Key result
Optimised care chain reduced bed-related complications, 1-year mortality, and length of stay compared to conventional care in elderly Chinese patients with hip fractures.
Why the study?
Although optimized care chain and fast track models can promote recovery in hip fracture patients, there was no systematic review evaluating fast track in this setting.
Does an optimised care chain reduce complications, mortality, and length of stay in elderly Chinese patients with hip fractures?
Meta-Analysis (n=2,200)
Does an optimised care chain reduce complications, mortality, and length of stay in elderly Chinese patients with hip fractures?
Optimised care chains, including fast track and green channel approaches, improve clinical outcomes and shorten hospital stays for elderly patients with hip fractures in China.
Supports optimised care chain adoption in elderly hip fracture care; extends prior pathway evidence to Chinese populations.
BACKGROUND: Studies have found that optimised care chain (OCC) can promote the recovery of hip fracture patients. Fast track (FT) has been widely proven to play a good role, but there is no systematic review report. METHODS: We conducted a comprehensive search and obtained search data as of April 2020. These included randomised controlled trials (RCTs) and cohort trials (CTs). We applied the research input Review Manager 5.3 for data synthesis, and used Stata 12.0 for meta- regression analysis. RESULTS: This review reported 2200 hip fractures. Our analysis showed that OCC can reduce complications and 1-year mortality, and shorten the length of stay (LOS). After dividing the complications into bed-related complications and other complications, OCC has advantages in reducing bed-related complications, but has no significant effect on other complications. For the conventional care group, the secondary outcome of the OCC group showed there was no significant difference in duration of surgery, and the rest were significantly improved. Subgroup analysis between green channel (GC) and FT showed a shorter LOS for GC. CONCLUSIONS: This meta-analysis suggests that the use of OCC in China promotes rehabilitation in elderly patients with hip fractures, that FT and GC are similar in effect in China, and that GC shows a greater advantage in reducing LOS.
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Wang et al. (2021) conducted a meta-analysis in Hip fractures (n=2,200). Optimised care chain (OCC) vs. Conventional care was evaluated on Complications, 1-year mortality, and length of stay. Optimised care chain reduced bed-related complications, 1-year mortality, and length of stay compared to conventional care in elderly Chinese patients with hip fractures.
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