Resultados en salud tras la implantación de una guía multidisciplinar para la atención a la fractura de cadera
Casanova Querol, Teresa (Hospital de Sant Joan Despí Moisès Broggi)
Santiago Bautista, José María (Servicio de Geriatría. Hospital Sociosanitari de L'Hospitalet)
Lafuente Salinas, Manel (Hospital de Sant Joan Despí Moisès Broggi)
Güell Farré, Elena (Hospital de Sant Joan Despí Moisès Broggi)
Girós Torres, Joan (Hospital de Sant Joan Despí Moisès Broggi)
Martín-Baranera, Montserrat (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i de Medicina Preventiva i Salut Pública)
Miralles Basseda, Ramón (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Universitat Autònoma de Barcelona. Departament de Medicina

Títol variant:	Health outcomes after the implementation of multidisciplinary clinical guidelines for the care of hip fractures
Data:	2022
Resum:	Background and objectives: This study aims to evaluate the impact of implementing multidisciplinary clinical guidelines in the process of caring for patients with hip fractures. Materials and methods: This work is a pre- and post-intervention prospective study in the Orthogeriatrics Unit of a second-level hospital after implementing multidisciplinary clinical guidelines for hip fracture care. We analyzed patients' baseline characteristics and the variations observed in care provided and in outcome variables in the 2 periods studied (June 2015-May 2016 and June 2016-May 2017). Results: The baseline characteristics of the population were similar in the pre-intervention period (n=455) compared to the post-intervention period (n=456). Patients' mean age was 84. 8 ± 6. 8 years and 70. 8% were women. The implementation of the multidisciplinary clinical guidelines led to a reduction in the mean length of hospital stay (16. 9 days vs 15. 6 days, p=. 014); improved osteoporosis treatment prescribing (51. 6% vs 88%, p<. 001); and reduced episodes of delirium (44% vs 31. 2%, p<. 001), bronchospasm (18. 3% vs 12%, p=. 019), heart failure (20% vs 11. 5%, p<. 001), and COPD exacerbation (7. 9% vs 3. 8%, p=. 017). We observed an increase in pressure ulcers at discharge (2. 9 vs 9%, p<. 001). There were no differences in the percentage of operations in less than 48 hours (56% vs 61. 2% p=. 64), hospital readmissions (6. 9% vs 5. 9%, p=. 51), or mortality (5. 0% vs 7. 2%, p=. 17). Conclusions: The implementation of multidisciplinary clinical guidelines improved aspects of the care process for patients with hip fracture.
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Llengua:	Castellà
Document:	Article ; recerca ; Versió acceptada per publicar
Matèria:	Fractura de fémur ; Medicina Interna ; Atención Continuada ; Ortogeriatría
Publicat a:	Revista clínica española, Vol. 222, Núm. 2 (febrero 2022) , p. 73-81, ISSN 1578-1860

DOI: 10.1016/j.rce.2021.04.002

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