Avalicao preliminar de un protocolo assistencial de artroplastia total de quadril

Abstract

The hip arthrosis is a degenerativejoint disease occurring main]y in the elderly patients, a recently growing population. Rational
measwes are needed to better carry out the sur-¡cal procedurcsand lo reduce cost for the health system, since almost two thirds of the costs are due to the admission period. Therefore, a global, rnultidisciphinary assistance program for total hip arthroplasty (THAAP), including ambulatory appointments and programmed home care by a nursing team, was established to guide patients and theii' relatives for the procedure. This is a pilot study for a randomized prospective clinical trial to assess the feasibihity of the THAAP and to determine the protocol adherence by the medical and nurse team. Secondarily, it atternpts to determine the impact of the program on admission period, patient functional autonomy and postoperali ve events, as well as lo assess the lcasibiltty of the
programmed nursing home-care. A total of 22 patients (8 males, 12 females) with mean (SD) age of 59.45 (16.87) ranging trom 21 to 86 years were includedin the study. They were divided into two groups according whether they were (group 1, n=10) or were not (group 2, n=10) included in the THAAP. The malo comorbidity for both groups were SAH (2 vs. 1). diabetes (1 vs. 0) and alcoho! consuniption (1 VS. 0), respectively. Mean (SD) postoperative (PO) period vas significantly reduced (p=0.0055) in group 1; 5.2 (0.4) as compared to group 2: 7.5 (2.3). Adherence to the THAAP was 9017ú and 10011, lordoctors and nurses, rcspectively. Seven out
of nine patients in group 1 were bed-seated on the second POD, two were seated on the third POD and none were bed-ridden. Al¡of them were able to waik with crutches a day later. Al! patients in group 2 left bed on the fourth POD. In conclusion, the present protocol dernonstrated to he feasib!e, team adherence was adequate and resulted in a reduceci adrnission period. The progress of the program shall determine its cfficacy and the feasibility of programmed nursing home care.