Danish researchers have identified a treatment and care program that can reduce complications and mortality after surgery to repair a fractured hip. Working with the new program, anesthesiologists assessed patients earlier and healthcare providers used a targeted nerve block instead of systemic opioids to relieve pain.

Patients were also placed in a specialized hip fracture unit and received a systematic approach to nutrition, oxygen therapy, and prevention of urinary retention. Researchers then tracked rates of inhospital postoperative complications and 1-year mortality before and after the program was introduced.

About 20% of patients in the program had at least one complication, compared with 33% of those treated before the program began. Patients in the program also had lower rates of confusion, pneumonia, and urinary tract infection. Their length of stay was 9.7 days, compared with 15.8 days for those not in the program.

In all, 61% of patients who received the new program of care returned to their own homes after surgery, compared with 47% in the other group. One-year mortality was 23% and 29%, respectively.

The researchers call for more study to determine which elements of the program were most effective.

Source: Pedersen SJ, Borgbjerg FM, Schousboe B, et al. A comprehensive hip fracture program reduces complication rates and mortality. J Am Geriatr Soc. 2008; 56(10):1831-1838.