3 days (early vs. delayed: 29 days vs. 32 days). The early surgery group had more cases of intertrochanteric fractures (57% vs. 43%) and internal fixation (74% vs. 55%) than did the delayed surgery group. In contrast, the delayed surgery group had more cases of femoral neck fractures (43% vs. 57%) and bipolar hip arthroplasty (25% vs. 42%) or total hip arthroplasty (1.2% vs. 3.0%). Moreover, the early surgery group showed a lower incidence of complications, except anemia (12% vs. 8.8%). Logistic regression analysis using the adjusted model revealed that early surgery and implementation of regional clinical pathways reduced LOS by 2.58 and 8.06 days, respectively (p |
| doi_str_mv | 10.1371/journal.pone.0282766 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_plos_</sourceid><recordid>TN_cdi_plos_journals_3086815792</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A803346770</galeid><doaj_id>oai_doaj_org_article_3293e235b9c8433db8f298ebdc90d481</doaj_id><sourcerecordid>A803346770</sourcerecordid><originalsourceid>FETCH-LOGICAL-c642t-238a5e9b637dc06f42ba68d5b9d6744c7da67e545d0082bea8c0f937405eee263</originalsourceid><addsrcrecordid>eNqNk89u1DAQxiMEoqXwBggsISE47OLYieP0gqpSoKhSEf-u1sSZJK6ycbCdwr4rD4PT3VZd1APKwZHnN983HnuS5GlKlykv0jcXdnID9MvRDrikTLJCiHvJflpythCM8vu3_veSR95fUJpzKcTDZI-XVPJMiv3kzwm4fk385FqjoSfBIYQVDoFM3gwtcdgaG22I7s1wRYwQul-w9iTYGK0njSR0SHoc2tAR25DR-mBHdBDMJZLO-tGEmOcDrIkZSGdG0jjQYXI4i5lo5g_JURQLLsKor_Igmq698ds6ZotPMMKAHsk7A-1g5-BnZ3WsISod21VlhihnB1JDgAo8Pk4eNNB7fLJdD5Lv70--HX9cnJ1_OD0-OltokbGwYFxCjmUleFFrKpqMVSBknVdlLYos00UNosA8y2tKJasQpKZNyYuM5ojIBD9Inm90x956tb0YrziVQqZ5UbJInG6I2sKFGp1ZgVsrC0ZdbVjXKnDB6B4VZyVHxqO7lhnndSUbVkqsal3SOpNp1Hq7dZuqFdY69s9BvyO6GxlMp1p7qdKUlVRwGRVebRWc_TmhD2plvMa-j-2106bwMs8KNhf-4h_07uNtqRbiCczQ2GisZ1F1JCnnmSgKGqnlHVT8alwZHZ9xY-L-TsLrnYTIBPwdWpi8V6dfv_w_e_5jl315i-0Q-tB520_z4_G7YLYBdXyZ3mFz0-WUqnkKr7uh5ilU2ymMac9u39BN0vXY8b8FQzMS</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3086815792</pqid></control><display><type>article</type><title>Early surgical treatment using regional clinical pathways to reduce the length of postoperative hospital stay in hip fracture patients: A retrospective analysis using the Japanese Diagnosis Procedure Combination database</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><source>Free Full-Text Journals in Chemistry</source><source>Public Library of Science (PLoS)</source><creator>Nishimura, Haruki ; Suzuki, Hitoshi ; Tokutsu, Kei ; Muramatsu, Keiji ; Kawasaki, Makoto ; Yamanaka, Yoshiaki ; Uchida, Soshi ; Nakamura, Eiichiro ; Fushimi, Kiyohide ; Matsuda, Shinya ; Sakai, Akinori</creator><creatorcontrib>Nishimura, Haruki ; Suzuki, Hitoshi ; Tokutsu, Kei ; Muramatsu, Keiji ; Kawasaki, Makoto ; Yamanaka, Yoshiaki ; Uchida, Soshi ; Nakamura, Eiichiro ; Fushimi, Kiyohide ; Matsuda, Shinya ; Sakai, Akinori</creatorcontrib><description>Hip fracture is a common injury in older adults; however, the optimal timing of surgical treatment remains undetermined in Japan. Therefore, this retrospective study aimed to ascertain the rate of early surgery among hip fracture patients and investigate its effectiveness, along with "regional clinical pathways" (patient plan of care devised by Japanese clinicians), in reducing the length of hospital stay (LOS) postoperatively. We hypothesized that performing early surgery along with a regional clinical pathway is effective to reduce the postoperative LOS and complications among hip fracture patients. We examined the data of patients diagnosed with femoral neck and peritrochanteric fractures retrieved from the Japanese Diagnosis Procedure Combination database between April 2016 and March 2018. Patients were divided into the early (43,928, 34%; surgery within 2 days of admission) and delayed (84,237, 66%; surgery after 2 days of admission) surgery groups. The difference in postoperative LOS between the two groups was 3 days (early vs. delayed: 29 days vs. 32 days). The early surgery group had more cases of intertrochanteric fractures (57% vs. 43%) and internal fixation (74% vs. 55%) than did the delayed surgery group. In contrast, the delayed surgery group had more cases of femoral neck fractures (43% vs. 57%) and bipolar hip arthroplasty (25% vs. 42%) or total hip arthroplasty (1.2% vs. 3.0%). Moreover, the early surgery group showed a lower incidence of complications, except anemia (12% vs. 8.8%). Logistic regression analysis using the adjusted model revealed that early surgery and implementation of regional clinical pathways reduced LOS by 2.58 and 8.06 days, respectively (p<0.001). Early surgery and implementation of regional clinical pathways for hip fracture patients are effective in reducing postoperative LOS, allowing regional clinical pathways to have a greater impact. These findings will help acute care providers when treating hip fracture patients.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0282766</identifier><identifier>PMID: 39083486</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Aged ; Aged, 80 and over ; Anemia ; Biology and Life Sciences ; Biomedical materials ; Blood transfusions ; Body mass index ; Bone surgery ; Cardiovascular disease ; Clinical practice guidelines ; Complications ; Critical Pathways ; Databases, Factual ; Dementia ; Diabetes ; Diagnosis ; East Asian People ; Effectiveness ; Female ; Femur ; Fracture Fixation, Internal - adverse effects ; Fracture Fixation, Internal - methods ; Fractures ; Health services ; Hip ; Hip Fractures - surgery ; Hip joint ; Hospitalization ; Hospitals ; Humans ; Injury analysis ; Internal fixation in fractures ; Japan - epidemiology ; Joint replacement surgery ; Length of Stay ; Male ; Medical diagnosis ; Medical research ; Medicine and Health Sciences ; Medicine, Experimental ; Mortality ; Older people ; Orthopedics ; Osteoporosis ; Patient care planning ; Patients ; Pneumonia ; Postoperative ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology ; Postoperative Complications - prevention & control ; Pressure ulcers ; Regional analysis ; Regional planning ; Regression analysis ; Regression models ; Retrospective Studies ; Surgeons ; Surgery ; Surgical site infections ; Thrombosis ; Total hip arthroplasty ; Tranexamic acid</subject><ispartof>PloS one, 2024-07, Vol.19 (7), p.e0282766</ispartof><rights>Copyright: © 2024 Nishimura et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</rights><rights>COPYRIGHT 2024 Public Library of Science</rights><rights>2024 Nishimura et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2024 Nishimura et al 2024 Nishimura et al</rights><rights>2024 Nishimura et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c642t-238a5e9b637dc06f42ba68d5b9d6744c7da67e545d0082bea8c0f937405eee263</cites><orcidid>0000-0001-6936-3019</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11290638/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11290638/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39083486$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nishimura, Haruki</creatorcontrib><creatorcontrib>Suzuki, Hitoshi</creatorcontrib><creatorcontrib>Tokutsu, Kei</creatorcontrib><creatorcontrib>Muramatsu, Keiji</creatorcontrib><creatorcontrib>Kawasaki, Makoto</creatorcontrib><creatorcontrib>Yamanaka, Yoshiaki</creatorcontrib><creatorcontrib>Uchida, Soshi</creatorcontrib><creatorcontrib>Nakamura, Eiichiro</creatorcontrib><creatorcontrib>Fushimi, Kiyohide</creatorcontrib><creatorcontrib>Matsuda, Shinya</creatorcontrib><creatorcontrib>Sakai, Akinori</creatorcontrib><title>Early surgical treatment using regional clinical pathways to reduce the length of postoperative hospital stay in hip fracture patients: A retrospective analysis using the Japanese Diagnosis Procedure Combination database</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Hip fracture is a common injury in older adults; however, the optimal timing of surgical treatment remains undetermined in Japan. Therefore, this retrospective study aimed to ascertain the rate of early surgery among hip fracture patients and investigate its effectiveness, along with "regional clinical pathways" (patient plan of care devised by Japanese clinicians), in reducing the length of hospital stay (LOS) postoperatively. We hypothesized that performing early surgery along with a regional clinical pathway is effective to reduce the postoperative LOS and complications among hip fracture patients. We examined the data of patients diagnosed with femoral neck and peritrochanteric fractures retrieved from the Japanese Diagnosis Procedure Combination database between April 2016 and March 2018. Patients were divided into the early (43,928, 34%; surgery within 2 days of admission) and delayed (84,237, 66%; surgery after 2 days of admission) surgery groups. The difference in postoperative LOS between the two groups was 3 days (early vs. delayed: 29 days vs. 32 days). The early surgery group had more cases of intertrochanteric fractures (57% vs. 43%) and internal fixation (74% vs. 55%) than did the delayed surgery group. In contrast, the delayed surgery group had more cases of femoral neck fractures (43% vs. 57%) and bipolar hip arthroplasty (25% vs. 42%) or total hip arthroplasty (1.2% vs. 3.0%). Moreover, the early surgery group showed a lower incidence of complications, except anemia (12% vs. 8.8%). Logistic regression analysis using the adjusted model revealed that early surgery and implementation of regional clinical pathways reduced LOS by 2.58 and 8.06 days, respectively (p<0.001). Early surgery and implementation of regional clinical pathways for hip fracture patients are effective in reducing postoperative LOS, allowing regional clinical pathways to have a greater impact. These findings will help acute care providers when treating hip fracture patients.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anemia</subject><subject>Biology and Life Sciences</subject><subject>Biomedical materials</subject><subject>Blood transfusions</subject><subject>Body mass index</subject><subject>Bone surgery</subject><subject>Cardiovascular disease</subject><subject>Clinical practice guidelines</subject><subject>Complications</subject><subject>Critical Pathways</subject><subject>Databases, Factual</subject><subject>Dementia</subject><subject>Diabetes</subject><subject>Diagnosis</subject><subject>East Asian People</subject><subject>Effectiveness</subject><subject>Female</subject><subject>Femur</subject><subject>Fracture Fixation, Internal - adverse effects</subject><subject>Fracture Fixation, Internal - methods</subject><subject>Fractures</subject><subject>Health services</subject><subject>Hip</subject><subject>Hip Fractures - surgery</subject><subject>Hip joint</subject><subject>Hospitalization</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Injury analysis</subject><subject>Internal fixation in fractures</subject><subject>Japan - epidemiology</subject><subject>Joint replacement surgery</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Medical diagnosis</subject><subject>Medical research</subject><subject>Medicine and Health Sciences</subject><subject>Medicine, Experimental</subject><subject>Mortality</subject><subject>Older people</subject><subject>Orthopedics</subject><subject>Osteoporosis</subject><subject>Patient care planning</subject><subject>Patients</subject><subject>Pneumonia</subject><subject>Postoperative</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Complications - prevention & control</subject><subject>Pressure ulcers</subject><subject>Regional analysis</subject><subject>Regional planning</subject><subject>Regression analysis</subject><subject>Regression models</subject><subject>Retrospective Studies</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Surgical site infections</subject><subject>Thrombosis</subject><subject>Total hip arthroplasty</subject><subject>Tranexamic acid</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNk89u1DAQxiMEoqXwBggsISE47OLYieP0gqpSoKhSEf-u1sSZJK6ycbCdwr4rD4PT3VZd1APKwZHnN983HnuS5GlKlykv0jcXdnID9MvRDrikTLJCiHvJflpythCM8vu3_veSR95fUJpzKcTDZI-XVPJMiv3kzwm4fk385FqjoSfBIYQVDoFM3gwtcdgaG22I7s1wRYwQul-w9iTYGK0njSR0SHoc2tAR25DR-mBHdBDMJZLO-tGEmOcDrIkZSGdG0jjQYXI4i5lo5g_JURQLLsKor_Igmq698ds6ZotPMMKAHsk7A-1g5-BnZ3WsISod21VlhihnB1JDgAo8Pk4eNNB7fLJdD5Lv70--HX9cnJ1_OD0-OltokbGwYFxCjmUleFFrKpqMVSBknVdlLYos00UNosA8y2tKJasQpKZNyYuM5ojIBD9Inm90x956tb0YrziVQqZ5UbJInG6I2sKFGp1ZgVsrC0ZdbVjXKnDB6B4VZyVHxqO7lhnndSUbVkqsal3SOpNp1Hq7dZuqFdY69s9BvyO6GxlMp1p7qdKUlVRwGRVebRWc_TmhD2plvMa-j-2106bwMs8KNhf-4h_07uNtqRbiCczQ2GisZ1F1JCnnmSgKGqnlHVT8alwZHZ9xY-L-TsLrnYTIBPwdWpi8V6dfv_w_e_5jl315i-0Q-tB520_z4_G7YLYBdXyZ3mFz0-WUqnkKr7uh5ilU2ymMac9u39BN0vXY8b8FQzMS</recordid><startdate>20240731</startdate><enddate>20240731</enddate><creator>Nishimura, Haruki</creator><creator>Suzuki, Hitoshi</creator><creator>Tokutsu, Kei</creator><creator>Muramatsu, Keiji</creator><creator>Kawasaki, Makoto</creator><creator>Yamanaka, Yoshiaki</creator><creator>Uchida, Soshi</creator><creator>Nakamura, Eiichiro</creator><creator>Fushimi, Kiyohide</creator><creator>Matsuda, Shinya</creator><creator>Sakai, Akinori</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-6936-3019</orcidid></search><sort><creationdate>20240731</creationdate><title>Early surgical treatment using regional clinical pathways to reduce the length of postoperative hospital stay in hip fracture patients: A retrospective analysis using the Japanese Diagnosis Procedure Combination database</title><author>Nishimura, Haruki ; Suzuki, Hitoshi ; Tokutsu, Kei ; Muramatsu, Keiji ; Kawasaki, Makoto ; Yamanaka, Yoshiaki ; Uchida, Soshi ; Nakamura, Eiichiro ; Fushimi, Kiyohide ; Matsuda, Shinya ; Sakai, Akinori</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c642t-238a5e9b637dc06f42ba68d5b9d6744c7da67e545d0082bea8c0f937405eee263</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anemia</topic><topic>Biology and Life Sciences</topic><topic>Biomedical materials</topic><topic>Blood transfusions</topic><topic>Body mass index</topic><topic>Bone surgery</topic><topic>Cardiovascular disease</topic><topic>Clinical practice guidelines</topic><topic>Complications</topic><topic>Critical Pathways</topic><topic>Databases, Factual</topic><topic>Dementia</topic><topic>Diabetes</topic><topic>Diagnosis</topic><topic>East Asian People</topic><topic>Effectiveness</topic><topic>Female</topic><topic>Femur</topic><topic>Fracture Fixation, Internal - adverse effects</topic><topic>Fracture Fixation, Internal - methods</topic><topic>Fractures</topic><topic>Health services</topic><topic>Hip</topic><topic>Hip Fractures - surgery</topic><topic>Hip joint</topic><topic>Hospitalization</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Injury analysis</topic><topic>Internal fixation in fractures</topic><topic>Japan - epidemiology</topic><topic>Joint replacement surgery</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Medical diagnosis</topic><topic>Medical research</topic><topic>Medicine and Health Sciences</topic><topic>Medicine, Experimental</topic><topic>Mortality</topic><topic>Older people</topic><topic>Orthopedics</topic><topic>Osteoporosis</topic><topic>Patient care planning</topic><topic>Patients</topic><topic>Pneumonia</topic><topic>Postoperative</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - etiology</topic><topic>Postoperative Complications - prevention & control</topic><topic>Pressure ulcers</topic><topic>Regional analysis</topic><topic>Regional planning</topic><topic>Regression analysis</topic><topic>Regression models</topic><topic>Retrospective Studies</topic><topic>Surgeons</topic><topic>Surgery</topic><topic>Surgical site infections</topic><topic>Thrombosis</topic><topic>Total hip arthroplasty</topic><topic>Tranexamic acid</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nishimura, Haruki</creatorcontrib><creatorcontrib>Suzuki, Hitoshi</creatorcontrib><creatorcontrib>Tokutsu, Kei</creatorcontrib><creatorcontrib>Muramatsu, Keiji</creatorcontrib><creatorcontrib>Kawasaki, Makoto</creatorcontrib><creatorcontrib>Yamanaka, Yoshiaki</creatorcontrib><creatorcontrib>Uchida, Soshi</creatorcontrib><creatorcontrib>Nakamura, Eiichiro</creatorcontrib><creatorcontrib>Fushimi, Kiyohide</creatorcontrib><creatorcontrib>Matsuda, Shinya</creatorcontrib><creatorcontrib>Sakai, Akinori</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - Academic</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Agricultural Science Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nishimura, Haruki</au><au>Suzuki, Hitoshi</au><au>Tokutsu, Kei</au><au>Muramatsu, Keiji</au><au>Kawasaki, Makoto</au><au>Yamanaka, Yoshiaki</au><au>Uchida, Soshi</au><au>Nakamura, Eiichiro</au><au>Fushimi, Kiyohide</au><au>Matsuda, Shinya</au><au>Sakai, Akinori</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Early surgical treatment using regional clinical pathways to reduce the length of postoperative hospital stay in hip fracture patients: A retrospective analysis using the Japanese Diagnosis Procedure Combination database</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2024-07-31</date><risdate>2024</risdate><volume>19</volume><issue>7</issue><spage>e0282766</spage><pages>e0282766-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Hip fracture is a common injury in older adults; however, the optimal timing of surgical treatment remains undetermined in Japan. Therefore, this retrospective study aimed to ascertain the rate of early surgery among hip fracture patients and investigate its effectiveness, along with "regional clinical pathways" (patient plan of care devised by Japanese clinicians), in reducing the length of hospital stay (LOS) postoperatively. We hypothesized that performing early surgery along with a regional clinical pathway is effective to reduce the postoperative LOS and complications among hip fracture patients. We examined the data of patients diagnosed with femoral neck and peritrochanteric fractures retrieved from the Japanese Diagnosis Procedure Combination database between April 2016 and March 2018. Patients were divided into the early (43,928, 34%; surgery within 2 days of admission) and delayed (84,237, 66%; surgery after 2 days of admission) surgery groups. The difference in postoperative LOS between the two groups was 3 days (early vs. delayed: 29 days vs. 32 days). The early surgery group had more cases of intertrochanteric fractures (57% vs. 43%) and internal fixation (74% vs. 55%) than did the delayed surgery group. In contrast, the delayed surgery group had more cases of femoral neck fractures (43% vs. 57%) and bipolar hip arthroplasty (25% vs. 42%) or total hip arthroplasty (1.2% vs. 3.0%). Moreover, the early surgery group showed a lower incidence of complications, except anemia (12% vs. 8.8%). Logistic regression analysis using the adjusted model revealed that early surgery and implementation of regional clinical pathways reduced LOS by 2.58 and 8.06 days, respectively (p<0.001). Early surgery and implementation of regional clinical pathways for hip fracture patients are effective in reducing postoperative LOS, allowing regional clinical pathways to have a greater impact. These findings will help acute care providers when treating hip fracture patients.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>39083486</pmid><doi>10.1371/journal.pone.0282766</doi><tpages>e0282766</tpages><orcidid>https://orcid.org/0000-0001-6936-3019</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2024-07, Vol.19 (7), p.e0282766 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_3086815792 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Aged Aged, 80 and over Anemia Biology and Life Sciences Biomedical materials Blood transfusions Body mass index Bone surgery Cardiovascular disease Clinical practice guidelines Complications Critical Pathways Databases, Factual Dementia Diabetes Diagnosis East Asian People Effectiveness Female Femur Fracture Fixation, Internal - adverse effects Fracture Fixation, Internal - methods Fractures Health services Hip Hip Fractures - surgery Hip joint Hospitalization Hospitals Humans Injury analysis Internal fixation in fractures Japan - epidemiology Joint replacement surgery Length of Stay Male Medical diagnosis Medical research Medicine and Health Sciences Medicine, Experimental Mortality Older people Orthopedics Osteoporosis Patient care planning Patients Pneumonia Postoperative Postoperative Complications - epidemiology Postoperative Complications - etiology Postoperative Complications - prevention & control Pressure ulcers Regional analysis Regional planning Regression analysis Regression models Retrospective Studies Surgeons Surgery Surgical site infections Thrombosis Total hip arthroplasty Tranexamic acid |
| title | Early surgical treatment using regional clinical pathways to reduce the length of postoperative hospital stay in hip fracture patients: A retrospective analysis using the Japanese Diagnosis Procedure Combination database |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-13T05%3A51%3A23IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Early%20surgical%20treatment%20using%20regional%20clinical%20pathways%20to%20reduce%20the%20length%20of%20postoperative%20hospital%20stay%20in%20hip%20fracture%20patients:%20A%20retrospective%20analysis%20using%20the%20Japanese%20Diagnosis%20Procedure%20Combination%20database&rft.jtitle=PloS%20one&rft.au=Nishimura,%20Haruki&rft.date=2024-07-31&rft.volume=19&rft.issue=7&rft.spage=e0282766&rft.pages=e0282766-&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0282766&rft_dat=%3Cgale_plos_%3EA803346770%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=3086815792&rft_id=info:pmid/39083486&rft_galeid=A803346770&rft_doaj_id=oai_doaj_org_article_3293e235b9c8433db8f298ebdc90d481&rfr_iscdi=true |