Dowsey M M, Kilgour M L, Santamaria N M, Choong P F
Department of Orthopaedics, St Vincent's Hospital, Melbourne, VIC.
Med J Aust. 1999 Jan 18;170(2):59-62. doi: 10.5694/j.1326-5377.1999.tb126882.x.
To ascertain the effectiveness of clinical pathways for improving patient outcomes and decreasing lengths of stay after hip and knee arthroplasty.
Twelve-month randomised prospective trial comparing patients treated through a clinical pathway with those treated by an established standard of care at a single tertiary referral university hospital.
163 patients (56 men and 107 women; mean age, 66 years) undergoing primary hip or knee arthroplasty, and randomly allocated to the clinical pathway (92 patients) and the control group (71 patients).
Time to sitting out of bed and walking; rates of complications and readmissions; match to planned discharge destination; and length of hospital stay.
Clinical pathway patients had a shorter mean length of stay (P = 0.011), earlier ambulation (P = 0.001), a lower readmission rate (P = 0.06) and closer matching of discharge destination. There were beneficial effects of attending patient seminars and preadmission clinics for both pathway and control patients.
Clinical pathway is an effective method of improving patient outcomes and decreasing length of stay following hip and knee arthroplasty.
确定临床路径在改善髋关节和膝关节置换术后患者预后及缩短住院时间方面的有效性。
一项为期12个月的随机前瞻性试验，比较在一家单一的三级转诊大学医院中，通过临床路径治疗的患者与按照既定标准治疗的患者。
163例行初次髋关节或膝关节置换术的患者（56名男性和107名女性；平均年龄66岁），随机分为临床路径组（92例）和对照组（71例）。
坐起和行走时间；并发症和再入院率；与计划出院目的地的匹配情况；以及住院时间。
临床路径组患者的平均住院时间较短（P = 0.011），更早开始行走（P = 0.001），再入院率较低（P = 0.06），出院目的地匹配度更高。参加患者研讨会和入院前诊所对临床路径组和对照组患者均有有益影响。
临床路径是改善髋关节和膝关节置换术后患者预后及缩短住院时间的有效方法。
