Evidence map›Paper›PMID 38090600›Full record

ArticleJournal of orthopaedics2024

Enhanced recovery after surgery (ERAS) protocol reduces need for patient selection for day surgery total knee arthroplasty.

Sheng Xu, Ming Han Lincoln Liow, Xuan Eric Liu, Hee-Nee Pang, Shi-Lu Chia, Keng Jin Darren Tay, Seng Jin Yeo, Jerry Yongqiang Chen

Abstract read
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Article in Journal of orthopaedics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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2 · The registry

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3 · Its place in the literature

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2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Sheng XuDepartment of Orthopaedic Surgery, Singapore General Hospital, Singapore.
Ming Han Lincoln LiowDepartment of Orthopaedic Surgery, Singapore General Hospital, Singapore.
Xuan Eric LiuDepartment of Orthopaedic Surgery, Singapore General Hospital, Singapore.
Hee-Nee PangDepartment of Orthopaedic Surgery, Singapore General Hospital, Singapore.
Shi-Lu ChiaDepartment of Orthopaedic Surgery, Singapore General Hospital, Singapore.
Keng Jin Darren TayDepartment of Orthopaedic Surgery, Singapore General Hospital, Singapore.
Seng Jin YeoDepartment of Orthopaedic Surgery, Singapore General Hospital, Singapore.
Jerry Yongqiang ChenDepartment of Orthopaedic Surgery, Singapore General Hospital, Singapore.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: This study explored the safety and efficacy of Enhanced Recovery After Surgery (ERAS) together with a Day-surgery protocol on some commonly used selection criteria for expedited discharge after Total Knee Arthroplasty (TKA). Methods: ERAS Day surgery TKA performed between Aug 2020 to July 2021 were included in this study. Discharge within 24 h was considered passing protocol. Complications such as infection, re-admission, and re-operation within 30-days were recorded. Patient demographics, medical comorbidities, and outcome measures at 6-month post-operatively were analysed between those who were successfully discharged within 24 h and those with prolong admission. Results: A total of 342 patients were included in the study. 315 patients (92.1 %) were discharged within 24 h s. Inadequately controlled pain was the most common reason for delayed discharge (17.9 %). No statistically significant difference in gender, age, Charlson Comorbidity Index (CCI), Body Mass Index (BMI), and American Society of Anaesthesiologist Classification (ASA) were noted between patients who failed protocol and those who passed. Readmission rate within 30days was 2.6 %. Infection occurred in 5 cases, including 2 prosthetic joint infection (PJI) requiring debridement, antibiotics, and implant retention (DAIR), 2 surgical site infection treated with antibiotics, and 1 pneumonia. No 30-days complication occurred in patients who initially failed ERAS Day-surgery protocol. Binary logistic regression was statistically insignificant on effect of gender, age, CCI, BMI, and ASA on passing protocol or 30-days complications. Propensity score matching of patients with prolong stay of more than 24 h did not demonstrate any difference in 6-month outcome. Conclusion: Patient characteristics such as gender, age, CCI, BMI, and ASA did not influence successful completion of ERAS Day-surgery protocol. Even if patients were initially enrolled in ERAS Day-surgery protocol but failed to be discharged within 24 h, this did not predispose them to increased 30-days complication or poorer 6-month outcome. Level of evidence: III.

Indexed as

Day-surgeryEnhanced recoveryERASTKATotal knee arthroplasty

Identifiers

PMID38090600
PMCPMC10711009

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