Efficacy of Capture the Fracture in Elderly Extracapsular Hip Fracturetreatment

Abstract

Background: Peritrochanteric femur fractures in the elderly are a very common injury and have emerged as a serious injury that incurs high incidence of complications, negatively impacting quality of life and result in a financial burden for health care systems. In Thailand, Capture the fracture, performing hip fracture surgery in the elderly within 72 hour of admission(3 days), is designed to improve patient care and reduce fracture-related complications.
Objective: The purpose of this report is to organize and summarize the outcome of Capture the fracture, addressing the association between time to surgery and perioperative complications, length of hospital stay, and medical health care expenses.
Methods: A retrospective observational cohort study was conducted between January 2018 to March 2021 in the orthopedic department of Surin hospital. Eligible patients were aged at least 50 years undergoing surgery for extracapsular hip fracture by proximal femoral nail antirotation (PFNA). Patients were excluded if their condition was clinically unstable. The populations of interest were classified into two groups: patients operated on within or after 3 days. To assess statistical heterogeneity in effects between studie, Categorical data were analyzed by chi-squared, t-test and Multiple logistic Regression. A p-value less than 0.05 is statistically significant.
Results: A total of 226 patients underwent surgical treatment between 2018 and 2021. Of these patients 105 patients underwent hip surgery within 3 days and 121 patients underwent surgery after 3 days. The mean age of patients was 77.5 years-old. Among various postoperative complications after hip fracture surgery, the incidence of outcomes werebetter in the earlier surgery group. Length of in-hospital stay can be reduced significantly by earlier surgery within 3 days (7.05 vs 13.15 days) as well as Medical health care expenses (60343 vs 74296 THBath). Patients underwent operation within 3 days tend to had a lower risk of complications (9% vs 20%) including urinary tract infection, pressure sore, venous thromboembolism, pneumonia and death.
Conclusion: According to Capture the Fracture protocol, earlier surgery in eldely patient with hip fractures, resulting in a reduction of length of hospital stays, medical costs, and postoperative complications.