Impact of ERAS compliance on the short-term outcomes for distal radius surgery: a single-center retrospective study.

Background: Distal radius fractures (DRF) account for one in five bony injuries in both primary and secondary trauma care. Enhanced recovery after surgery (ERAS) has been adopted successfully to improve clinical outcomes in multiple surgical disciplines; however, no study has investigated the effect...

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Publicado en:Journal of Orthopaedic Surgery & Research Vol. 18; no. 1; pp. 1 - 9
Autores principales: Mu Er Ti Zha, Mi Er A. Li Mu, Sun, Zhi Jian, Li, Ting, Ai Mai Ti, Re Zi Ya, Fu, Gang, Yao, Dong Chen, Yu, Xiang
Formato: critical path research tables/charts Journal Article
Publicado: BioMed Central 11/21/2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 11/21/2023
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      pub: BioMed Central
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        10.1186/s13018-023-04178-6
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        atl: Impact of ERAS compliance on the short-term outcomes for distal radius surgery: a single-center retrospective study.
      aug:
        au:
          Mu Er Ti Zha, Mi Er A. Li Mu
          Sun, Zhi Jian
          Li, Ting
          Ai Mai Ti, Re Zi Ya
          Fu, Gang
          Yao, Dong Chen
          Yu, Xiang
        affil: https://ror.org/02r247g67 Department of Orthopedic, People's Hospital of Xinjiang Uygur Autonomous Region China, 830001, Urumqi, Xinjiang, China
      sug:
        subj:
          Radius Fractures, Distal Surgery
          Enhanced Recovery After Surgery Evaluation
          Patient Compliance Evaluation
          Treatment Outcomes Evaluation
          Human
          Retrospective Design
          Preoperative Care Evaluation
          Postoperative Care Evaluation
          Perioperative Care Evaluation
          Comparative Studies
          Postoperative Complications
          Length of Stay
          Discharge Planning
          Health Care Costs
          Physical Performance
          Visual Analog Scaling
          Regression
          Descriptive Statistics
          Decision Making, Clinical
          Scales
          Questionnaires
          Funding Source
      ab: Background: Distal radius fractures (DRF) account for one in five bony injuries in both primary and secondary trauma care. Enhanced recovery after surgery (ERAS) has been adopted successfully to improve clinical outcomes in multiple surgical disciplines; however, no study has investigated the effect of different degrees of compliance with ERAS protocol on short-term outcomes following distal radius surgery. We aimed to analyze whether different degrees of compliance with the ERAS pathway are associated with clinical improvement following surgery for DRF. Methods: We retrospectively analyzed all consecutive patients with ERAS who underwent surgery for DRF at our department between May 2019 and October 2022. Their pre-, peri-, and post-operative compliance with the 22 elements of the ERAS program were assessed. We compared parameters between low- (< 68.1%) and high-compliance (> 68.1%) groups, including patient complications, total length of hospitalization, discharge time after surgery, hospital costs, time taken to return to preinjury level performance level, number of visual analogue scale (VAS) pain scores > 3 points during hospitalization, disabilities of the arm, shoulder and hand (DASH) scores. We performed multiple linear regression analyses to assess the impact of ERAS compliance on the postoperative function level (DASH scores). Results: No significant differences were detected between the high- and low-compliance groups with respect to demographics, including sex, age, body mass index (BMI), and comorbidities (P > 0.05). We observed significant differences between the high- and low-compliance groups in terms of the DASH score (32.25 ± 9.97 vs. 40.50 ± 15.65, p < 0.05) at 6 months postoperatively, the discharge time after surgery (2.45 ± 1.46 vs. 3.14 ± 1.50, p < 0.05), and number of times when the VAS pain score was > 3 points during hospitalization (0.88, [0.44, 1.31], p < 0.05). Our study demonstrated a significant negative association between ERAS compliance and the function level of patients postoperatively (DASH scores) when adjusted for age, comorbidity, sex, and BMI. Conclusions: This study provided a realistic evaluation and comparison of the ERAS protocol among patients with DRF and can guide clinical decision making. The ERAS protocol may improve outcomes after surgery, with high postoperative function levels and reduced pain and discharge time after surgery, without increased complication rates or hospital costs.
      pubtype: Academic Journal
      doctype:
        critical path
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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