Impact of ASAP Multidisciplinary Optimization Care Protocol on Clinical Outcome in Elderly Inpatients for Hip Fracture

Study Overview
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Brief Summary
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To compare the impact of ASAP protocol (geriatric advice, early surgery, loco-regional anesthesia and pharmacological adaptation) on elderly patients with hip fracture and clinical outcome.

Detailed Description
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Retrospective double cohort analysis for ASA physical status 1, 2 and 3 elderly patients >65 years old, scheduled to undergo surgery for hip fracture between January 1st 2017 and December 31st 2022. The investigator want to confirm the better outcome on 30-days mortality after surgery in patients where the ASAP protocol was applied, starting from 1 January 2020. ASAP protocol follow the latest international guidelines about hip fracture in elderly patient. The investigator focuses the research about the impact of ASAP protocol on clinical outcome: geriatrician's advice, impact of loco-regional techniques on intra-operative and postoperative pain control, chronic pharmacological therapy's adaptation and 30-days postoperative mortality.

Official Title
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Impact of ASAP Multidisciplinary Optimization Care Protocol on Clinical Outcome in Elderly Inpatients for Hip Fracture: Retrospective Cohort Study

Conditions
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Hip Fractures

Intervention / Treatment
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* Other: ASAP care's protocol


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Over 65 years old patients with hip fractures between January 1st 2017 and December 31th 2022 Exclusion Criteria: Fracture without indication for surgery Death before surgery Intensive care's or polytrauma patients (> 2 fracture sites) or under pharmacological coma needed before and after surgery.

Ages Eligible for Study
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Minimum Age: 65 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>Patients aged >65 years old scheduled for hip fracture between January 1st 2017 and December 31th 2019. Standard anesthesiology cares were performed, as usual in our hospital institution. | |
| ASAP cohort<br>Patients aged >65 years old scheduled for hip fracture between January 1st 2020 and December 31th 2022. Standard anesthesiology cares were performed, as usual in our hospital institution, but the investigator focused the attention on these cares' adaptation: early geriatrician's advice, prefer locoregional anesthesia techniques where possible, early surgical therapy and medical adaptation on chronic therapy. | Other: ASAP care's protocol<br>* Early geriatrician's advice, prefer locoregional anesthesia techniques where possible, early surgical therapy and medical adaptation on chronic patient's therapy (in particular with regard to sedative, anticholinergic and psychotropic drugs).<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postoperative complications | Neurological, cardiovascular, pulmonary, renal, infectious and gastrointestinal complications after surgery. | 7 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Days of hospitalisation | Total hospitalisation days | 30 days | 
| 30-days postoperative mortality | Mortality 1 month after surgery | 30 days |