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.
RCT Entities:
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.
Authors: Lauren A Beaupre; C Allyson Jones; L Duncan Saunders; D William C Johnston; Jeanette Buckingham; Sumit R Majumdar Journal: J Gen Intern Med Date: 2005-11 Impact factor: 5.128
Authors: M Baroni; R Serra; V Boccardi; S Ercolani; E Zengarini; P Casucci; R Valecchi; G Rinonapoli; A Caraffa; P Mecocci; C Ruggiero Journal: Osteoporos Int Date: 2019-02-04 Impact factor: 4.507
Authors: L A Beaupre; J G Cinats; A Senthilselvan; D Lier; C A Jones; A Scharfenberger; D W C Johnston; L D Saunders Journal: Qual Saf Health Care Date: 2006-10
Authors: Gary Naglie; Catherine Tansey; James L Kirkland; Darryl J Ogilvie-Harris; Allan S Detsky; Edward Etchells; George Tomlinson; Keith O'Rourke; Barry Goldlist Journal: CMAJ Date: 2002-07-09 Impact factor: 8.262