Evidence map›Paper›PMID 29985681›Full record

Observational studyActa orthopaedica2018

No increase in readmissions or adverse events after implementation of fast-track program in total hip and knee replacement at 8 Swedish hospitals: An observational before-and-after study of 14,148 total joint replacements 2011-2015.

Urban Berg, Erik BüLow, Martin Sundberg, Ola Rolfson

Registry-linked trialAbstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Acta orthopaedica, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04653415 (The Impact of Pre-emptive Large Doses of Methylprednisolone Combined With Gabapentin on Pain Treatment and Convalescence After Total Knee Arthroplasty in Elderly), which is not on this map. Cited by 27 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04653415 phase4completednot on this mapstarted 2019, after this paper: background citation

The Impact of Pre-emptive Large Doses of Methylprednisolone Combined With Gabapentin on Pain Treatment and Convalescence After Total Knee Arthroplasty in Elderly: A Double-blind Randomized Study

TypeinterventionalSponsorJagiellonian UniversityRan2019 to 2020Enrolled160ConditionsArthroplasty Complications, Knee Osteoarthritis, Pain, Postoperative, Perioperative ComplicationArmsGabapentin 300mg, Methylprednisolone 125 mg, Tablet, Normal Saline 10 mL Injection
3 · Its place in the literature

Who cites it

27 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Article
  6. Article
  7. Review
  8. Article
  9. Review
  10. Review
  11. Article
  12. Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Observational
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Urban Berga Department of Orthopaedics , Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg.
Erik BüLowa Department of Orthopaedics , Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg.
Martin Sundbergd Department of Orthopedics , Clinical Sciences, Lund University and Skåne University Hospital , Lund , Sweden.
Ola Rolfsona Department of Orthopaedics , Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background and purpose - Fast-track care programs in elective total hip and knee replacement (THR/TKR) have been introduced in several countries during the last decade resulting in a significant reduction of hospital stay without any rise in readmissions or early adverse events (AE). We evaluated the risk of readmissions and AE within 30 and 90 days after surgery when a fast-track program was introduced in routine care of joint replacement at 8 Swedish hospitals. Patients and methods - Fast-track care programs were introduced at 8 public hospitals in Västra Götaland region from 2012 to 2014. We obtained data from the Swedish Hip and Knee Arthroplasty Registers for patients operated with THR and TKR in 2011-2015. All readmissions and new contacts with the health care system within 3 months with a possible connection to the surgical intervention were requested from the regional patient register. We compared patients operated before and after the introduction of the fast-track program. Results - Implementation of the fast-track program resulted in a decrease in median hospital length of stay (LOS) from 5 to 3 days in both THR and TKR. The total readmission rate <90 days for THR was 7.2% with fast-track compared with 6.7% in the previous program, and for TKR 8.4% in both groups. Almost half of the readmissions occurred without any AE identified. There was no statistically significant difference concerning readmissions or AE when comparing the programs. Interpretation - Implementation of a fast-track care program in routine care of elective hip and knee replacement is effective in reducing hospital stay without increasing the risk of readmissions or adverse events within 90 days after surgery.

Indexed as

AgedAged, 80 and overArthroplasty, Replacement, HipArthroplasty, Replacement, KneeCritical PathwaysFemaleHospitalizationHumansLength of StayMaleMiddle AgedPatient ReadmissionPostoperative ComplicationsRegistriesSweden

Identifiers

PMID29985681
PMCPMC6202734

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.