Enhanced recovery after surgery components and perioperative outcomes: a nationwide observational study

British Journal of Anaesthesia
Stavros G MemtsoudisHenrik Kehlet

Abstract

Enhanced recovery after surgery (ERAS) protocols have been shown to benefit recovery after several operations. However, large-scale data on the association between the level of ERAS use and perioperative complications are scarce, particularly in surgeries with increasing ERAS uptake, including total hip (THA) and knee arthroplasty (TKA). Using US national data, we examined the relationship between the number of ERAS components implemented ('level') and perioperative outcomes. After ethics approval, we included 1 540 462 elective THA/TKA procedures (2006-2016, as recorded in the Premier Healthcare claims database) in this retrospective cohort study. Main outcomes were any complication, cardiopulmonary complications, mortality, blood transfusions, and length of stay. Eight commonly used ERAS components were included. Mixed-effects models measured associations between ERAS level and outcomes, with odds ratios (OR) and confidence intervals (CI) reported. ERAS use increased over time; overall, 21.6% (n=324 437), 62.7% (n=965 953), and 18.0% (n=250 072) of cases were classified as 'High', 'Medium', or 'Low' ERAS. 'High ERAS', 'Medium ERAS', and 'Low ERAS' level of use were defined as such if they received either >6, 5-6, or <5 ERAS c...Continue Reading

References

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Apr 21, 2011·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·Dario GregoriEva Pagano
Sep 8, 2011·Acta Orthopaedica·Ajay MalviyaMike R Reed
Nov 10, 2011·Acta Orthopaedica·Henrik HustedHenrik Kehlet
Jan 29, 2014·The British Journal of Surgery·A NicholsonA F Smith
May 1, 2015·British Journal of Anaesthesia·J C SimpsonUNKNOWN National Enhanced Recovery Partnership Advisory Board
Sep 12, 2017·Pain·Crispiana CozowiczStavros G Memtsoudis
Oct 25, 2017·Annals of Surgery·Julia R BerianJulie K Thacker
Dec 1, 2017·Anesthesia and Analgesia·Henrik Kehlet, Girish P Joshi
May 22, 2018·Acta Orthopaedica·Henrik Kehlet, Viktoria Lindberg-Larsen
Aug 8, 2018·Diseases of the Colon and Rectum·Nancy L GreerTimothy J Wilt
Oct 18, 2018·Acta Orthopaedica·Pelle B PetersenUNKNOWN Lundbeck Foundation Center for Fast-track Hip and Knee Replacement Collaborative Group
Dec 6, 2018·Acta Orthopaedica·Thomas W Wainwright, Henrik Kehlet
Mar 1, 2019·JAMA : the Journal of the American Medical Association·Stavros G MemtsoudisHenrik Kehlet
Mar 15, 2019·Journal of Orthopaedic Surgery and Research·Zhi-Chao HuAi-Min Wu

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Citations

Jul 1, 2020·International Orthopaedics·Jean-Yves JennyUNKNOWN Société Française de Chirurgie Orthopédique et Traumatologique (SOFCOT)
Nov 13, 2020·Archives of Orthopaedic and Trauma Surgery·Satit ThiengwittayapornFontip Leelachiewchankul
Dec 11, 2020·Anesthesiology·Henrik Kehlet, Nicolai Bang Foss
Jan 23, 2021·British Journal of Anaesthesia·Thomas W WainwrightHenrik Kehlet
Feb 1, 2021·British Journal of Anaesthesia·William J FawcettMichael J Scott
Dec 6, 2020·Scientific Reports·Pelle Baggesgaard PetersenUNKNOWN Lundbeck Foundation Centre for Fast-track Hip and Knee Replacement Collaborative Group
Apr 21, 2021·Seminars in Thoracic and Cardiovascular Surgery·Marcelo Cerullo
Mar 3, 2020·British Journal of Anaesthesia·Daniel I McIsaac
May 13, 2021·Journal of Cardiothoracic and Vascular Anesthesia·Christopher F TirottaMary Helen Tran
Jul 30, 2021·Current Opinion in Anaesthesiology·Leander MancelAna M Lopez

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