Implementation of clinical guidelines for the treatment of patients with proximal femoral fractures at Vladivostok City Hospital No. 2

Abstract

Objective: To evaluate the outcomes of implementing the algorithm from the Federal Clinical Guidelines "Proximal Femoral Fractures" into the practice of the trauma service at Vladivostok Clinical Hospital No. 2. Materials and methods. With the implementation of the clinical guidelines at Vladivostok Clinical Hospital No. 2, a local protocol for the diagnosis and treatment of patients with proximal femoral fractures was developed. During the period from 2023 to 2024, 1,345 patients with proximal femoral fractures were treated at the hospital, which accounts for 12.9% of all hospitalized patients. The entire patient cohort was classified according to ICD-10 into the following subgroups: fracture of the femoral neck (S72.0), pertrochanteric (intertrochanteric) fracture (S72.1), and subtrochanteric fracture (S72.2). Results. By the end of 2024, the overall proportion of operated patients increased to 94.5%. Mortality in the operated group decreased from 2.45% in 2023 to 2.2% in 2024. In-hospital mortality among nonoperated patients reached 17.9%. The proportion of patients who underwent surgery within the first 48 hours increased from 32.2% at the end of 2023 to 64.2% by the end of 2024. Conclusion. The implementation of clinical guidelines for the treatment of patients with proximal femoral fractures, as presented in this study and carried out at Vladivostok Clinical Hospital No. 2, highlights the identified challenges and provides a framework that can be applied in other hospital settings