Clinical effect comparison between day surgery mode and inpatient operation mode for intertrochanteric fracture in elderly_West China Medical Journal

Authors：

 YANG Zhaohui ¹ , KANG Lishi ² , NIE Boyuan ¹ , WANG Qingling ¹

1. Day Surgery Department, the Second Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, P. R. China;
2. Orthopaedic Department, Taiyuan Central Hospital, Taiyuan, Shanxi 030009, P. R. China;

Corresponding?author：

YANG Zhaohui, Email: yangzh101@sina.com

Keywords：

Intertrochanteric fracture in elderly; Day surgery mode; Inpatient operation mode

DOI：

10.7507/1002-0179.201912245

Video：

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Objective To compare the clinical effect of day surgery mode and inpatient operation mode for intertrochanteric fracture in elderly patients.Methods Thirty-seven elderly patients with intertrochanteric fracture treated in day surgery mode in the Second Hospital of Shanxi Medical University from July 2018 to July 2019 were retrospectively included. At the same time, another 37 elderly patients with intertrochanteric fracture treated in general inpatient operation mode in the same period were randomly selected. The preoperative waiting time, operation time, length of hospital stay, hospital expenses, postoperative complications, and clinical effect were compared between the two groups.Results There was no significant difference in operation time [(56.21±10.75) vs. (58.81±12.56) min] or postoperative Harris hip scores (1 month after surgery: 61.03±7.74 vs. 59.47±7.42; 3 months after surgery: 85.40±4.22 vs. 85.03±4.33) between the two groups (P>0.05). In terms of the preoperative waiting time [(23.17±3.18) vs. (52.64±10.12) h], length of hospital stay [(2.01±0.97) vs. (8.34±4.22) d], hospital expenses [(4.012±0.771)×10⁴ vs. (4.679±1.117)×10⁴ yuan], and the incidence of deep venous thrombosis during perioperative period (10.8% vs.37.8%), the day surgery mode group had more obvious advantages than general inpatient operation mode group (P<0.05).Conclusions Day surgery mode is safe and effective for intertrochanteric fracture in elderly patients. It is worthy of great application for clinical work in the future.

Citation： YANG Zhaohui, KANG Lishi, NIE Boyuan, WANG Qingling. Clinical effect comparison between day surgery mode and inpatient operation mode for intertrochanteric fracture in elderly. West China Medical Journal, 2020, 35(2): 156-160. doi: 10.7507/1002-0179.201912245 Copy

1.	Nicoll JH. The surgery of infancy. BMJ, 1909, 2(2542): 753-754.
2.	Philip BK. Day care surgery: the United States model of health care. Ambul Surg, 2012, 17(4): 81-82.
3.	Hoggett L, Anderton MJ, Khatri M. 30-day complication rates and patient-reported outcomes following day case primary lumbar microdiscectomy in a regional NHS spinal centre. Ann R Coll Surg Engl, 2018, 101(1): 50-54.
4.	Cadariu F, Enache A, Avram M, et al. Day surgery in Romania. Ann Ital Chir, 2017, 88: 567-571.
5.	Jarrett PEM. The International Association for Ambulatory Surgery (IAAS). Ambul Surg, 2003, 10: 113-113.
6.	劉子嘉, 黃會真, 黃宇光. 從加速康復外科理念看日間手術: 英國 2019 年日間手術指南解讀. 協和醫學雜志, 2019, 10(6): 570-574.
7.	Cummings SR, Melton LJ. Epidemiology and outcomes of osteoporotic fractures. Lancet, 2002, 359(9319): 1761-1767.
8.	Ma JX, Wang J, Xu WG, et al. Biomechanical outcome of proximal femoral nail antirotation is superior to proximal femoral locking compression plate for reverse oblique intertrochanteric fractures: a biomechanical study of intertrochanteric fractures. Acta Orthop Traumatol Turc, 2015, 49(4): 426-432.
9.	萬安營, 唐淼. 老年股骨粗隆間骨折近端防旋髓內釘固定圍手術期加速康復. 中國矯形外科雜志, 2018, 26(10): 888-892.
10.	Saul D, Riekenberg J, Ammon JC, et al. Hip fractures: therapy, timing, and complication spectrum. Orthop Surg, 2019, 11(6): 994-1002.
11.	Inouye SK, van Dyck CH, Alessi CA, et al. Clarifying confusion: the confusion assessment method. A new method for detection of delirium. Ann Intern Med, 1990, 113(12): 941-948.
12.	Fernandez MA, Griffin XL, Costa ML. Management of hip fracture. Br Med Bull, 2015, 115(1): 165-172.
13.	唐海, 羅先正. 1043 例粗隆間骨折的病因分析. 中華骨科雜志, 1996(12): 24-26.
14.	Stambough JB, Nunhy RM, Curry MC, et al. Rapid recovery protocols for primary total hip arthroplasty can safely reduce length of stay without increasing readmissions. J Arthroplasty, 2015, 30(4): 521-526.
15.	Mabry TM, Prpa B, Haidukewych GJ, et al. Long-term results of total hip arthroplasty for femoral neck fracture nonunion. J Bone Joint Surg Am, 2004, 86-A(10): 2263-2267.
16.	楊路德, 吳曉波, 解品亮, 等. 快速康復外科在老年股骨轉子間骨折圍術期的運用效果. 中華創傷雜志, 2018, 34(10): 939-944.
17.	莫洋, 瞿宏穎, 吳思容, 等. 膝關節鏡日間手術衛生經濟學效果分析. 華西醫學, 2016, 31(4): 642-644.

1. Nicoll JH. The surgery of infancy. BMJ, 1909, 2(2542): 753-754.
2. Philip BK. Day care surgery: the United States model of health care. Ambul Surg, 2012, 17(4): 81-82.
3. Hoggett L, Anderton MJ, Khatri M. 30-day complication rates and patient-reported outcomes following day case primary lumbar microdiscectomy in a regional NHS spinal centre. Ann R Coll Surg Engl, 2018, 101(1): 50-54.
4. Cadariu F, Enache A, Avram M, et al. Day surgery in Romania. Ann Ital Chir, 2017, 88: 567-571.
5. Jarrett PEM. The International Association for Ambulatory Surgery (IAAS). Ambul Surg, 2003, 10: 113-113.
6. 劉子嘉, 黃會真, 黃宇光. 從加速康復外科理念看日間手術: 英國 2019 年日間手術指南解讀. 協和醫學雜志, 2019, 10(6): 570-574.
7. Cummings SR, Melton LJ. Epidemiology and outcomes of osteoporotic fractures. Lancet, 2002, 359(9319): 1761-1767.
8. Ma JX, Wang J, Xu WG, et al. Biomechanical outcome of proximal femoral nail antirotation is superior to proximal femoral locking compression plate for reverse oblique intertrochanteric fractures: a biomechanical study of intertrochanteric fractures. Acta Orthop Traumatol Turc, 2015, 49(4): 426-432.
9. 萬安營, 唐淼. 老年股骨粗隆間骨折近端防旋髓內釘固定圍手術期加速康復. 中國矯形外科雜志, 2018, 26(10): 888-892.
10. Saul D, Riekenberg J, Ammon JC, et al. Hip fractures: therapy, timing, and complication spectrum. Orthop Surg, 2019, 11(6): 994-1002.
11. Inouye SK, van Dyck CH, Alessi CA, et al. Clarifying confusion: the confusion assessment method. A new method for detection of delirium. Ann Intern Med, 1990, 113(12): 941-948.
12. Fernandez MA, Griffin XL, Costa ML. Management of hip fracture. Br Med Bull, 2015, 115(1): 165-172.
13. 唐海, 羅先正. 1043 例粗隆間骨折的病因分析. 中華骨科雜志, 1996(12): 24-26.
14. Stambough JB, Nunhy RM, Curry MC, et al. Rapid recovery protocols for primary total hip arthroplasty can safely reduce length of stay without increasing readmissions. J Arthroplasty, 2015, 30(4): 521-526.
15. Mabry TM, Prpa B, Haidukewych GJ, et al. Long-term results of total hip arthroplasty for femoral neck fracture nonunion. J Bone Joint Surg Am, 2004, 86-A(10): 2263-2267.
16. 楊路德, 吳曉波, 解品亮, 等. 快速康復外科在老年股骨轉子間骨折圍術期的運用效果. 中華創傷雜志, 2018, 34(10): 939-944.
17. 莫洋, 瞿宏穎, 吳思容, 等. 膝關節鏡日間手術衛生經濟學效果分析. 華西醫學, 2016, 31(4): 642-644.

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Clinical effect comparison between day surgery mode and inpatient operation mode for intertrochanteric fracture in elderly

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