Effect Of ERAS On Perioperitiveblood Glucose Control In Elderly Patients With Intertrochanteric Fracture And Hyperglycemia

Objectives Comparing the effect of traditional concept on perioperative glucose control of elderly patients with fenmoral intertrochanteric fracture,we were aimed to explore the effect of the concept of ERAS on perioperative glucose control.Methods The trauma orthopedic department has formally established ERAS group since 1st Aug,2017.Based on this time,30 eligible cases of elderly patients with intertrochanteric fracture and hyperglycemia before 1st Aug were selected,at the same time,and 30 eligible cases of which were selected after 1st Aug,which were named as control group and experimental group respectively.The Two groups were quantitative analyzed in baseline data,POSSUM score,preoperative preparation time,time to take out the suture and ambulation,length of stay and standard deviation of blood glucose(SDBG)to compare the clinical data and evaluate the curative result.Results 1.There 30 cases in the experimental group,including 14 male and 16 female cases,whose mean age was 79.74±6.91 years old,admission random glucose was 13.67±4.32mmol/L,the average POSSUM preoperative physical score was 29.13±3.87,SDBG was 1.84±0.90,preoperative preparation time was 3.23±1.13 days,first ambulation after surgery was 2.03±0.76 days,time to take out the suture was 14.03±1.69 days and length of hospital stay was 9.72±3.19 days.There 30 cases in the control group,including 12 male and 18 female cases,whose mean age was 80.25±7.84 years old,admission random glucose was 14.23±3.11/L,the average POSSUM preoperative physical score was 30.03±4.16,SDBG was 2.67±1.18,preoperative preparation time was 5.87±1.28 days,first ambulation after surgery was 7.65±1.02 days,time to take out the suture was 14.25±2.11 days and length of hospital stay was 14.11±6.24 days.There are 12 patients in this experiment had perioperative complications,2 of which got pulmonary infection and 1 of which got urinary tract infection in experimental group;5 of which got pulmonary infection and 4 of which got urinary tract infection in control group,and eventually they all recovered and discharged without any deaths.3.There were no significant difference(P>0.05)between the experimental group and the control group in the baseline data(sex,age,admission random blood glucose,etc.).The POSSUM preoperative physical score and time to take out the suture were no significant difference between the two groups(P>0.05).Preoperative preparation time,first ambulation after surgery,length of hospital stay were significantly different(P <0.01).Conclusions: 1.Through a series of measures of ERAS,it could effectively reduce blood glucose fluctuations and improved glucose control.2.By reducing blood glucose fluctuations,it could reduce Preoperative preparation time and length of hospital stay.