Safety and benefit of ambulation within 24 hours in elderly patients undergoing lumbar fusion: propensity score matching study of 882 patients

Wang, Shuai-Kang; Li, Yong-Jin; Wang, Peng; Li, Xiang-Yu; Kong, Chao; Ma, Jin; Lu, Shi-Bao

doi:10.1016/j.spinee.2023.11.014

The Spine Journal

2024

DOI: 10.1016/j.spinee.2023.11.014

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Safety and benefit of ambulation within 24 hours in elderly patients undergoing lumbar fusion: propensity score matching study of 882 patients

Shuai-Kang Wang,

Yong-Jin Li,

Peng Wang

et al.

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2024

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Cited by 4 publications

References 26 publications

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The Implementation of Enhanced Recovery After Spine Surgery in High and Low/Middle-income Countries: A Systematic Review and Meta-Analysis

Lele,

Moreton,

Mejia-Mantilla

et al. 2024

Journal of Neurosurgical Anesthesiology

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In this review article, we explore the implementation and outcomes of enhanced recovery after spine surgery (spine ERAS) across different World Bank country-income levels. A systematic literature search was conducted through PubMed, Embase, Scopus, and CINAHL databases for articles on the implementation of spine ERAS in both adult and pediatric populations. Study characteristics, ERAS elements, and outcomes were analyzed and meta-analyses were performed for length of stay (LOS) and cost outcomes. The number of spine ERAS studies from low-middle-income countries (LMICs) increased since 2017, when the first spine ERAS implementation study was published. LMICs were more likely than high-income countries (HICs) to conduct studies on patients aged ≥18 years (odds ratio [OR], 6.00; 95% CI, 1.58-42.80), with sample sizes 51 to 100 (OR, 4.50; 95% CI, 1.21-22.90), and randomized controlled trials (OR, 7.25; 95% CI, 1.77-53.50). Preoperative optimization was more frequently implemented in LMICs than in HICs (OR, 2.14; 95% CI, 1.06-4.41), and operation time was more often studied in LMICs (OR 3.78; 95% CI, 1.77-8.35). Implementation of spine ERAS resulted in reductions in LOS in both LMIC (−2.06; 95% CI, −2.47 to −1.64 d) and HIC (−0.99; 95% CI, −1.28 to −0.70 d) hospitals. However, spine ERAS implementation did result in a significant reduction in costs. This review highlights the global landscape of ERAS implementation in spine surgery, demonstrating its effectiveness in reducing LOS across diverse settings. Further research with standardized reporting of ERAS elements and outcomes is warranted to explore the impact of spine ERAS on cost-effectiveness and other patient-centered outcomes.

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The Implementation of Enhanced Recovery After Spine Surgery in High and Low/Middle-income Countries: A Systematic Review and Meta-Analysis

Lele,

Moreton,

Mejia-Mantilla

et al. 2024

Journal of Neurosurgical Anesthesiology

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Multimodal prehabilitation combined with perioperative enhanced recovery after surgery care for older patients undergoing spinal fusion surgery in China: protocol for a multicentre randomised controlled trial (PRACTICE trial)

Wang,

Wang

et al. 2024

BMJ Open

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IntroductionBesides the comorbid risk factors shared by older and younger patients, older individuals may also experience malnutrition, as well as cognitive or functional impairments. The accumulation of frailty and various geriatric syndromes in older individuals results in decreased physiological reserves, which makes the recovery process after spine surgery particularly challenging. Theoretically, combining the presurgery optimisation provided by a multimodal prehabilitation programme with the reduction of surgical stress provided by an enhanced recovery after surgery (ERAS) programme could improve postoperative recovery of older patients.Methods and analysisThis is a prospective, multicentre, assessor-blinded, randomised controlled study. Patients who are 75 years of age or older and are scheduled for spinal fusion surgery will be enrolled on three academic medical centres. Regular preadmission education and perioperative ERAS care will be given to participants who were randomised to the control group. Participants randomised to the intervention group will receive multimodal prehabilitation combined with ERAS (PREERAS) management. We will include 164 patients with spinal fusion in three hospitals in China. All included patients will be followed for 90 days after surgery or until death. The primary outcome is the Comprehensive Complication Index (CCI), which ranges from 0 to 100, where a score of 100 indicates death due to complications. Secondary outcomes include length of stay and non-home discharge, rates of postoperative complications and unplanned readmission, North American Spine Society satisfaction, and Oswestry Disability Index/Neck disability index. Ninety-day CCI will be compared between groups using linear regression. Other continuous or categorical outcomes will be compared using linear or logistic regression.Ethics and disseminationThis study has received ethical approval from the Xuanwu Hospital of Capital Medical University Ethics Committees (2024-088-001). The findings will be submitted to a peer-reviewed journal for publication.Trial registration numberNCT06140797.

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Advancing the timing of drainage removal: a comprehensive analysis of different drainage removal criteria in patients undergoing short-level lumbar fusion surgery

Cui,

Han,

Chen

et al. 2024

BMC Surg

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Safety and benefit of ambulation within 24 hours in elderly patients undergoing lumbar fusion: propensity score matching study of 882 patients

Cited by 4 publications

References 26 publications

The Implementation of Enhanced Recovery After Spine Surgery in High and Low/Middle-income Countries: A Systematic Review and Meta-Analysis

The Implementation of Enhanced Recovery After Spine Surgery in High and Low/Middle-income Countries: A Systematic Review and Meta-Analysis

Multimodal prehabilitation combined with perioperative enhanced recovery after surgery care for older patients undergoing spinal fusion surgery in China: protocol for a multicentre randomised controlled trial (PRACTICE trial)

Advancing the timing of drainage removal: a comprehensive analysis of different drainage removal criteria in patients undergoing short-level lumbar fusion surgery

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