We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Impact of enhanced recovery after surgery on postoperative recovery after joint arthroplasty: results from a systematic review and meta-analysis.
- Authors
Qi-Feng Deng; Hui-Yun Gu; Wu-ya Peng; Qiong Zhang; Zheng-Dong Huang; Chao Zhang; Yun-Xiang Yu; Deng, Qi-Feng; Gu, Hui-Yun; Peng, Wu-Ya; Zhang, Qiong; Huang, Zheng-Dong; Zhang, Chao; Yu, Yun-Xiang
- Abstract
<bold>Study Design: </bold>Systematic review with meta-analysis.<bold>Objectives: </bold>To evaluate the effects of enhanced recovery after surgery (ERAS) on the postoperative recovery of patients who underwent total hip arthroplasty (THA) or total knee arthroplasty (TKA).<bold>Methods: </bold>The PubMed, Embase, Cochrane and ISI Web of Science databases were searched to identify literature including randomised controlled trials (RCTs), cohort studies and case-control studies through 2 May 2018. The analysed outcomes were mortality rate, transfusion rate, range of motion (ROM), 30-day readmission rate, postoperative complication rate and in-hospital length of stay (LOS).<bold>Results: </bold>A total of 25 studies involving 16 699 patients met the inclusion criteria and were included in the meta-analysis. Compared with conventional care, ERAS was associated with a significant decrease in mortality rate (relative risk (RR) 0.48, 95% CI 0.27 to 0.85), transfusion rate (RR 0.43, 95% CI 0.37 to 0.51), complication rate (RR 0.74, 95% CI 0.62 to 0.87) and LOS (mean difference (MD) -2.03, 95% CI -2.64 to -1.42) among all included trials. However, no significant difference was found in ROM (MD 7.53, 95% CI -2.16 to 17.23) and 30-day readmission rate (RR 0.86, 95% CI 0.56 to 1.30). There was no significant difference in complications of TKA (RR 0.84, 95% CI 0.34 to 2.06) and transfusion rate in RCTs (RR 0.66, 95% CI 0.15 to 2.88) between the ERAS group and the control group.<bold>Conclusions: </bold>This meta-analysis showed that ERAS significantly reduced the mortality rate, transfusion rate, incidence of complications and LOS of patients undergoing TKA or THA. However, ERAS did not show a significant impact on ROM and 30-day readmission rate. Complications after hip replacement are less than those of knee replacement, and the young patients recover better.<bold>Level Of Evidence: </bold>Level 1.
- Subjects
ARTHROPLASTY; META-analysis; SURGICAL complications; CHRONOLOGY; MOTION; CONVALESCENCE; INFORMATION storage &; retrieval systems; MEDICAL databases; MEDICAL information storage &; retrieval systems; MEDLINE; ONLINE information services; POSTOPERATIVE care; TOTAL hip replacement; TOTAL knee replacement; SYSTEMATIC reviews; REHABILITATION
- Publication
Postgraduate Medical Journal, 2018, Vol 94, Issue 1118, p678
- ISSN
0032-5473
- Publication type
journal article
- DOI
10.1136/postgradmedj-2018-136166