Clinical pathway for hip fractures in the elderly: the Hospital for Joint Diseases experience
Hip fractures are common injuries in the elderly and are associated with considerable morbidity and mortality. Although technical advances in the treatment of the elderly have resulted in improved fracture fixation and surgical outcomes, clinical pathways have been developed to further improve patie...
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| Veröffentlicht in: | Clinical orthopaedics and related research 2004-08, Vol.425 (425), p.72-81 |
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| container_title | Clinical orthopaedics and related research |
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| creator | Koval, Kenneth J Chen, Andrew L Aharonoff, Gina B Egol, Kenneth A Zuckerman, Joseph D |
| description | Hip fractures are common injuries in the elderly and are associated with considerable morbidity and mortality. Although technical advances in the treatment of the elderly have resulted in improved fracture fixation and surgical outcomes, clinical pathways have been developed to further improve patient outcome while shortening hospital length of stay after hip fracture. We describe the clinical pathway used since 1990 at the Hospital for Joint Diseases. The outcomes of 747 patients treated before 1990 were compared with outcomes of 318 patients treated at our hospital after initiation of the clinical pathway. Use of the clinical pathway was associated with significant decreases in the acute care hospital length of stay, in-hospital mortality, and 1-year mortality. |
| doi_str_mv | 10.1097/01.blo.0000132266.59787.d2 |
| format | Article |
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Although technical advances in the treatment of the elderly have resulted in improved fracture fixation and surgical outcomes, clinical pathways have been developed to further improve patient outcome while shortening hospital length of stay after hip fracture. We describe the clinical pathway used since 1990 at the Hospital for Joint Diseases. The outcomes of 747 patients treated before 1990 were compared with outcomes of 318 patients treated at our hospital after initiation of the clinical pathway. Use of the clinical pathway was associated with significant decreases in the acute care hospital length of stay, in-hospital mortality, and 1-year mortality.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Critical Pathways</subject><subject>Female</subject><subject>Hip Fractures - surgery</subject><subject>Humans</subject><subject>Male</subject><subject>Patient Discharge</subject><subject>Postoperative Care - standards</subject><subject>Prospective Studies</subject><subject>Quality of Health Care</subject><issn>0009-921X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkMtOwzAQRb0A0VL4BRSxYJfgR2LH3aHyKKgSG5DYIMtxxqpRmgQ7EfTvcWmlzmZ0R_fOaA5C1wRnBEtxi0lWNV2GYxFGKedZIUUpspqeoGkcylRS8jFB5yF8Rcnygp6hCSmopELiKfpcNK51RjdJr4f1j94mtvPJ2vWJ9doMo4eQuDYZ1pBAU4NvtvN_sexC74YY29lfOtcOyb0LoEP0w28P3kFr4AKdWt0EuDz0GXp_fHhbLNPV69Pz4m6VGlqUQ2p0LQpcSsmsKEiVc2y0ZBUFKK3W2IKwJJcARluaE2EZj4_y3OYEapxbxmboZr-39933CGFQGxcMNI1uoRuD4lxwLmkRjfO90fguBA9W9d5ttN8qgtUOqMJERaDqCFT9A1U1jeGrw5Wx2kB9jB5osj8tmnYl</recordid><startdate>20040801</startdate><enddate>20040801</enddate><creator>Koval, Kenneth J</creator><creator>Chen, Andrew L</creator><creator>Aharonoff, Gina B</creator><creator>Egol, Kenneth A</creator><creator>Zuckerman, Joseph D</creator><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>7X8</scope></search><sort><creationdate>20040801</creationdate><title>Clinical pathway for hip fractures in the elderly: the Hospital for Joint Diseases experience</title><author>Koval, Kenneth J ; Chen, Andrew L ; Aharonoff, Gina B ; Egol, Kenneth A ; Zuckerman, Joseph D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c258t-cad7508993f751b460ca93b2ee8faa0fe7f149eecaf2417f3626664f41ed04f33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Critical Pathways</topic><topic>Female</topic><topic>Hip Fractures - surgery</topic><topic>Humans</topic><topic>Male</topic><topic>Patient Discharge</topic><topic>Postoperative Care - standards</topic><topic>Prospective Studies</topic><topic>Quality of Health Care</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Koval, Kenneth J</creatorcontrib><creatorcontrib>Chen, Andrew L</creatorcontrib><creatorcontrib>Aharonoff, Gina B</creatorcontrib><creatorcontrib>Egol, Kenneth A</creatorcontrib><creatorcontrib>Zuckerman, Joseph D</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical orthopaedics and related research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Koval, Kenneth J</au><au>Chen, Andrew L</au><au>Aharonoff, Gina B</au><au>Egol, Kenneth A</au><au>Zuckerman, Joseph D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical pathway for hip fractures in the elderly: the Hospital for Joint Diseases experience</atitle><jtitle>Clinical orthopaedics and related research</jtitle><addtitle>Clin Orthop Relat Res</addtitle><date>2004-08-01</date><risdate>2004</risdate><volume>425</volume><issue>425</issue><spage>72</spage><epage>81</epage><pages>72-81</pages><issn>0009-921X</issn><abstract>Hip fractures are common injuries in the elderly and are associated with considerable morbidity and mortality. 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| language | eng |
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| source | MEDLINE; Journals@Ovid Ovid Autoload |
| subjects | Aged Aged, 80 and over Critical Pathways Female Hip Fractures - surgery Humans Male Patient Discharge Postoperative Care - standards Prospective Studies Quality of Health Care |
| title | Clinical pathway for hip fractures in the elderly: the Hospital for Joint Diseases experience |
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