Fast Track Hip Fracture - an Optimized Pathway for Hip Fracture Patients

Study Overview
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Brief Summary
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The study examines if the introduction of a fast track pathway for hip fracture patients had an influence on mortality and quality of life by comparing these outcomes between all hip fracture patients operated at Akershus University Hospital two years before and two years after this change in standard care.

Detailed Description
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The Norwegian hip fracture register prospectively collects data on all hip fracture patients including, among others, time to surgery, type of fracture, type of surgery and American Society of Anesthesiologists (ASA) score. The register also collects quality of life data 4 and 12 months after surgery. Using the unique Norwegian personal identification number the data from the Norwegian hip fracture register will be connected with data from the electronic patient record at Akershus University hospital (AHUS). Fast track surgery for hip fracture patients was introduced at the end of 2013. Mortality and quality of life data will be compared for all hip fracture patients operated at AHUS two years before and two years after this change in standard care. The combined data from the register and the electronic patient records will be used for regression analysis.

Official Title
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Influence of a Fast Track Pathway for Hip Fracture Patients on Mortality and Quality of Life

Conditions
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Hip Fractures

Intervention / Treatment
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* Other: Fast track patient pathway


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Operated at Akershus university hospital for a hip fracture (neck of femur, trochanteric, subtrochanteric) in 2012, 2013, 2014 or 2015 18 years or older Exclusion Criteria: stress fracture

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Standard care<br>Hip fracture patients operated at Akershus University hospital in 2012 and 2013. | |
| Fast track patient pathway<br>Hip fracture patients operated at Akershus University hospital in 2014 and 2015. | Other: Fast track patient pathway<br>* Admittance: Ambulance - Radiology - Orthopaedic ward. Focus on preoperative information, stress reduction, pain relief, early mobilization and nutritional status.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 30 day mortality rate | Percentage of patients who die within 30 days from hip fracture surgery | Within 30 days from surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 1 year mortality rate | Percentage of patients who die within 1 year from hip fracture surgery | Within 1 year from surgery | 
| Quality of life | Quality of life measured by EQ-5D | 4 and 12 months from surgery | 
| Readmissions | Unscheduled, all-cause readmission within 30 days from discharge from the index admission | Within 30 days from discharge | 
| Postoperative infection | Superficial and / or deep surgical site infection | Within 1 year from surgery | 
| Re-operation | All-cause re-operation at the site of the index surgery | Within 1 year from surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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fast track