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Application of integrated management bundle incorporating with multidisciplinary measures improved in-hospital outcomes and early survival in geriatric hip fracture patients with perioperative heart failure: a retrospective cohort study
BACKGROUND: In elderly, hip fracture is often complicated by perioperative heart failure, related to worse prognosis. We aimed to analyze the effects of integrated management bundle incorporating with multidisciplinary measures on in-hospital outcomes and early survival in elderly hip fracture patie...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9135836/ https://www.ncbi.nlm.nih.gov/pubmed/35067910 http://dx.doi.org/10.1007/s40520-021-02038-z |
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author | Fu, Mingming Zhang, Yaqian Guo, Junfei Zhao, Yuqi Hou, Zhiyong Wang, Zhiqian Zhang, Yingze |
author_facet | Fu, Mingming Zhang, Yaqian Guo, Junfei Zhao, Yuqi Hou, Zhiyong Wang, Zhiqian Zhang, Yingze |
author_sort | Fu, Mingming |
collection | PubMed |
description | BACKGROUND: In elderly, hip fracture is often complicated by perioperative heart failure, related to worse prognosis. We aimed to analyze the effects of integrated management bundle incorporating with multidisciplinary measures on in-hospital outcomes and early survival in elderly hip fracture patients with perioperative heart failure. METHODS: In this retrospective cohort study, a total of 421 hip fracture patients aged 65 and over who developed perioperative heart failure were included. According to different perioperative management modes applied, patients were retrospectively divided into multidisciplinary management group (Group A), including 277 patients, and integrated management bundle group (Group B), including 144 patients. The B-type natriuretic peptide (BNP) and C-reactive protein (CRP) levels, complications, length of stay, and hospitalization costs were observed and compared between two groups. Overall survival was compared by Kaplan–Meier methods. Cox regression analysis was used to identify prognostic factors associated with overall survival. RESULTS: A total of 421 patients were enrolled for analysis, including 277 in Group A and 144 in Group B. BNP and CRP levels were significantly decreased compared with admission (P < 0.05). Furthermore, BNP and CRP in Group B decreased much more than those in Group A (P < 0.05). The reductions were observed in length of stay, hospitalization costs and incidence of pulmonary infection, hypoproteinemia, and acute cerebral infarction in Group B (all P < 0.05). The Kaplan–Meier plots showed significantly superior overall survival in Group B. Integrated management bundle was independent favorable prognostic factors. CONCLUSIONS: The integrated management bundle incorporating with multidisciplinary measures significantly improved the therapeutic effect of perioperative heart failure, reduced inflammatory response, and yielded better hospital outcomes. It brought better survival benefits for geriatric hip fracture patients with perioperative heart failure. The results of this study can play an important role in clinical work and provide a valuable theoretical basis for selection of management model in elderly hip fracture patients with perioperative heart failure. |
format | Online Article Text |
id | pubmed-9135836 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-91358362022-05-28 Application of integrated management bundle incorporating with multidisciplinary measures improved in-hospital outcomes and early survival in geriatric hip fracture patients with perioperative heart failure: a retrospective cohort study Fu, Mingming Zhang, Yaqian Guo, Junfei Zhao, Yuqi Hou, Zhiyong Wang, Zhiqian Zhang, Yingze Aging Clin Exp Res Original Article BACKGROUND: In elderly, hip fracture is often complicated by perioperative heart failure, related to worse prognosis. We aimed to analyze the effects of integrated management bundle incorporating with multidisciplinary measures on in-hospital outcomes and early survival in elderly hip fracture patients with perioperative heart failure. METHODS: In this retrospective cohort study, a total of 421 hip fracture patients aged 65 and over who developed perioperative heart failure were included. According to different perioperative management modes applied, patients were retrospectively divided into multidisciplinary management group (Group A), including 277 patients, and integrated management bundle group (Group B), including 144 patients. The B-type natriuretic peptide (BNP) and C-reactive protein (CRP) levels, complications, length of stay, and hospitalization costs were observed and compared between two groups. Overall survival was compared by Kaplan–Meier methods. Cox regression analysis was used to identify prognostic factors associated with overall survival. RESULTS: A total of 421 patients were enrolled for analysis, including 277 in Group A and 144 in Group B. BNP and CRP levels were significantly decreased compared with admission (P < 0.05). Furthermore, BNP and CRP in Group B decreased much more than those in Group A (P < 0.05). The reductions were observed in length of stay, hospitalization costs and incidence of pulmonary infection, hypoproteinemia, and acute cerebral infarction in Group B (all P < 0.05). The Kaplan–Meier plots showed significantly superior overall survival in Group B. Integrated management bundle was independent favorable prognostic factors. CONCLUSIONS: The integrated management bundle incorporating with multidisciplinary measures significantly improved the therapeutic effect of perioperative heart failure, reduced inflammatory response, and yielded better hospital outcomes. It brought better survival benefits for geriatric hip fracture patients with perioperative heart failure. The results of this study can play an important role in clinical work and provide a valuable theoretical basis for selection of management model in elderly hip fracture patients with perioperative heart failure. Springer International Publishing 2022-01-24 2022 /pmc/articles/PMC9135836/ /pubmed/35067910 http://dx.doi.org/10.1007/s40520-021-02038-z Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Fu, Mingming Zhang, Yaqian Guo, Junfei Zhao, Yuqi Hou, Zhiyong Wang, Zhiqian Zhang, Yingze Application of integrated management bundle incorporating with multidisciplinary measures improved in-hospital outcomes and early survival in geriatric hip fracture patients with perioperative heart failure: a retrospective cohort study |
title | Application of integrated management bundle incorporating with multidisciplinary measures improved in-hospital outcomes and early survival in geriatric hip fracture patients with perioperative heart failure: a retrospective cohort study |
title_full | Application of integrated management bundle incorporating with multidisciplinary measures improved in-hospital outcomes and early survival in geriatric hip fracture patients with perioperative heart failure: a retrospective cohort study |
title_fullStr | Application of integrated management bundle incorporating with multidisciplinary measures improved in-hospital outcomes and early survival in geriatric hip fracture patients with perioperative heart failure: a retrospective cohort study |
title_full_unstemmed | Application of integrated management bundle incorporating with multidisciplinary measures improved in-hospital outcomes and early survival in geriatric hip fracture patients with perioperative heart failure: a retrospective cohort study |
title_short | Application of integrated management bundle incorporating with multidisciplinary measures improved in-hospital outcomes and early survival in geriatric hip fracture patients with perioperative heart failure: a retrospective cohort study |
title_sort | application of integrated management bundle incorporating with multidisciplinary measures improved in-hospital outcomes and early survival in geriatric hip fracture patients with perioperative heart failure: a retrospective cohort study |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9135836/ https://www.ncbi.nlm.nih.gov/pubmed/35067910 http://dx.doi.org/10.1007/s40520-021-02038-z |
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