Multidisciplinary team improves the efficiency of diagnosis and treatment of intertrochanteric fractures in the elderly
Objective To investigate whether multidisciplinary team(MDT)can improve the effi-ciency of diagnosis and treatment of intertrochanteric fractures in elderly patients.Methods A total of 92 elderly patients with intertrochanteric fractures treated with MDT mode in Shanxi Provincial People's Hos-pital from June 2023 to May 2024 and 84 such patients treated with traditional mode in Shanxi Provincial People's Hospital from June 2022 to May 2023 were selected as the MDT group and the control group,re-spectively.General data were collected.The preoperative waiting time,operation time,intraoperative blood loss,postoperative hospital stay,hospitalization cost,postoperative complications incidence,48 h operation rate and 1,3 months postoperative mortality were compared between the two groups.Independent sample t test was used for measurement data,x2 test was used for count data.Results There was no difference in general data between the two groups.The preoperative waiting time in the MDT group was sig-nificantly lower than that in the control group[(32.2±4.4)h vs.(98.6±11.2)h,t=8.311,P＜0.01].The postoperative hospital stay in the MDT group was significantly lower than that in the control group[(3.2±0.8)d vs.(5.8±1.8)d,t=13.054,P＜0.05].There was no significant difference in operation time[(50.5±11.2)min vs.(56.0±15.5)min]and intraoperative blood loss[(140.3±21.5)ml vs.(134.5±18.4)ml]between the two groups(t=2.261,1.114,P＞0.05).The hospitalization cost of MDT group was lower than that of control group[(25 266.8±1 325.6)yuan vs.(32 107.5±3 122.8)yuan,t=6.115,P＜0.05].The incidence of postoperative complications in MDT group was significantly lower than that in control group[13％(12/92)vs.51.2％(43/84),x2=11.712,P＜0.01].The incidence of pulmonary infection[4.3％(4/92)vs.13.1％(11/84)],deep vein thrombosis[3.3％(3/92)vs.13.1％(11/84)],bedsore[1.1％(1/92)vs.8.3％(7/84)]and delirium[3.3％(3/92)vs.9.5％(8/84)]in MDT group were lower In the control group(x2=3.172,4.225,5.302,2.317,P＜0.05);Sudden death[0％(0/92)vs.1.2％(1/84),x2=1.026],heart failure[1.1％(1/92)vs.2.4％(2/84),x2=0.244],respiratory failure[0％(0/92)vs.2.4％(2/84),x2=2.703]and pulmonary embolism[0％(0/92)vs.1.2％(1/84),x2=1.236]between the two groups were not statistically significant(P＞0.05).The operation rate within 48 hours in MDT group was significantly high-er than that in control group[48.9％(45/92)vs.11.9％(10/84),x2=9.652,P＜0.05].There was no significant difference in 1 month[2.2％(2/92)vs.3.6％(3/84),x2=0.813,P＞0.05]and 3 months[3.3％(3/92)vs.4.8％(4/84),x=0.172,P＞0.05]mortality between MDT group and con-trol group.Conclusion MDT can significantly improve the efficiency of diagnosis and treatment of inter-trochanteric fractures in the elderly.
Multidisciplinary teamDiagnosis and treatment patternsOld ageIntertro-chanteric fracture of the femur
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