Reduced short-term complications and mortality following enhanced recovery primary hip and knee arthroplasty: results form 6,000 consecutive procedures.
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Authors
Khan, Sameer
Malviya, Ajay
Muller, Scott
Carluke, Ian
Partington, Paul
Emmerson, Kevin
Reed, Mike
Issue Date
2014
Type
Article
Language
en
Keywords
hip arthroplasty , knee arthroplasty , enhanced recovery , patient outcomes
Alternative Title
Abstract
Background and purpose: Enhanced Recovery (ER) is a well-established multidisciplinary strategy in lower limb arthroplasty and was introduced in our department in May 2008. This retrospective study reviews short-term outcomes in a consecutive unselected series of 3,000 procedures (the "ER" group), and compares them to a numerically comparable cohort that had been operated on previously using a traditional protocol (the "Trad" group).
Methods: Prospectively collected data on surgical endpoints (length of stay (LOS), return to theater (RTT), re-admission, and 30- and 90-day mortality) and medical complications (stroke, gastrointestinal bleeding, myocardial infarction, and pneumonia within 30 days; deep vein thrombosis and pulmonary embolism within 60 days) were compared.
Results: ER included 1,256 THR patients and 1,744 TKR patients (1,369 THRs and 1,631 TKRs in Trad). The median LOS in the ER group was reduced (3 days vs. 6 days; p = 0.01). Blood transfusion rate was also reduced (7.6% vs. 23%; p
Interpretation: This is the largest study of ER arthroplasty, and provides safety data on a consecutive unselected series. The program has achieved a statistically significant reduction in LOS and in cardiac ischemic events for our patients, with a near-significant decrease in return to theater and in mortality rates.
Description
Citation
Khan, S., Malviya, A., Muller, S. et al. (2014) Reduced short-term complications and mortality following enhanced recovery primary hip and knee arthroplasty: results form 6,000 consecutive procedures. Acta Orthopaedica; 85 (1) : 26-31.
Publisher
License
Journal
Acta Orthopaedica
Volume
Issue
PubMed ID
ISSN
1745-3682