International Journal of Nursing Research

Objective To explore the effect of a multidisciplinary co-management model based on the Enhanced Recovery After Surgery (ERAS) concept on ultra-early ambulation in elderly patients with intertrochanteric femoral fractures. Methods A randomized controlled trial design was adopted. A total of 100 elderly patients with intertrochanteric femoral fractures admitted to our hospital from April 2023 to June 2025 were selected and divided into an experimental group and a control group (50 cases each) using the random number table method. The experimental group implemented a multidisciplinary co-management model guided by ERAS principles, forming a multidisciplinary team comprising orthopedic surgeons, anesthesiologists, rehabilitation therapists, nutritionists, and others to develop individualized perioperative management protocols. These protocols included preoperative nutritional support, optimized anesthesia regimens, multimodal analgesia, and stepwise rehabilitation training, among other comprehensive interventions. The control group received traditional perioperative care. Outcomes including Activities of Daily Living (ADL) scores, Visual Analogue Scale (VAS) pain scores, incidence of delirium (Neelon and Champagne Confusion Scale [Nu-DESC]), pressure injury risk (Braden Scale), and time to first postoperative ambulation were compared between the two groups. Results The experimental group had ADL scores of 55 (50, 56.25), while the control group scored 40 (35, 40) (Z = -8.783, P < 0.001, statistically significant). VAS pain scores were 2 (2, 4) in the experimental group versus 4 (4, 6) in the control group (Z = -5.64, P < 0.001, statistically significant). Delirium occurred in 3 cases in the experimental group and 10 in the control group (χ² = 4.332, P = 0.037, statistically significant). Braden scores for pressure injury risk were 17.5 (16.75, 18) in the experimental group and 12.5 (11, 14) in the control group (Z = -7.754, P < 0.001, statistically significant). Time to first postoperative ambulation was 2.5 (2, 3) days in the experimental group versus 5.5 (4, 7) days in the control group (Z = -8.176, P < 0.001, statistically significant). Conclusion The multidisciplinary co-management model under the ERAS concept improved patients' activities of daily living, reduced pain, lowered the risk of pressure injuries and delirium incidence, and enabled elderly patients with intertrochanteric femoral fractures to achieve ultra-early ambulation.

Enhanced Recovery After Surgery; Multidisciplinary; Elderly intertrochanteric femoral fractures; Time to ambulation