Clinical pathways for geriatric patients with proximal femoral fracture improve process and outcome.

Objective: The objective of the current study was to evaluate the implementation of clinical pathways (CPs) in hip fracture management.
Methods: Six hundred and five proximal femoral fractures were prospectively included into a hospital data-base. The effects of CPs were evaluated using a pre-during-post design. Different procedural (time to surgery, length of stay, discharge, etc.) and patient outcome parameters (mortality, complications, etc.) were evaluated.
Results: In both categories significant changes could be detected during the three-year period. E.g. significant reduction of time to surgery, improvement of discharge management, reduction of internal complications. However, no significant changes could be demonstrated for mortality or revision rate.
Conclusion: We could show a relevant improvement with the implementation of clinical pathways for the treatment of proximal femoral fractures in elderly patients.
Level of Evidence: III, prospective non-randomised cohort study.
(Copyright © 2019. Published by Elsevier Masson SAS.)