José Miguel Luarte, José Tomás Vizcaya, Diego Munita, Esteban Stocker, Romina Núñez, Juan Antonio Merino, Claudio Rojas
{"title":"围手术期优化方案可以改善髋关节和膝关节置换术的效果并缩短住院时间：智利的经验。","authors":"José Miguel Luarte, José Tomás Vizcaya, Diego Munita, Esteban Stocker, Romina Núñez, Juan Antonio Merino, Claudio Rojas","doi":"10.1016/j.recot.2025.03.002","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and objective: </strong>Perioperative optimization programs have been shown to improve outcomes in total hip and knee arthroplasty; however, the evidence in Latin America is limited. Our objective is to evaluate the impact of implementing a multidisciplinary optimization program in prosthetic surgery at a Latin American center.</p><p><strong>Materials and methods: </strong>A retrospective cohort study evaluating elective hip and knee prosthesis surgeries between 2016 and 2023 at a private hospital. We compared pre-intervention (2016-2018) and post-intervention (2019-2023) groups following the implementation of a multidisciplinary perioperative optimization program in 2019. The impact of the program on hospital length of stay and 90-day readmission rates was assessed.</p><p><strong>Results: </strong>A total of 1,462 patients (1,636 surgeries) were included, with 429 surgeries in the pre-intervention group and 1,207 in the post-intervention group. Hospital length of stay decreased from 3.5 to 2.22 days (p<0.05). The 90-day readmission rate decreased from 2.56% to 2.24% (p=0.71), with a significant reduction in knee arthrofibrosis (from 0.9% to 0.2%, p<0.05). The optimization program was the main factor contributing to the reduction in hospital length of stay.</p><p><strong>Conclusions: </strong>The multidisciplinary perioperative program implemented significantly reduced hospital stay without increasing 90-day readmission rates.Furthermore, it equated outcomes between patients with public and private insurance.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A PERIOPERATIVE OPTIMIZATION PROGRAM CAN IMPROVE RESULTS AND REDUCE HOSPITAL LENGTH OF STAY IN HIP AND KNEE ARTHROPLASTY: EXPERIENCE IN CHILE.\",\"authors\":\"José Miguel Luarte, José Tomás Vizcaya, Diego Munita, Esteban Stocker, Romina Núñez, Juan Antonio Merino, Claudio Rojas\",\"doi\":\"10.1016/j.recot.2025.03.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and objective: </strong>Perioperative optimization programs have been shown to improve outcomes in total hip and knee arthroplasty; however, the evidence in Latin America is limited. Our objective is to evaluate the impact of implementing a multidisciplinary optimization program in prosthetic surgery at a Latin American center.</p><p><strong>Materials and methods: </strong>A retrospective cohort study evaluating elective hip and knee prosthesis surgeries between 2016 and 2023 at a private hospital. We compared pre-intervention (2016-2018) and post-intervention (2019-2023) groups following the implementation of a multidisciplinary perioperative optimization program in 2019. The impact of the program on hospital length of stay and 90-day readmission rates was assessed.</p><p><strong>Results: </strong>A total of 1,462 patients (1,636 surgeries) were included, with 429 surgeries in the pre-intervention group and 1,207 in the post-intervention group. Hospital length of stay decreased from 3.5 to 2.22 days (p<0.05). The 90-day readmission rate decreased from 2.56% to 2.24% (p=0.71), with a significant reduction in knee arthrofibrosis (from 0.9% to 0.2%, p<0.05). The optimization program was the main factor contributing to the reduction in hospital length of stay.</p><p><strong>Conclusions: </strong>The multidisciplinary perioperative program implemented significantly reduced hospital stay without increasing 90-day readmission rates.Furthermore, it equated outcomes between patients with public and private insurance.</p>\",\"PeriodicalId\":39664,\"journal\":{\"name\":\"Revista Espanola de Cirugia Ortopedica y Traumatologia\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-03-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Revista Espanola de Cirugia Ortopedica y Traumatologia\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1016/j.recot.2025.03.002\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Revista Espanola de Cirugia Ortopedica y Traumatologia","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.recot.2025.03.002","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
A PERIOPERATIVE OPTIMIZATION PROGRAM CAN IMPROVE RESULTS AND REDUCE HOSPITAL LENGTH OF STAY IN HIP AND KNEE ARTHROPLASTY: EXPERIENCE IN CHILE.
Background and objective: Perioperative optimization programs have been shown to improve outcomes in total hip and knee arthroplasty; however, the evidence in Latin America is limited. Our objective is to evaluate the impact of implementing a multidisciplinary optimization program in prosthetic surgery at a Latin American center.
Materials and methods: A retrospective cohort study evaluating elective hip and knee prosthesis surgeries between 2016 and 2023 at a private hospital. We compared pre-intervention (2016-2018) and post-intervention (2019-2023) groups following the implementation of a multidisciplinary perioperative optimization program in 2019. The impact of the program on hospital length of stay and 90-day readmission rates was assessed.
Results: A total of 1,462 patients (1,636 surgeries) were included, with 429 surgeries in the pre-intervention group and 1,207 in the post-intervention group. Hospital length of stay decreased from 3.5 to 2.22 days (p<0.05). The 90-day readmission rate decreased from 2.56% to 2.24% (p=0.71), with a significant reduction in knee arthrofibrosis (from 0.9% to 0.2%, p<0.05). The optimization program was the main factor contributing to the reduction in hospital length of stay.
Conclusions: The multidisciplinary perioperative program implemented significantly reduced hospital stay without increasing 90-day readmission rates.Furthermore, it equated outcomes between patients with public and private insurance.
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