Evidence map›Paper›PMID 37233951›Full record

ArticleSpine deformity2023

Utilization of individual components of enhanced recovery after surgery (ERAS) protocol improves post-operative outcomes in adolescent idiopathic scoliosis: a blueprint for progressive adoption of ERAS.

David E Lebel, Masayoshi Machida, Robert Koucheki, Fiona Campbell, Natasha Bath, Martin Koyle, Danielle Ruskin, David Levin, Sarah Brennenstuhl, Jennifer Stinson

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In one paragraph

Article in Spine deformity, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 2 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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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

10 authors.

David E LebelDivision of Orthopaedic Surgery, The Hospital for Sick Children, Toronto, ON, Canada. david.lebel@sickkids.ca.
Masayoshi MachidaDivision of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Canada.
Robert KouchekiDivision of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Canada.ORCID http://orcid.org/0000-0002-6156-6660
Fiona CampbellDivision of Orthopaedic Surgery, The Hospital for Sick Children, Toronto, ON, Canada.
Natasha BathDivision of Orthopaedic Surgery, The Hospital for Sick Children, Toronto, ON, Canada.
Martin KoyleDivision of Urology, The Hospital for Sick Children, Toronto, Canada.
Danielle RuskinDivision of Orthopaedic Surgery, The Hospital for Sick Children, Toronto, ON, Canada.
David LevinDivision of Orthopaedic Surgery, The Hospital for Sick Children, Toronto, ON, Canada.
Sarah BrennenstuhlDivision of Orthopaedic Surgery, The Hospital for Sick Children, Toronto, ON, Canada.
Jennifer StinsonDivision of Orthopaedic Surgery, The Hospital for Sick Children, Toronto, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeEnhanced recovery after surgery [ERAS] is an approach for standardization of perioperative care aimed at improving patient outcomes. The primary aim of this study was to determine if length of stay (LOS) differed by protocol type (ERAS vs. non-ERAS [N-ERAS]) in patients undergoing surgery for adolescent idiopathic scoliosis (AIS).

methodsA retrospective cohort study was conducted. Patient characteristics were collected and compared between groups. Differences in LOS were assessed using regression adjusting for age, sex, BMI, pre-surgical Cobb angle, levels fused and year of surgery.

resultsFifty nine ERAS patients were compared to 81 N-ERAS patients. Patients were comparable in their baseline characteristics. Median LOS was 3 days (IQR = 3-4) for the ERAS group, compared to 5 days (IQR = 4-5) for the N-ERAS group (p < 0.001). The ERAS group had a significantly lower adjusted rate of stay (RR = 0.75; 95% CI = 0.62-0.92). The ERAS group had significantly lower average pain on post-operative days 0 (least-squares-mean [LSM] 2.66 vs. 4.41, p < 0.001), POD1 (LSM 3.12 vs. 4.48, p < 0.001) and POD5 (LSM 2.84 vs. 4.42, p = 0.035). The ERAS group had lower opioid consumption (p < 0.001). LOS was predicted by the number of protocol elements received; those receiving two (RR = 1.54 95% CI = 1.05-2.24), one (RR = 1.49; 95% CI = 1.09-2.03) or none (RR = 1.60, 95% CI = 1.21-2.13) had significantly longer rates of stay than those receiving all four.

conclusionAdoption of modified ERAS-based protocol for patients undergoing PSF for AIS led to significant reduction in LOS, average pain scores, and opioid consumption.

Indexed as

Enhanced Recovery After SurgeryKyphosisScoliosisAdolescentAnalgesics, OpioidHumansPainRetrospective StudiesAnalgesics, OpioidEnhanced recovery after surgeryERASIdiopathic scoliosisRapid recovery pathwayRRPSpine surgery

Identifiers

PMID37233951
PMCPMC10425294

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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.