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[骨科老年病团队实施后髋部骨折护理的质量指标]

[Quality indicators in hip fracture care after the implementation of an orthogeriatrics team].

作者信息

Viveros-García J C, Guillermo-Nuncio E A, Nieto-Sandoval H R, Baldenebro-Lugo L S

机构信息

Hospital Regional Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), León, Guanajuato. México.

Servicio de Traumatología. Hospital Regional Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), León, Guanajuato. México.

出版信息

Acta Ortop Mex. 2021 Mar-Apr;35(2):181-187.

Abstract

INTRODUCTION

The incidence of hip fracture will increase dramatically in the coming decades. It has been associated with high mortality and morbidity. Orthogeriatric programs have improved outcomes in fragility hip fracture worldwide. There is little evidence in Mexico on the impact of orthogeriatrics and adherence to quality indicators.

OBJECTIVE

To compare adherence to quality indicators in hip fracture before and after the implementation of an orthogeriatrics team compared to the traditional model.

MATERIAL AND METHODS

Quasi-experimental study conducted in León, Mexico. Adherence to quality indicators before and after an interconsultant orthogeriatrics team was compared. The indicators measured were: surgical delay, treatment for osteoporosis, early mobilization, type of implant and delirium.

RESULTS

We included 83 patients. The surgical delay was reduced from 144 to 116 hours (28 hours), the percentage of patients with early surgery was increased from 7.9 to 18%, in addition the percentage of patients with treatment for osteoporosis was increased and the incidence of delirium was reduced.

CONCLUSION

Adherence to indicators is low, however, it was possible to discreetly increase adherence to these indicators. Internal policies must be generated in public hospitals to improve this adherence and see its impact on long-term outcomes.

摘要

引言

在未来几十年中,髋部骨折的发病率将急剧上升。它与高死亡率和高发病率相关。骨科老年医学项目已在全球范围内改善了脆性髋部骨折的治疗结果。在墨西哥,几乎没有证据表明骨科老年医学及对质量指标的遵守情况会产生何种影响。

目的

将骨科老年医学团队实施前后髋部骨折患者对质量指标的遵守情况与传统模式进行比较。

材料与方法

在墨西哥莱昂进行的准实验研究。比较了骨科老年医学会诊团队实施前后对质量指标的遵守情况。所测量的指标包括:手术延迟、骨质疏松症治疗、早期活动、植入物类型和谵妄。

结果

我们纳入了83例患者。手术延迟从144小时减少至116小时(减少了28小时),早期手术患者的比例从7.9%增加到18%,此外,接受骨质疏松症治疗的患者比例增加,谵妄的发生率降低。

结论

对指标的遵守情况较低,然而,谨慎地提高对这些指标的遵守情况是有可能的。公立医院必须制定内部政策以提高这种遵守情况,并观察其对长期结果的影响。

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