School of Surgery, Ningxia Medical University, Yinchuan, China.
School of Nursing, Jinan University, Guangzhou, China.
Int J Health Plann Manage. 2021 Sep;36(5):1445-1464. doi: 10.1002/hpm.3261. Epub 2021 Jun 17.
Studies have found that optimised care chain (OCC) can promote the recovery of hip fracture patients. Fast track (FT) has been widely proven to play a good role, but there is no systematic review report.
We conducted a comprehensive search and obtained search data as of April 2020. These included randomised controlled trials (RCTs) and cohort trials (CTs). We applied the research input Review Manager 5.3 for data synthesis, and used Stata 12.0 for meta- regression analysis.
This review reported 2200 hip fractures. Our analysis showed that OCC can reduce complications and 1-year mortality, and shorten the length of stay (LOS). After dividing the complications into bed-related complications and other complications, OCC has advantages in reducing bed-related complications, but has no significant effect on other complications. For the conventional care group, the secondary outcome of the OCC group showed there was no significant difference in duration of surgery, and the rest were significantly improved. Subgroup analysis between green channel (GC) and FT showed a shorter LOS for GC.
This meta-analysis suggests that the use of OCC in China promotes rehabilitation in elderly patients with hip fractures, that FT and GC are similar in effect in China, and that GC shows a greater advantage in reducing LOS.
研究发现优化护理链（OCC）可促进髋部骨折患者的康复。快速通道（FT）已被广泛证明能发挥良好的作用，但尚未有系统评价报告。
我们全面检索并获取截至 2020 年 4 月的检索数据，包括随机对照试验（RCT）和队列试验（CT）。我们应用研究输入 Review Manager 5.3 进行数据合成，并使用 Stata 12.0 进行荟萃回归分析。
本综述报道了 2200 例髋部骨折。分析表明，OCC 可减少并发症和 1 年死亡率，并缩短住院时间（LOS）。将并发症分为与床位相关的并发症和其他并发症后，OCC 有利于减少与床位相关的并发症，但对其他并发症无显著影响。对于常规护理组，OCC 组的次要结局显示手术时间无显著差异，其余均有显著改善。在绿色通道（GC）和 FT 之间进行亚组分析，GC 的 LOS 更短。
本荟萃分析表明，在中国使用 OCC 可促进老年髋部骨折患者的康复，FT 和 GC 的效果相似，GC 在缩短 LOS 方面具有更大优势。
