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Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Implementing, adapting, and validating an evidence-based algorithm for hip fracture surgery

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. High Reliability of a Scoring System for Implant Position in Undisplaced Femoral Neck Fractures

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Invited commentary

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

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OBJECTIVES:
Reoperations are common after surgical treatment of hip fractures but may be reduced by optimal choice of implant based on fracture classification. We hypothesized that implementing a surgical treatment algorithm was possible in our hospital and would result in a reduced reoperation rate.

DESIGN:
Retrospective comparative study.

SETTING:
Provincial level III trauma center.

PATIENTS:
The evidence-based "Hvidovre Algorithm" for treatment of hip fractures was adopted and implemented at our provincial institution in September 2008. Three hundred eighty-six consecutive patients older than 50 years admitted with a hip fracture in the first year after implementation were prospectively included and compared with 417 retrospectively included similar patients admitted within the last year before implementation.

INTERVENTION:
Implementation of an evidence-based treatment algorithm for hip fracture surgery.

RESULTS:
Eighty-five percent (330 of 386) patients were operated according to the algorithm after implementation, compared with 67% (280 of 417) of procedures before implementation (P < 0.001). After implementation, the overall reoperation rate showed a tendency toward a reduction to 8% (32 of 386) from 12% (48 of 417) (P = 0.1). Among all the 803 included patients, the reoperation rate was lower if procedures had been performed according to the algorithm recommendations: 9% (53 of 610) versus 14% (27 of 193) (P = 0.009).

CONCLUSIONS:
The algorithm for hip fracture surgery was easily implemented, and our results support that using it facilitates a low reoperation rate. The reoperation rate may be further reduced with higher adherence to algorithm recommendation.

LEVEL OF EVIDENCE:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
OriginalsprogEngelsk
TidsskriftJournal of Orthopaedic Trauma
Vol/bind28
Udgave nummer2
Sider (fra-til)e21-6
Antal sider6
ISSN0890-5339
DOI
StatusUdgivet - feb. 2014

ID: 42848802