Key factors for successful 24-h discharge following Enhanced Recovery After Surgery protocols in total knee arthroplasty.

IF 1.9
Ee Chern Ng, Sheng Xu, Xuan Eric Liu, Jason Beng Teck Lim, Ming Han Lincoln Liow, Hee Nee Pang, Darren Keng Jin Tay, Seng Jin Yeo, Jerry Yongqiang Chen
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Abstract

Introduction: Total knee arthroplasty (TKA) remains the gold standard treatment for end-stage knee osteoarthritis. With rising TKA numbers, effective resource management, such as reducing length of stay, is crucial. While prior studies have focused on patient characteristics, this study aimed to investigate the influence of demographics and pre- and immediate postoperative patient-reported outcome measures (PROMs) on successful 24-h discharge using Enhanced Recovery After Surgery (ERAS) protocols.

Methods: Patients who underwent TKA with ERAS from August 2020 to July 2021 were followed up. Successful protocol completion was defined as discharge within 24 hours of surgery. Baseline characteristics and PROMs were recorded. Outcomes measures were compared between patients who successfully completed or failed the ERAS protocol, and variables were imputed into a binary logistic regression.

Results: Of 342 patients, 315 (92.1%) completed the ERAS protocol for TKA. Logistic regression analysis showed that higher postoperative pain scores and American Society of Anesthesiology (ASA) class > 2 significantly reduced the likelihood of passing the ERAS protocol (postoperative visual analogue scale odds ratio 0.742, P = 0.004; ASA > 2 odds ratio 0.196, P = 0.02). The model demonstrated satisfactory goodness of fit and accurately classified 80.1% of patients at the optimal cut-off. Receiver operating characteristic curve analysis showed good probability of discriminating between patients (area under the curve = 0.741).

Conclusion: Immediate postoperative pain scores and ASA class may be useful adjuncts in predicting successful 24-h discharge after TKA using ERAS protocol.

全膝关节置换术后增强恢复方案成功24小时出院的关键因素。
全膝关节置换术(TKA)仍然是终末期膝关节骨关节炎的金标准治疗方法。随着TKA人数的增加,有效的资源管理,如缩短停留时间,至关重要。虽然之前的研究主要集中在患者特征上,但本研究旨在调查人口统计学和术前和术后立即患者报告的结果测量(PROMs)对使用增强术后恢复(ERAS)方案的24小时成功出院的影响。方法:对2020年8月至2021年7月期间接受全膝关节置换术合并ERAS的患者进行随访。手术方案的成功完成定义为手术24小时内出院。记录基线特征和prom。比较成功完成或失败ERAS方案的患者之间的结果测量,并将变量输入二元逻辑回归。结果:342例患者中,315例(92.1%)完成了ERAS治疗TKA方案。Logistic回归分析显示,术后疼痛评分越高,美国麻醉学学会(ASA) >2级评分越高,ERAS方案通过的可能性越低(术后视觉模拟量表优势比0.742,P = 0.004;ASA bbbb2优势比0.196,P = 0.02)。该模型具有满意的拟合优度,在最佳截止点上,准确率为80.1%。受试者工作特征曲线分析显示,患者之间的区分概率较好(曲线下面积= 0.741)。结论:即刻术后疼痛评分和ASA分级可作为ERAS方案预测TKA术后24小时成功出院的有效辅助指标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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