Multidisciplinary Approach to Reduce Postoperative Complications and Improve the Activity of Patients With Hip Fracture: A 24-month Follow-up Survey
Abstract Background: Many multidisciplinary approaches such as fracture liaison services (FLS) have been introduced in the United Kingdom and Japan and have reduced medical complications and secondary fractures. This study investigated patient outcomes following the introduction of FLS.Methods: Patients who were over 50 years old and experienced fragility hip fractures between January 1, 2015 and December 31, 2017, were enrolled in the study. We divided patients into a control group without FLS (94 patients; mean age: 83.8 years; 21 men and 73 women) and a FLS group (373 patients; mean age: 83.3 years; 69 men and 304 women).Results: The time from injury to surgery decreased significantly from 2.42 days to 1.83 days following the introduction of FLS (p = 0.003). The proportion of patients who underwent surgery within 36 hours of injury also increased significantly in the FLS group (p = 0.014). In the FLS group, a significant decrease was observed in the total number of cases with complications after admission (p = 0.004). Significantly more patients with a Barthel index (BI) of ≥80 were observed in the FLS group at 6 months, 12 months, and 24 months following injury (p = 0.046, 0.018, and 0.048, respectively). Multiple logistic regression analysis revealed that the BI at the time of injury, surgery within 36 hours of injury, and postoperative complications was associated with death within 12 or 24 months after the injury.Conclusions: Our results indicate that FLS contributed to earlier recovery and rehabilitation following surgery and accelerated the rehabilitation of medical complications following admission. Our FLS is expected to improve patient activity and decrease secondary hip fracture in patients who have undergone hip surgery.