Observation of the impact of the ERAS-based multidisciplinary treatment model (MDT) on the perioperative management of elderly patients with hip fractures in primary hospitals.

Abstract

To explore the impact of the ERAS-based (Enhanced Recovery After Surgery) Multidisciplinary Treatment Model (MDT) on perioperative management indicators of elderly patients with hip fractures in primary hospitals. A retrospective study was conducted on 120 elderly patients with hip fractures treated at our hospital from October 2020 to October 2024. The patients were divided into two groups: one group received the conventional model, while the other group received the ERAS-guided MDT model, with 58 and 62 patients in each group, respectively. Perioperative indicators and secondary outcomes (pain scores, symptom self-assessment scores, hip joint function, daily living abilities, and postoperative complication rates) were compared between the two groups. Data that met normality assumptions were compared using repeated measures ANOVA. Patients in the ERAS-MDT group had a shorter time to mobilization (16.55 ± 1.17 h) compared to the conventional group and walked for a longer duration daily (2.00 ± 0.66 h). Compared to preoperative, VAS (Visual Analog Scale) scores significantly decreased on postoperative day 7 in both groups (P < 0.05), with the ERAS-MDT group showing superior results (P < 0.05). At discharge, SCL-90 (Symptom Checklist-90) scores were significantly lower in the ERAS-MDT group compared to the conventional group (P < 0.05). Harris scores for hip function in the ERAS-MDT group were significantly higher than those in the conventional group at all time points (P < 0.05). Before intervention, there was no difference in daily living ability between the two groups (P > 0.05), but postoperative daily living abilities improved significantly in the ERAS-MDT group (P < 0.05). The complication rate during hospitalization was significantly lower in the ERAS-MDT group compared to the conventional group (P < 0.05). The ERAS-based MDT model has a potential impact on perioperative management indicators for elderly hip fracture patients in primary hospitals.