Outcomes in the elderly patient following enhanced recovery pathways for elective lower‐limb arthroplasty surgery

U, Edmond Chun Ying; Starks, Ian

doi:10.1002/msc.1389

Cited by 2 publications

(1 citation statement)

References 15 publications

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“…Related studies in China have reported that the average LOS under the ERAS concept was 10 d, with a median of 8 d. In contrast, the average LOS in the control group was 18 d, with a median of 13 d[ 22 ]. In other countries, the average LOS of patients with ERAS was shorter than in China, and was 5-6 d[ 23 , 24 ]. However, about 50%-80% of the discharged patients in developed countries are taken out of hospital care institutions[ 25 ], which might help explain this differences between countries.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of enhanced recovery after surgery in the perioperative management of patients with bone surgery in China

Zhao¹,

Liu²,

Zhao³

et al. 2021

WJCC

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BACKGROUND Enhanced recovery after surgery (ERAS) was introduced in China in 2007. Over time, the scope of ERAS has expanded from abdominal surgery to orthopedics, urology and other fields. Continuous development and research has contributed to progress of ERAS in China. In 2019, to promote the application of ERAS in bone tumor surgery, we formed the “Consensus of Experts on Perioperative Management of Accelerated Rehabilitation in Major Surgery of Bone Tumors in China”. AIM To evaluate the effect of enhanced recovery after bone tumor surgery in perioperative management in China. METHODS One hundred and seven patients who underwent bone tumor surgery at the Second Affiliated Hospital of Xi’an Jiaotong University between May 2019 and April 2021 were randomized into a study group (53 cases) and a control group (54 cases). The study group adopted the ERAS protocol and the control group adopted conventional care. Main outcome measures included postoperative length of stay (LOS), postoperative complications, mortality, and 30-d readmission rates. Secondary outcomes included postoperative visual analog scale (VAS) score of pain, number of blood transfusions, drainage volume in 24 h after operation, patient satisfaction 30 d after discharge, VAS score at 30 d after discharge, and daily standing walking time. RESULTS There were no significant differences in the baseline data, clinical features and surgical site between the two groups. The LOS in the study group with the ERAS protocol was 7.72 ± 3.34 d compared with 10.28 ± 4.27 d in the control group who followed conventional care. The incidence of postoperative nausea and vomiting (PONV) in the study group was 19% and 37% in the control group. The VAS scores of pain on postoperative day 1 (POD1) and POD3 in the study group were 4.79 ± 2.34 and 2.79 ± 1.53 compared with 5.28 ± 3.27 and 3.98 ± 2.27 in the control group. The drainage volume in 24 h after the operation was 124.36 ± 23.43 mL in the study group and 167.43 ± 30.87 mL in the control group. The number of blood transfusions in the study group was also lower. The patient satisfaction rate was higher in the study group than in the control group. CONCLUSION The ERAS protocol in the perioperative period of bone tumor surgery can decrease LOS, PONV, and postoperative pain, blood transfusion and 24-h drainage, improve patient satisfaction and accelerate recovery.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of enhanced recovery after surgery in the perioperative management of patients with bone surgery in China

Zhao¹,

Liu²,

Zhao³

et al. 2021

WJCC

View full text Add to dashboard Cite

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Fast-track hip and knee arthroplasty in older adults—a prospective cohort of 1,427 procedures in patients ≥85 years

2019

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Introduction fast-track protocols in total hip and knee arthroplasty (THA/TKA) have improved postoperative recovery and reduced postoperative morbidity. Additionally, increasing life expectancy and improved surgical techniques have led to an increasing number of older adult patients undergoing THA/TKA. However, no large detailed studies on fast-track THA/TKA in older adults are available. Consequently, we aimed to describe the length of stay (LOS) and postoperative morbidity in a large cohort of patients ≥85 years within a continuous multicentre fast-track collaboration. Methods we used a prospective observational cohort design with unselected consecutive data between 2010 and 2017 on primary elective THA and TKA patients ≥85 years. Data were obtained from nine centres reporting to the Lundbeck Foundation Centre for Fast-track Hip and Knee Replacement database and the Danish National Patient Registry on LOS, readmissions and mortality. Causes of morbidity were determined by review of health records. Results we included 1,427 (3.9% of all THA/TKA) procedures with 62.3% THA. Median age was 87 (IQR: 85–88) years with 71% women. LOS decreased from median 4 (3–6) days in 2010 to 2 (2–3) days in 2017. The proportion with LOS > 4 days decreased from 32 to 18%. Readmission and mortality rate remained at about 11.7 and 0.9% after 30 days and 16.0 and 1.5% after 90 days, respectively. Conclusion this detailed large multicentre fast-track THA/TKA study in patients ≥85 years found major reductions in LOS without increase in readmission or mortality rates. The unchanged readmission rate poses an area for further improvements.

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Outcomes in the elderly patient following enhanced recovery pathways for elective lower‐limb arthroplasty surgery

Cited by 2 publications

References 15 publications

Effectiveness of enhanced recovery after surgery in the perioperative management of patients with bone surgery in China

Effectiveness of enhanced recovery after surgery in the perioperative management of patients with bone surgery in China

Fast-track hip and knee arthroplasty in older adults—a prospective cohort of 1,427 procedures in patients ≥85 years

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