在初级部和膝关节关节整形术中非选择性增强恢复途径:倾向性得分对安全性和有效性进行了匹配分析
Amr Selim1,2, Deepak Menon3,4, Eleanor Rouse3
1Robert Jones & Agnes Hunt Orthopaedic Hospital, Oswestry, SY10 7AG, UK. amr.selim@nhs.net.
Arthroplasty (London, England)
|February 8, 2026
概括
手术后增强恢复 (ERAS) 显著减少了关节和膝关节置换患者的停留时间. 这种标准化的ERAS协议被证明是安全有效的,可以节省大量的成本,但不会增加不良事件.
科学领域:
- 整形外科手术 整形外科手术
- 外科手术的结果
- 患者恢复协议 患者恢复协议
背景情况:
- 手术后增强康复 (ERAS) 协议旨在改善康复,减少住院时间,降低关节关节整形手术的成本.
- 一个普遍的,标准化的,非选择性的ERAS服务被实施在一个高容量的三级整形中心,用于初级关节和膝关节关节整形.
研究的目的:
- 调查普遍标准化非选择性ERAS服务的安全性和有效性.
- 评估ERAS对停留时间,再入院,感染和膝关节整形术死亡率的影响.
主要方法:
- 一项比较研究将1811名ERAS患者与3549名标准护理患者 (2:1比) 根据程序,年龄,性别,ASA等级和BMI进行了匹配.
- 测量的主要结果包括停留时间 (LOS),30天再入院,感染率 (整体,表面,深度) 和30日和90日死亡率.
主要成果:
- 与标准护理组 (3天) 相比,ERAS组的中位数LOS (1天) 显著较短 (P < 0.001).
- 虽然ERAS组的再接收率,感染率和死亡率较低,但这些差异在统计学上并不显著.
- 据估计,每名患者的成本减少了718.60英,主要是由于减少的LOS. 对80岁以上患者的亚组分析显示,统计学上显著的LOS减少了3天.
结论:
- 非选择性ERAS是安全有效的减少LOS在初级全关节和全膝关节关节整形手术患者在不同的年龄组和并发症状态.
- 实施ERAS带来了减少LOS和潜在的成本节约,并趋向于降低外科手术期间的发病率和死亡率,尽管在统计学上并不显著.
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