Proximal femoral fractures:influence of multidisciplinary care

Hip fractures are the most common operatively treated fractures. Most patients are frail elderly people. A hip fracture means admittance to the hospital and almost always an operation, after which complications are frequently encountered. The rehabilitation is a prolonged process and many patients do not regain their level of preoperative functioning, thereby losing their independence partially or fully. Because of the numbers, the expenditures for hip fractures contribute to a substantial amount of the yearly healthcare costs. The aim of this thesis was to develop a comprehensive care pathway for the treatment of hip fractures, and to determine its effectiveness as well as its effect on the prevention of complications. The conclusion is that it was possible to introduce a comprehensive care pathway. After introduction the process was better: a decrease in preoperative fasting time, length of hospital stay and in-hospital mortality. However, after comparing 2 groups of patients in 2 hospitals, the functional outcome 6 months after a hip fracture was not better in the group, who was treated within a care pathway. Because of the frail elderly research population, it was difficult to have a complete follow-up. The amount of complications was as high as before. The most important risk factor for getting a complication was having other diseases, therefore most complications were not preventable