Enhanced recovery after surgery for hip and knee arthroplasty: a systematic review and meta-analysis

被引:255
作者
Zhu, Shibai [1 ]
Qian, Wenwei [1 ]
Jiang, Chao [1 ]
Ye, Canhua [1 ]
Chen, Xi [1 ]
机构
[1] Chinese Acad Med Sci, Dept Orthoped Surg, Peking Union Med Coll Hosp, Peking Union Med Coll, Beijing 100730, Peoples R China
基金
中国国家自然科学基金;
关键词
LENGTH-OF-STAY; FAST-TRACK HIP; REPLACEMENT; MORTALITY; PROGRAM;
D O I
10.1136/postgradmedj-2017-134991
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives To collect data of randomised controlled trials (RCTs) and clinical controlled trials (CCTs) for evaluating the effects of enhanced recovery after surgery on postoperative recovery of patients who received total hip arthroplasty (THA) or total knee arthroplasty (TKA). Methods Relevant, published studies were identified using the following key words: arthroplasty, joint replacement, enhanced recovery after surgery, fast track surgery, multi-mode analgesia, diet management, or steroid hormones. The following databases were used to identify the literature consisting of RCTs or CCTs with a date of search of 31 December 2016: PubMed, Cochrane, Web of knowledge, Ovid SpringerLink and EMBASE. All relevant data were collected from studies meeting the inclusion criteria. The outcome variables were postoperative length of stay (LOS), 30-day readmission rate, and total incidence of complications. RevMan5.2. software was adopted for the meta-analysis. Results A total of 10 published studies (9936 cases) met the inclusion criteria. The cumulative data included 4205 cases receiving enhanced recovery after surgery (ERAS), and 5731 cases receiving traditional recovery after surgery (non-ERAS). The meta-analysis showed that LOS was significantly lower in the ERAS group than in the control group (non-ERAS group) (p<0.01), and there were fewer incidences of complications in the ERAS group than in the control group (p=0.03). However, no significant difference was found in the 30-day readmission rate (p=0.18). Conclusions ERAS significantly reduces LOS and incidence of complications in patients who have had THA or TKA. However, ERAS does not appear to significantly impact 30-day readmission rates.
引用
收藏
页码:736 / 742
页数:7
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