Early surgery for treating hip fractures in elderly people may substantially improve patient outcomes according to the results of a randomized controlled trial published in ‘Canadian Medical Association Journal’.
Early surgery for treating hip fractures in the elderly may substantially improve outcomes for the patients, according to results of a randomized controlled trial published in ‘Canadian Medical Association Journal’.
Hip fractures can cause serious complications, resulting from admission facilities long-term care of some seniors who formerly lived at home until even death. It also causes pain, bleeding and immobility, leading to medical complications in people awaiting surgery. In many countries, the wait for hip surgery may be 24 hours or more, mainly for preoperative medical procedures and access to the operating room.
Team of Canadian researchers worked with a group of 60 people aging 45 years and older with a diagnosis of hip fracture, who required surgery on a weekday during the daylight hours. The patients in two hospitals in Hamilton, Ontario, Canada, and one in Pune, India, were randomly assigned to a group that received accelerated care (30 patients) and a controlled group that received standard care (30 people).
The average age of participants was 81 years, 63 percent were women and many had several diseases: 68 percent hypertension, coronary heart disease 20 percent and 17 percent dementia. For patients in the accelerated nursing group, the average time between the diagnosis of the fracture and the authorization for surgery was 1.5 hours compared with 3.4 hours in the standard care group.
The median time from diagnosis to surgery practice was six hours for the accelerated nursing group, about 18 hours less than the 24.2 hours waiting for surgery in the standard care group. The researchers proposed the goal of accelerating the surgery about six hours.
‘We believe that shortening the time as much as possible will provide the greatest potential for benefit such as myocardial infarction and acute stroke,’ says one of the principal investigators of this pilot, PJ Devereaux, McMaster University, in Hamilton, Ontario, Canada.
‘The results provide encouraging evidence that surgery can accelerate substantially with improved outcomes in these patients,’ highlights another of the study’s authors, Dr. Mohit Bhandari, McMaster University. This work team plans to conduct a large-scale study in 2014, inviting scientists interested to participate.
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