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European Journal of Orthopaedic Surgery & Traumatology

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01-10-2013 | General Review

The effect of care pathways for hip fractures: a systematic overview of secondary studies

Authors: Fabrizio Leigheb, Kris Vanhaecht, Walter Sermeus, Cathy Lodewijckx, Svin Deneckere, Steven Boonen, Paulo A. Boto, Rita Veloso Mendes, Massimiliano Panella

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 7/2013

Abstract

The aim of this paper was to perform a systematic overview of secondary literature studies on care pathways (CPs) for hip fracture (HF). The online databases MEDLINE–PubMed, Ovid–EMBASE, CINAHL–EBSCO–host, and The Cochrane Library were searched. A total of six papers, corresponding to six secondary studies, were included but only four secondary studies were HF-specific and thus assessed. Secondary studies were evaluated for patients’ clinical outcomes. There were wide differences among the studies that assessed the effects of CPs on HF patients, with some contrasting clinical outcomes reported. Secondary studies that were non-specific for CPs and included other multidisciplinary care approaches as well showed, in some cases, a shorter hospital length of stay (LOS) compared to usual care; studies that focused on promoting early mobilization showed better outcomes of mortality, morbidity, function, or service utilization; CPs mainly based on intensive occupational therapy and/or physical therapy exercises improved functional recovery and reduced LOS, with patients also discharged to a more favorable discharge destination; CPs principally focused on early mobilization improved functional recovery. A secondary study specifically designed for CPs showed lower odds of experiencing common complications of hospitalization after HF. In conclusion, although our overview suggests that CPs can reduce significantly LOS and can have a positive impact on different outcomes, data are insufficient for formal recommendations. To properly understand the effects of CPs for HF, a systematic review is needed of primary studies that specifically examined CPs for HF.

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Title: The effect of care pathways for hip fractures: a systematic overview of secondary studies
Authors: Fabrizio Leigheb
Kris Vanhaecht
Walter Sermeus
Cathy Lodewijckx
Svin Deneckere
Steven Boonen
Paulo A. Boto
Rita Veloso Mendes
Massimiliano Panella
Publication date: 01-10-2013
Publisher: Springer Paris
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue 7/2013
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-012-1085-x

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The effect of care pathways for hip fractures: a systematic overview of secondary studies

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