Department of Trauma Surgery, Ziekenhuisgroep Twente, Zilvermeeuw 1, 7609 PP Almelo, The Netherlands; University of Twente, Biomedical Signals and Systems Group, Drienerlolaan 5, 7522 NB Enschede, The Netherlands.
Department of Trauma Surgery, Ziekenhuisgroep Twente, Zilvermeeuw 1, 7609 PP Almelo, The Netherlands.
Injury. 2022 Aug;53(8):2818-2822. doi: 10.1016/j.injury.2022.06.017. Epub 2022 Jun 14.
Postoperative pneumonia is among the most common complications in elderly patients after hip fracture surgery. We implemented a proactive postoperative pneumonia prevention protocol and analyzed the incidence of postoperative pneumonia in elderly patients (≥70 years of age) receiving this protocol after hip fracture surgery versus those receiving usual care before the protocol's implementation at our institution.
From November 2018 to October 2019, the proactive postoperative pneumonia prevention protocol was implemented. The treatment included intensified physical therapy, postoperative pulmonary exercises and oral care, in addition to the usual surgical treatment for elderly patients with hip fracture. The intervention cohort data were compared with a historical control cohort treated from July 2017 to June 2018. The primary outcome of this study was the incidence of postoperative pneumonia in both groups, diagnosed according to the presence of two of three of the following: elevated infection parameters, radiologic examination confirmation of pneumonia of the chest or clinical suspicion.
A total of 494 patients (n= 249 in the historical control cohort and n=245 in the intervention cohort) were included. A total of 69 patients developed postoperative pneumonia. The incidence of postoperative pneumonia was significantly lower (6.7 percentage points) in the group receiving the proactive postoperative pneumonia prevention protocol (17.3% in the historical control cohort vs 10.6% in the intervention cohort; p=0.033).
A proactive postoperative pneumonia prevention protocol showed promise in decreasing the occurrence of postoperative pneumonia after hip fracture surgery in elderly patients.
髋部骨折手术后，老年患者术后肺炎是最常见的并发症之一。我们实施了一项主动的术后肺炎预防方案，并分析了在我院实施该方案前后接受该方案的老年患者（≥70 岁）术后肺炎的发生率与接受常规护理的患者相比。
从 2018 年 11 月至 2019 年 10 月，实施了主动术后肺炎预防方案。治疗包括强化物理治疗、术后肺功能锻炼和口腔护理，以及老年髋部骨折患者的常规手术治疗。干预组数据与 2017 年 7 月至 2018 年 6 月接受治疗的历史对照队列进行比较。本研究的主要结局是两组术后肺炎的发生率，根据以下三种情况中的两种确定：感染参数升高、胸部影像学检查证实肺炎或临床疑似肺炎。
共纳入 494 例患者（历史对照队列 249 例，干预队列 245 例）。共有 69 例患者发生术后肺炎。接受主动术后肺炎预防方案的患者术后肺炎发生率显著降低（6.7 个百分点）（历史对照队列为 17.3%，干预队列为 10.6%；p=0.033）。
主动术后肺炎预防方案有望降低老年髋部骨折患者术后肺炎的发生。
