Geriatric Hip Fracture: Fast track Surgery Care

Abstract

         Surgical treatment of hip fractures in older adults within 48–72 hours is a crucial factor in reducing complications, disability, and mortality. The TU-GHF team has therefore developed a care pathway incorporating Fast Track Surgery together with Fast Track Rehabilitation to expedite both surgical management and postoperative recovery. The goal is to shorten the time to surgery from the previous 48–72 hours to within 24–48 hours, initiate early mobilization within 24 hours, and implement a postoperative physical therapy program to encourage ambulation with a walker or movement via wheelchair within 48 hours.

        Performance outcomes in 2024–2025 (2567–2568 BE) showed that, in 2024, the proportion of patients receiving surgery within 24, 48, and 72 hours after admission was 41.01%, 62.14%, and 85.95%, respectively. In 2025, the corresponding percentages were 32.15%, 64.27%, and 88.36%. In terms of rehabilitation, the proportion of patients able to sit or mobilize within 24 hours increased from 60.13% in 2024 to 94.07% in 2025. Those able to ambulate with a walker or wheelchair within 48 hours increased from 74.05% to 91.39%, and the rate of discharge within 10 days increased from 79.70% to 87.06% in 2025.

        In summary, accelerated surgery and rapid rehabilitation significantly contribute to earlier mobilization, reduced complications, increased patient safety, shortened hospital stays, and lower overall treatment costs.