Article Text

Download PDFPDF

#35900 POMAHR – perioperative management of patient with hip fracture in centro hospitalar universitário lisboa norte (CHULN)
  1. Jorge Carteiro,
  2. Marco Dinis,
  3. João Valente and
  4. Alexandra Resende
  1. Anesthesiology, Centro Hospitalar Universitario Lisboa Norte, Lisbon, Portugal


Please confirm that an ethics committee approval has been applied for or granted: Not relevant (see information at the bottom of this page)

Background and Aims Proximal femoral fractures (PFF) are an important public health problem in industrialized societies, affecting older, mainly female, patients who are more likely to suffer from osteoporosis. PFF are associated with increased morbidity and functional impairment with a negative impact on patient’s quality of life. Nearly always, PFF requires hospitalisation, permanently disables 50% of patients and a 26% one-year mortality rate, in elderly patients, has been described. The National Institute for Health and Care Excellence (NICE) recommends that patients with a hip fracture should have surgery within 36 hours of admission to hospital. In CHULN, we elaborated a protocol that allows patients to have surgical intervention within 36-48 hours, creating a multidisciplinary patient-centered approach, optimizing their clinical status and enhancing their recovery.

POMAHR has the following principles 1-preoperative patient medical optimization according to clinical protocols 2-early pain control with regional anesthesia 3-nutritional protocols with liquid intake up to 2h before surgery and protein reinforcement 4-surgical intervention within 36-48h 5- perform chemical neurolysis to control pain in patients who lack surgical indication 6-early rehabilitation since day1

Results Patients with PFF are mainly elderly, often with several comorbidities, needing a multidisciplinary approach in addition to surgery within 48 hours. We hope to reduce perioperative complications, reducing time of hospitalisation and mortality thus enhancing recovery and previous functional status.

Conclusions The implementation of this protocol in our center, promotes a multidisciplinary approach, a prompt intervention and a continuous clinical monitoring of patients with PFF, from admission to hospital discharge. These factors are key to successful patients’ treatment.

  • hip fracture
  • PENG block
  • fascia iliaca block
  • regional anesthesia
  • orthopedics

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.