Association Between Use of Enhanced Recovery After Surgery Protocol and Postoperative Complications in Total Hip and Knee Arthroplasty in the Postoperative Outcomes Within Enhanced Recovery After Surgery Protocol in Elective Total Hip and Knee Arthroplasty Study (POWER2)
IMPORTANCE: The Enhanced Recovery After Surgery (ERAS) care protocol has been shown to improve outcomes compared with traditional care in certain types of surgery. OBJECTIVE: To assess the association of use of the ERAS protocols with complications in patients undergoing elective total hip arthropla...
Gespeichert in:
| Veröffentlicht in: | Archives of surgery (Chicago. 1960) 2020-04, Vol.155 (4), p.e196024-e196024 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | e196024 |
|---|---|
| container_issue | 4 |
| container_start_page | e196024 |
| container_title | Archives of surgery (Chicago. 1960) |
| container_volume | 155 |
| creator | Ripollés-Melchor, Javier Abad-Motos, Ane Díez-Remesal, Yolanda Aseguinolaza-Pagola, Marta Padin-Barreiro, Lidia Sánchez-Martín, Rubén Logroño-Egea, Margarita Catalá-Bauset, Juan C García-Orallo, Silvia Bisbe, Elvira Martín, Nuria Suárez-de-la-Rica, Alejandro Cuéllar-Martínez, Ana B Gil-Trujillo, Silvia Estupiñán-Jiménez, Juan Carlos Villanova-Baraza, Marta Gil-Lapetra, Cristina Pérez-Sánchez, Pilar Rodríguez-García, Nicolás Ramiro-Ruiz, Alvaro Farré-Tebar, Carla Martínez-García, Alejandro Arauzo-Pérez, Pedro García-Pérez, Cristina Abad-Gurumeta, Alfredo Miñambres-Villar, María A Sánchez-Campos, Alberto Jiménez-López, Ignacio Tena-Guerrero, José M Marín-Peña, Oliver Sánchez-Merchante, Míriam Vicente-Gutiérrez, Ubaldo Cassinello-Ogea, María C Ferrando-Ortolá, Carlos Berges-Gutiérrez, Héctor Fernanz-Antón, Jesús Gómez-Ríos, Manuel A Bordonaba-Bosque, Daniel Ramírez-Rodríguez, José M García-Erce, José Antonio Aldecoa, César |
| description | IMPORTANCE: The Enhanced Recovery After Surgery (ERAS) care protocol has been shown to improve outcomes compared with traditional care in certain types of surgery. OBJECTIVE: To assess the association of use of the ERAS protocols with complications in patients undergoing elective total hip arthroplasty (THA) and total knee arthroplasty (TKA). DESIGN, SETTING, AND PARTICIPANTS: This multicenter, prospective cohort study included patients recruited from 131 centers in Spain from October 22 through December 22, 2018. All consecutive adults scheduled for elective THA or TKA were eligible for inclusion. Patients were stratified between those treated in a self-designated ERAS center (ERAS group) and those treated in a non-ERAS center (non-ERAS group). Data were analyzed from June 15 through September 15, 2019. EXPOSURES: Total hip or knee arthroplasty and perioperative management. Sixteen individual ERAS items were assessed in all included patients, whether they were treated at a center that was part of an established ERAS protocol or not. MAIN OUTCOMES AND MEASURES: The primary outcome was postoperative complications within 30 days after surgery. Secondary outcomes included length of stay and mortality. RESULTS: During the 2-month recruitment period, 6146 patients were included (3580 women [58.2%]; median age, 71 [interquartile range (IQR), 63-76] years). Of these, 680 patients (11.1%) presented with postoperative complications. No differences were found in the number of patients with overall postoperative complications between ERAS and non-ERAS groups (163 [10.2%] vs 517 [11.4%]; odds ratio [OR], 0.89; 95% CI, 0.74-1.07; P = .22). Fewer patients in the ERAS group had moderate to severe complications (73 [4.6%] vs 279 [6.1%]; OR, 0.74; 95% CI, 0.56-0.96; P = .02). The median overall adherence rate with the ERAS protocol was 50.0% (IQR, 43.8%-62.5%), with the rate for ERAS facilities being 68.8% (IQR, 56.2%-81.2%) vs 50.0% (IQR, 37.5%-56.2%) at non-ERAS centers (P |
| doi_str_mv | 10.1001/jamasurg.2019.6024 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7042927</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><ama_id>2760956</ama_id><sourcerecordid>2397677839</sourcerecordid><originalsourceid>FETCH-LOGICAL-a449t-6bce418f37c382f77dbc09f656cc9e760294ee341d163b13ac41ee45095bc6b93</originalsourceid><addsrcrecordid>eNqNks9v0zAUxwMCsWlM3HdAlrhshxb_ilNfkErVMcSkVvuhHSPHeVlTJXawnaL-9zjtVsEu4Ittvc_7vvfsb5KcETwmGJPPa9Uq37vHMcVEjgWm_HVyTImYjAQV9M3hnPKj5NT7NY5rgjFn8l1yxCjmkqX0-NWHqfdW1yrU1qCvEH4BGHTvAdkKzc1KGQ0lugFtN-C2aFoFcOg2lh1uS2eD1bZBypRoaX2wHbiotAE0s23X1Hon61Ft0J0NqkFXdbeDfxgANHVh5WzXKB-2AxJW8EJl0QdtW_DooQ6rSPx3QwPbgN6J_KvybejLLTpfLh7mN_TiffK2Uo2H06f9JLm_nN_NrkbXi2_fZ9PrkeJchpEoNHAyqVim2YRWWVYWGstKpEJrCVn8DskBGCclEawgTGlOAHiKZVpoUUh2knzZ63Z90UKpwQSnmrxzdavcNreqzv-OmHqVP9pNnmFOJc2iwPmTgLM_e_Ahb2uvoWmUAdv7nLKUk0ywdKj16QW6tr0zcbxIyUxk2YQNFN1T2lnvHVSHZgjOB8vlz5bLB8vlg-Vi0sc_xzikPBssAmd7IOYeojQ-kEwF-w3wwOJT</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2397677839</pqid></control><display><type>article</type><title>Association Between Use of Enhanced Recovery After Surgery Protocol and Postoperative Complications in Total Hip and Knee Arthroplasty in the Postoperative Outcomes Within Enhanced Recovery After Surgery Protocol in Elective Total Hip and Knee Arthroplasty Study (POWER2)</title><source>MEDLINE</source><source>American Medical Association Journals</source><source>Alma/SFX Local Collection</source><creator>Ripollés-Melchor, Javier ; Abad-Motos, Ane ; Díez-Remesal, Yolanda ; Aseguinolaza-Pagola, Marta ; Padin-Barreiro, Lidia ; Sánchez-Martín, Rubén ; Logroño-Egea, Margarita ; Catalá-Bauset, Juan C ; García-Orallo, Silvia ; Bisbe, Elvira ; Martín, Nuria ; Suárez-de-la-Rica, Alejandro ; Cuéllar-Martínez, Ana B ; Gil-Trujillo, Silvia ; Estupiñán-Jiménez, Juan Carlos ; Villanova-Baraza, Marta ; Gil-Lapetra, Cristina ; Pérez-Sánchez, Pilar ; Rodríguez-García, Nicolás ; Ramiro-Ruiz, Alvaro ; Farré-Tebar, Carla ; Martínez-García, Alejandro ; Arauzo-Pérez, Pedro ; García-Pérez, Cristina ; Abad-Gurumeta, Alfredo ; Miñambres-Villar, María A ; Sánchez-Campos, Alberto ; Jiménez-López, Ignacio ; Tena-Guerrero, José M ; Marín-Peña, Oliver ; Sánchez-Merchante, Míriam ; Vicente-Gutiérrez, Ubaldo ; Cassinello-Ogea, María C ; Ferrando-Ortolá, Carlos ; Berges-Gutiérrez, Héctor ; Fernanz-Antón, Jesús ; Gómez-Ríos, Manuel A ; Bordonaba-Bosque, Daniel ; Ramírez-Rodríguez, José M ; García-Erce, José Antonio ; Aldecoa, César</creator><creatorcontrib>Ripollés-Melchor, Javier ; Abad-Motos, Ane ; Díez-Remesal, Yolanda ; Aseguinolaza-Pagola, Marta ; Padin-Barreiro, Lidia ; Sánchez-Martín, Rubén ; Logroño-Egea, Margarita ; Catalá-Bauset, Juan C ; García-Orallo, Silvia ; Bisbe, Elvira ; Martín, Nuria ; Suárez-de-la-Rica, Alejandro ; Cuéllar-Martínez, Ana B ; Gil-Trujillo, Silvia ; Estupiñán-Jiménez, Juan Carlos ; Villanova-Baraza, Marta ; Gil-Lapetra, Cristina ; Pérez-Sánchez, Pilar ; Rodríguez-García, Nicolás ; Ramiro-Ruiz, Alvaro ; Farré-Tebar, Carla ; Martínez-García, Alejandro ; Arauzo-Pérez, Pedro ; García-Pérez, Cristina ; Abad-Gurumeta, Alfredo ; Miñambres-Villar, María A ; Sánchez-Campos, Alberto ; Jiménez-López, Ignacio ; Tena-Guerrero, José M ; Marín-Peña, Oliver ; Sánchez-Merchante, Míriam ; Vicente-Gutiérrez, Ubaldo ; Cassinello-Ogea, María C ; Ferrando-Ortolá, Carlos ; Berges-Gutiérrez, Héctor ; Fernanz-Antón, Jesús ; Gómez-Ríos, Manuel A ; Bordonaba-Bosque, Daniel ; Ramírez-Rodríguez, José M ; García-Erce, José Antonio ; Aldecoa, César ; Postoperative Outcomes Within Enhanced Recovery After Surgery Protocol in Elective Total Hip and Knee Arthroplasty (POWER2) Study Investigators Group for the Spanish Perioperative Audit and Research Network (REDGERM) ; for the Postoperative Outcomes Within Enhanced Recovery After Surgery Protocol in Elective Total Hip and Knee Arthroplasty (POWER2) Study Investigators Group for the Spanish Perioperative Audit and Research Network (REDGERM)</creatorcontrib><description>IMPORTANCE: The Enhanced Recovery After Surgery (ERAS) care protocol has been shown to improve outcomes compared with traditional care in certain types of surgery. OBJECTIVE: To assess the association of use of the ERAS protocols with complications in patients undergoing elective total hip arthroplasty (THA) and total knee arthroplasty (TKA). DESIGN, SETTING, AND PARTICIPANTS: This multicenter, prospective cohort study included patients recruited from 131 centers in Spain from October 22 through December 22, 2018. All consecutive adults scheduled for elective THA or TKA were eligible for inclusion. Patients were stratified between those treated in a self-designated ERAS center (ERAS group) and those treated in a non-ERAS center (non-ERAS group). Data were analyzed from June 15 through September 15, 2019. EXPOSURES: Total hip or knee arthroplasty and perioperative management. Sixteen individual ERAS items were assessed in all included patients, whether they were treated at a center that was part of an established ERAS protocol or not. MAIN OUTCOMES AND MEASURES: The primary outcome was postoperative complications within 30 days after surgery. Secondary outcomes included length of stay and mortality. RESULTS: During the 2-month recruitment period, 6146 patients were included (3580 women [58.2%]; median age, 71 [interquartile range (IQR), 63-76] years). Of these, 680 patients (11.1%) presented with postoperative complications. No differences were found in the number of patients with overall postoperative complications between ERAS and non-ERAS groups (163 [10.2%] vs 517 [11.4%]; odds ratio [OR], 0.89; 95% CI, 0.74-1.07; P = .22). Fewer patients in the ERAS group had moderate to severe complications (73 [4.6%] vs 279 [6.1%]; OR, 0.74; 95% CI, 0.56-0.96; P = .02). The median overall adherence rate with the ERAS protocol was 50.0% (IQR, 43.8%-62.5%), with the rate for ERAS facilities being 68.8% (IQR, 56.2%-81.2%) vs 50.0% (IQR, 37.5%-56.2%) at non-ERAS centers (P < .001). Among the patients with the highest and lowest quartiles of adherence to ERAS components, the patients with the highest adherence had fewer overall postoperative complications (144 [10.6%] vs 270 [13.0%]; OR, 0.80; 95% CI, 0.64-0.99; P < .001) and moderate to severe postoperative complications (59 [4.4%] vs 143 [6.9%]; OR, 0.62; 95% CI, 0.45-0.84; P < .001) and shorter median length of hospital stay (4 [IQR, 3-5] vs 5 [IQR, 4-6] days; OR, 0.97; 95% CI, 0.96-0.99; P < .001). CONCLUSIONS AND RELEVANCE: An increase in adherence to the ERAS program was associated with a decrease in postoperative complications, although only a few ERAS items were individually associated with improved outcomes.</description><identifier>ISSN: 2168-6254</identifier><identifier>EISSN: 2168-6262</identifier><identifier>DOI: 10.1001/jamasurg.2019.6024</identifier><identifier>PMID: 32049352</identifier><language>eng</language><publisher>United States: American Medical Association</publisher><subject>Aged ; Arthroplasty, Replacement, Hip ; Arthroplasty, Replacement, Knee ; Clinical outcomes ; Elective surgery ; Elective Surgical Procedures ; Enhanced Recovery After Surgery ; Female ; Hip joint ; Humans ; Joint surgery ; Length of Stay - statistics & numerical data ; Male ; Middle Aged ; Online First ; Online Only ; Original Investigation ; Postoperative Complications - epidemiology ; Postoperative period ; Prospective Studies ; Recovery (Medical) ; Surgery ; United States - epidemiology</subject><ispartof>Archives of surgery (Chicago. 1960), 2020-04, Vol.155 (4), p.e196024-e196024</ispartof><rights>Copyright American Medical Association Apr 2020</rights><rights>Copyright 2020 American Medical Association. All Rights Reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a449t-6bce418f37c382f77dbc09f656cc9e760294ee341d163b13ac41ee45095bc6b93</citedby><cites>FETCH-LOGICAL-a449t-6bce418f37c382f77dbc09f656cc9e760294ee341d163b13ac41ee45095bc6b93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://jamanetwork.com/journals/jamasurgery/articlepdf/10.1001/jamasurg.2019.6024$$EPDF$$P50$$Gama$$H</linktopdf><linktohtml>$$Uhttps://jamanetwork.com/journals/jamasurgery/fullarticle/10.1001/jamasurg.2019.6024$$EHTML$$P50$$Gama$$H</linktohtml><link.rule.ids>64,230,314,777,781,882,3327,27905,27906,76238,76241</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32049352$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ripollés-Melchor, Javier</creatorcontrib><creatorcontrib>Abad-Motos, Ane</creatorcontrib><creatorcontrib>Díez-Remesal, Yolanda</creatorcontrib><creatorcontrib>Aseguinolaza-Pagola, Marta</creatorcontrib><creatorcontrib>Padin-Barreiro, Lidia</creatorcontrib><creatorcontrib>Sánchez-Martín, Rubén</creatorcontrib><creatorcontrib>Logroño-Egea, Margarita</creatorcontrib><creatorcontrib>Catalá-Bauset, Juan C</creatorcontrib><creatorcontrib>García-Orallo, Silvia</creatorcontrib><creatorcontrib>Bisbe, Elvira</creatorcontrib><creatorcontrib>Martín, Nuria</creatorcontrib><creatorcontrib>Suárez-de-la-Rica, Alejandro</creatorcontrib><creatorcontrib>Cuéllar-Martínez, Ana B</creatorcontrib><creatorcontrib>Gil-Trujillo, Silvia</creatorcontrib><creatorcontrib>Estupiñán-Jiménez, Juan Carlos</creatorcontrib><creatorcontrib>Villanova-Baraza, Marta</creatorcontrib><creatorcontrib>Gil-Lapetra, Cristina</creatorcontrib><creatorcontrib>Pérez-Sánchez, Pilar</creatorcontrib><creatorcontrib>Rodríguez-García, Nicolás</creatorcontrib><creatorcontrib>Ramiro-Ruiz, Alvaro</creatorcontrib><creatorcontrib>Farré-Tebar, Carla</creatorcontrib><creatorcontrib>Martínez-García, Alejandro</creatorcontrib><creatorcontrib>Arauzo-Pérez, Pedro</creatorcontrib><creatorcontrib>García-Pérez, Cristina</creatorcontrib><creatorcontrib>Abad-Gurumeta, Alfredo</creatorcontrib><creatorcontrib>Miñambres-Villar, María A</creatorcontrib><creatorcontrib>Sánchez-Campos, Alberto</creatorcontrib><creatorcontrib>Jiménez-López, Ignacio</creatorcontrib><creatorcontrib>Tena-Guerrero, José M</creatorcontrib><creatorcontrib>Marín-Peña, Oliver</creatorcontrib><creatorcontrib>Sánchez-Merchante, Míriam</creatorcontrib><creatorcontrib>Vicente-Gutiérrez, Ubaldo</creatorcontrib><creatorcontrib>Cassinello-Ogea, María C</creatorcontrib><creatorcontrib>Ferrando-Ortolá, Carlos</creatorcontrib><creatorcontrib>Berges-Gutiérrez, Héctor</creatorcontrib><creatorcontrib>Fernanz-Antón, Jesús</creatorcontrib><creatorcontrib>Gómez-Ríos, Manuel A</creatorcontrib><creatorcontrib>Bordonaba-Bosque, Daniel</creatorcontrib><creatorcontrib>Ramírez-Rodríguez, José M</creatorcontrib><creatorcontrib>García-Erce, José Antonio</creatorcontrib><creatorcontrib>Aldecoa, César</creatorcontrib><creatorcontrib>Postoperative Outcomes Within Enhanced Recovery After Surgery Protocol in Elective Total Hip and Knee Arthroplasty (POWER2) Study Investigators Group for the Spanish Perioperative Audit and Research Network (REDGERM)</creatorcontrib><creatorcontrib>for the Postoperative Outcomes Within Enhanced Recovery After Surgery Protocol in Elective Total Hip and Knee Arthroplasty (POWER2) Study Investigators Group for the Spanish Perioperative Audit and Research Network (REDGERM)</creatorcontrib><title>Association Between Use of Enhanced Recovery After Surgery Protocol and Postoperative Complications in Total Hip and Knee Arthroplasty in the Postoperative Outcomes Within Enhanced Recovery After Surgery Protocol in Elective Total Hip and Knee Arthroplasty Study (POWER2)</title><title>Archives of surgery (Chicago. 1960)</title><addtitle>JAMA Surg</addtitle><description>IMPORTANCE: The Enhanced Recovery After Surgery (ERAS) care protocol has been shown to improve outcomes compared with traditional care in certain types of surgery. OBJECTIVE: To assess the association of use of the ERAS protocols with complications in patients undergoing elective total hip arthroplasty (THA) and total knee arthroplasty (TKA). DESIGN, SETTING, AND PARTICIPANTS: This multicenter, prospective cohort study included patients recruited from 131 centers in Spain from October 22 through December 22, 2018. All consecutive adults scheduled for elective THA or TKA were eligible for inclusion. Patients were stratified between those treated in a self-designated ERAS center (ERAS group) and those treated in a non-ERAS center (non-ERAS group). Data were analyzed from June 15 through September 15, 2019. EXPOSURES: Total hip or knee arthroplasty and perioperative management. Sixteen individual ERAS items were assessed in all included patients, whether they were treated at a center that was part of an established ERAS protocol or not. MAIN OUTCOMES AND MEASURES: The primary outcome was postoperative complications within 30 days after surgery. Secondary outcomes included length of stay and mortality. RESULTS: During the 2-month recruitment period, 6146 patients were included (3580 women [58.2%]; median age, 71 [interquartile range (IQR), 63-76] years). Of these, 680 patients (11.1%) presented with postoperative complications. No differences were found in the number of patients with overall postoperative complications between ERAS and non-ERAS groups (163 [10.2%] vs 517 [11.4%]; odds ratio [OR], 0.89; 95% CI, 0.74-1.07; P = .22). Fewer patients in the ERAS group had moderate to severe complications (73 [4.6%] vs 279 [6.1%]; OR, 0.74; 95% CI, 0.56-0.96; P = .02). The median overall adherence rate with the ERAS protocol was 50.0% (IQR, 43.8%-62.5%), with the rate for ERAS facilities being 68.8% (IQR, 56.2%-81.2%) vs 50.0% (IQR, 37.5%-56.2%) at non-ERAS centers (P < .001). Among the patients with the highest and lowest quartiles of adherence to ERAS components, the patients with the highest adherence had fewer overall postoperative complications (144 [10.6%] vs 270 [13.0%]; OR, 0.80; 95% CI, 0.64-0.99; P < .001) and moderate to severe postoperative complications (59 [4.4%] vs 143 [6.9%]; OR, 0.62; 95% CI, 0.45-0.84; P < .001) and shorter median length of hospital stay (4 [IQR, 3-5] vs 5 [IQR, 4-6] days; OR, 0.97; 95% CI, 0.96-0.99; P < .001). CONCLUSIONS AND RELEVANCE: An increase in adherence to the ERAS program was associated with a decrease in postoperative complications, although only a few ERAS items were individually associated with improved outcomes.</description><subject>Aged</subject><subject>Arthroplasty, Replacement, Hip</subject><subject>Arthroplasty, Replacement, Knee</subject><subject>Clinical outcomes</subject><subject>Elective surgery</subject><subject>Elective Surgical Procedures</subject><subject>Enhanced Recovery After Surgery</subject><subject>Female</subject><subject>Hip joint</subject><subject>Humans</subject><subject>Joint surgery</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Online First</subject><subject>Online Only</subject><subject>Original Investigation</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative period</subject><subject>Prospective Studies</subject><subject>Recovery (Medical)</subject><subject>Surgery</subject><subject>United States - epidemiology</subject><issn>2168-6254</issn><issn>2168-6262</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNks9v0zAUxwMCsWlM3HdAlrhshxb_ilNfkErVMcSkVvuhHSPHeVlTJXawnaL-9zjtVsEu4Ittvc_7vvfsb5KcETwmGJPPa9Uq37vHMcVEjgWm_HVyTImYjAQV9M3hnPKj5NT7NY5rgjFn8l1yxCjmkqX0-NWHqfdW1yrU1qCvEH4BGHTvAdkKzc1KGQ0lugFtN-C2aFoFcOg2lh1uS2eD1bZBypRoaX2wHbiotAE0s23X1Hon61Ft0J0NqkFXdbeDfxgANHVh5WzXKB-2AxJW8EJl0QdtW_DooQ6rSPx3QwPbgN6J_KvybejLLTpfLh7mN_TiffK2Uo2H06f9JLm_nN_NrkbXi2_fZ9PrkeJchpEoNHAyqVim2YRWWVYWGstKpEJrCVn8DskBGCclEawgTGlOAHiKZVpoUUh2knzZ63Z90UKpwQSnmrxzdavcNreqzv-OmHqVP9pNnmFOJc2iwPmTgLM_e_Ahb2uvoWmUAdv7nLKUk0ywdKj16QW6tr0zcbxIyUxk2YQNFN1T2lnvHVSHZgjOB8vlz5bLB8vlg-Vi0sc_xzikPBssAmd7IOYeojQ-kEwF-w3wwOJT</recordid><startdate>20200401</startdate><enddate>20200401</enddate><creator>Ripollés-Melchor, Javier</creator><creator>Abad-Motos, Ane</creator><creator>Díez-Remesal, Yolanda</creator><creator>Aseguinolaza-Pagola, Marta</creator><creator>Padin-Barreiro, Lidia</creator><creator>Sánchez-Martín, Rubén</creator><creator>Logroño-Egea, Margarita</creator><creator>Catalá-Bauset, Juan C</creator><creator>García-Orallo, Silvia</creator><creator>Bisbe, Elvira</creator><creator>Martín, Nuria</creator><creator>Suárez-de-la-Rica, Alejandro</creator><creator>Cuéllar-Martínez, Ana B</creator><creator>Gil-Trujillo, Silvia</creator><creator>Estupiñán-Jiménez, Juan Carlos</creator><creator>Villanova-Baraza, Marta</creator><creator>Gil-Lapetra, Cristina</creator><creator>Pérez-Sánchez, Pilar</creator><creator>Rodríguez-García, Nicolás</creator><creator>Ramiro-Ruiz, Alvaro</creator><creator>Farré-Tebar, Carla</creator><creator>Martínez-García, Alejandro</creator><creator>Arauzo-Pérez, Pedro</creator><creator>García-Pérez, Cristina</creator><creator>Abad-Gurumeta, Alfredo</creator><creator>Miñambres-Villar, María A</creator><creator>Sánchez-Campos, Alberto</creator><creator>Jiménez-López, Ignacio</creator><creator>Tena-Guerrero, José M</creator><creator>Marín-Peña, Oliver</creator><creator>Sánchez-Merchante, Míriam</creator><creator>Vicente-Gutiérrez, Ubaldo</creator><creator>Cassinello-Ogea, María C</creator><creator>Ferrando-Ortolá, Carlos</creator><creator>Berges-Gutiérrez, Héctor</creator><creator>Fernanz-Antón, Jesús</creator><creator>Gómez-Ríos, Manuel A</creator><creator>Bordonaba-Bosque, Daniel</creator><creator>Ramírez-Rodríguez, José M</creator><creator>García-Erce, José Antonio</creator><creator>Aldecoa, César</creator><general>American Medical Association</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20200401</creationdate><title>Association Between Use of Enhanced Recovery After Surgery Protocol and Postoperative Complications in Total Hip and Knee Arthroplasty in the Postoperative Outcomes Within Enhanced Recovery After Surgery Protocol in Elective Total Hip and Knee Arthroplasty Study (POWER2)</title><author>Ripollés-Melchor, Javier ; Abad-Motos, Ane ; Díez-Remesal, Yolanda ; Aseguinolaza-Pagola, Marta ; Padin-Barreiro, Lidia ; Sánchez-Martín, Rubén ; Logroño-Egea, Margarita ; Catalá-Bauset, Juan C ; García-Orallo, Silvia ; Bisbe, Elvira ; Martín, Nuria ; Suárez-de-la-Rica, Alejandro ; Cuéllar-Martínez, Ana B ; Gil-Trujillo, Silvia ; Estupiñán-Jiménez, Juan Carlos ; Villanova-Baraza, Marta ; Gil-Lapetra, Cristina ; Pérez-Sánchez, Pilar ; Rodríguez-García, Nicolás ; Ramiro-Ruiz, Alvaro ; Farré-Tebar, Carla ; Martínez-García, Alejandro ; Arauzo-Pérez, Pedro ; García-Pérez, Cristina ; Abad-Gurumeta, Alfredo ; Miñambres-Villar, María A ; Sánchez-Campos, Alberto ; Jiménez-López, Ignacio ; Tena-Guerrero, José M ; Marín-Peña, Oliver ; Sánchez-Merchante, Míriam ; Vicente-Gutiérrez, Ubaldo ; Cassinello-Ogea, María C ; Ferrando-Ortolá, Carlos ; Berges-Gutiérrez, Héctor ; Fernanz-Antón, Jesús ; Gómez-Ríos, Manuel A ; Bordonaba-Bosque, Daniel ; Ramírez-Rodríguez, José M ; García-Erce, José Antonio ; Aldecoa, César</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a449t-6bce418f37c382f77dbc09f656cc9e760294ee341d163b13ac41ee45095bc6b93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Aged</topic><topic>Arthroplasty, Replacement, Hip</topic><topic>Arthroplasty, Replacement, Knee</topic><topic>Clinical outcomes</topic><topic>Elective surgery</topic><topic>Elective Surgical Procedures</topic><topic>Enhanced Recovery After Surgery</topic><topic>Female</topic><topic>Hip joint</topic><topic>Humans</topic><topic>Joint surgery</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Online First</topic><topic>Online Only</topic><topic>Original Investigation</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative period</topic><topic>Prospective Studies</topic><topic>Recovery (Medical)</topic><topic>Surgery</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ripollés-Melchor, Javier</creatorcontrib><creatorcontrib>Abad-Motos, Ane</creatorcontrib><creatorcontrib>Díez-Remesal, Yolanda</creatorcontrib><creatorcontrib>Aseguinolaza-Pagola, Marta</creatorcontrib><creatorcontrib>Padin-Barreiro, Lidia</creatorcontrib><creatorcontrib>Sánchez-Martín, Rubén</creatorcontrib><creatorcontrib>Logroño-Egea, Margarita</creatorcontrib><creatorcontrib>Catalá-Bauset, Juan C</creatorcontrib><creatorcontrib>García-Orallo, Silvia</creatorcontrib><creatorcontrib>Bisbe, Elvira</creatorcontrib><creatorcontrib>Martín, Nuria</creatorcontrib><creatorcontrib>Suárez-de-la-Rica, Alejandro</creatorcontrib><creatorcontrib>Cuéllar-Martínez, Ana B</creatorcontrib><creatorcontrib>Gil-Trujillo, Silvia</creatorcontrib><creatorcontrib>Estupiñán-Jiménez, Juan Carlos</creatorcontrib><creatorcontrib>Villanova-Baraza, Marta</creatorcontrib><creatorcontrib>Gil-Lapetra, Cristina</creatorcontrib><creatorcontrib>Pérez-Sánchez, Pilar</creatorcontrib><creatorcontrib>Rodríguez-García, Nicolás</creatorcontrib><creatorcontrib>Ramiro-Ruiz, Alvaro</creatorcontrib><creatorcontrib>Farré-Tebar, Carla</creatorcontrib><creatorcontrib>Martínez-García, Alejandro</creatorcontrib><creatorcontrib>Arauzo-Pérez, Pedro</creatorcontrib><creatorcontrib>García-Pérez, Cristina</creatorcontrib><creatorcontrib>Abad-Gurumeta, Alfredo</creatorcontrib><creatorcontrib>Miñambres-Villar, María A</creatorcontrib><creatorcontrib>Sánchez-Campos, Alberto</creatorcontrib><creatorcontrib>Jiménez-López, Ignacio</creatorcontrib><creatorcontrib>Tena-Guerrero, José M</creatorcontrib><creatorcontrib>Marín-Peña, Oliver</creatorcontrib><creatorcontrib>Sánchez-Merchante, Míriam</creatorcontrib><creatorcontrib>Vicente-Gutiérrez, Ubaldo</creatorcontrib><creatorcontrib>Cassinello-Ogea, María C</creatorcontrib><creatorcontrib>Ferrando-Ortolá, Carlos</creatorcontrib><creatorcontrib>Berges-Gutiérrez, Héctor</creatorcontrib><creatorcontrib>Fernanz-Antón, Jesús</creatorcontrib><creatorcontrib>Gómez-Ríos, Manuel A</creatorcontrib><creatorcontrib>Bordonaba-Bosque, Daniel</creatorcontrib><creatorcontrib>Ramírez-Rodríguez, José M</creatorcontrib><creatorcontrib>García-Erce, José Antonio</creatorcontrib><creatorcontrib>Aldecoa, César</creatorcontrib><creatorcontrib>Postoperative Outcomes Within Enhanced Recovery After Surgery Protocol in Elective Total Hip and Knee Arthroplasty (POWER2) Study Investigators Group for the Spanish Perioperative Audit and Research Network (REDGERM)</creatorcontrib><creatorcontrib>for the Postoperative Outcomes Within Enhanced Recovery After Surgery Protocol in Elective Total Hip and Knee Arthroplasty (POWER2) Study Investigators Group for the Spanish Perioperative Audit and Research Network (REDGERM)</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Archives of surgery (Chicago. 1960)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ripollés-Melchor, Javier</au><au>Abad-Motos, Ane</au><au>Díez-Remesal, Yolanda</au><au>Aseguinolaza-Pagola, Marta</au><au>Padin-Barreiro, Lidia</au><au>Sánchez-Martín, Rubén</au><au>Logroño-Egea, Margarita</au><au>Catalá-Bauset, Juan C</au><au>García-Orallo, Silvia</au><au>Bisbe, Elvira</au><au>Martín, Nuria</au><au>Suárez-de-la-Rica, Alejandro</au><au>Cuéllar-Martínez, Ana B</au><au>Gil-Trujillo, Silvia</au><au>Estupiñán-Jiménez, Juan Carlos</au><au>Villanova-Baraza, Marta</au><au>Gil-Lapetra, Cristina</au><au>Pérez-Sánchez, Pilar</au><au>Rodríguez-García, Nicolás</au><au>Ramiro-Ruiz, Alvaro</au><au>Farré-Tebar, Carla</au><au>Martínez-García, Alejandro</au><au>Arauzo-Pérez, Pedro</au><au>García-Pérez, Cristina</au><au>Abad-Gurumeta, Alfredo</au><au>Miñambres-Villar, María A</au><au>Sánchez-Campos, Alberto</au><au>Jiménez-López, Ignacio</au><au>Tena-Guerrero, José M</au><au>Marín-Peña, Oliver</au><au>Sánchez-Merchante, Míriam</au><au>Vicente-Gutiérrez, Ubaldo</au><au>Cassinello-Ogea, María C</au><au>Ferrando-Ortolá, Carlos</au><au>Berges-Gutiérrez, Héctor</au><au>Fernanz-Antón, Jesús</au><au>Gómez-Ríos, Manuel A</au><au>Bordonaba-Bosque, Daniel</au><au>Ramírez-Rodríguez, José M</au><au>García-Erce, José Antonio</au><au>Aldecoa, César</au><aucorp>Postoperative Outcomes Within Enhanced Recovery After Surgery Protocol in Elective Total Hip and Knee Arthroplasty (POWER2) Study Investigators Group for the Spanish Perioperative Audit and Research Network (REDGERM)</aucorp><aucorp>for the Postoperative Outcomes Within Enhanced Recovery After Surgery Protocol in Elective Total Hip and Knee Arthroplasty (POWER2) Study Investigators Group for the Spanish Perioperative Audit and Research Network (REDGERM)</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association Between Use of Enhanced Recovery After Surgery Protocol and Postoperative Complications in Total Hip and Knee Arthroplasty in the Postoperative Outcomes Within Enhanced Recovery After Surgery Protocol in Elective Total Hip and Knee Arthroplasty Study (POWER2)</atitle><jtitle>Archives of surgery (Chicago. 1960)</jtitle><addtitle>JAMA Surg</addtitle><date>2020-04-01</date><risdate>2020</risdate><volume>155</volume><issue>4</issue><spage>e196024</spage><epage>e196024</epage><pages>e196024-e196024</pages><issn>2168-6254</issn><eissn>2168-6262</eissn><abstract>IMPORTANCE: The Enhanced Recovery After Surgery (ERAS) care protocol has been shown to improve outcomes compared with traditional care in certain types of surgery. OBJECTIVE: To assess the association of use of the ERAS protocols with complications in patients undergoing elective total hip arthroplasty (THA) and total knee arthroplasty (TKA). DESIGN, SETTING, AND PARTICIPANTS: This multicenter, prospective cohort study included patients recruited from 131 centers in Spain from October 22 through December 22, 2018. All consecutive adults scheduled for elective THA or TKA were eligible for inclusion. Patients were stratified between those treated in a self-designated ERAS center (ERAS group) and those treated in a non-ERAS center (non-ERAS group). Data were analyzed from June 15 through September 15, 2019. EXPOSURES: Total hip or knee arthroplasty and perioperative management. Sixteen individual ERAS items were assessed in all included patients, whether they were treated at a center that was part of an established ERAS protocol or not. MAIN OUTCOMES AND MEASURES: The primary outcome was postoperative complications within 30 days after surgery. Secondary outcomes included length of stay and mortality. RESULTS: During the 2-month recruitment period, 6146 patients were included (3580 women [58.2%]; median age, 71 [interquartile range (IQR), 63-76] years). Of these, 680 patients (11.1%) presented with postoperative complications. No differences were found in the number of patients with overall postoperative complications between ERAS and non-ERAS groups (163 [10.2%] vs 517 [11.4%]; odds ratio [OR], 0.89; 95% CI, 0.74-1.07; P = .22). Fewer patients in the ERAS group had moderate to severe complications (73 [4.6%] vs 279 [6.1%]; OR, 0.74; 95% CI, 0.56-0.96; P = .02). The median overall adherence rate with the ERAS protocol was 50.0% (IQR, 43.8%-62.5%), with the rate for ERAS facilities being 68.8% (IQR, 56.2%-81.2%) vs 50.0% (IQR, 37.5%-56.2%) at non-ERAS centers (P < .001). Among the patients with the highest and lowest quartiles of adherence to ERAS components, the patients with the highest adherence had fewer overall postoperative complications (144 [10.6%] vs 270 [13.0%]; OR, 0.80; 95% CI, 0.64-0.99; P < .001) and moderate to severe postoperative complications (59 [4.4%] vs 143 [6.9%]; OR, 0.62; 95% CI, 0.45-0.84; P < .001) and shorter median length of hospital stay (4 [IQR, 3-5] vs 5 [IQR, 4-6] days; OR, 0.97; 95% CI, 0.96-0.99; P < .001). CONCLUSIONS AND RELEVANCE: An increase in adherence to the ERAS program was associated with a decrease in postoperative complications, although only a few ERAS items were individually associated with improved outcomes.</abstract><cop>United States</cop><pub>American Medical Association</pub><pmid>32049352</pmid><doi>10.1001/jamasurg.2019.6024</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2168-6254 |
| ispartof | Archives of surgery (Chicago. 1960), 2020-04, Vol.155 (4), p.e196024-e196024 |
| issn | 2168-6254 2168-6262 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7042927 |
| source | MEDLINE; American Medical Association Journals; Alma/SFX Local Collection |
| subjects | Aged Arthroplasty, Replacement, Hip Arthroplasty, Replacement, Knee Clinical outcomes Elective surgery Elective Surgical Procedures Enhanced Recovery After Surgery Female Hip joint Humans Joint surgery Length of Stay - statistics & numerical data Male Middle Aged Online First Online Only Original Investigation Postoperative Complications - epidemiology Postoperative period Prospective Studies Recovery (Medical) Surgery United States - epidemiology |
| title | Association Between Use of Enhanced Recovery After Surgery Protocol and Postoperative Complications in Total Hip and Knee Arthroplasty in the Postoperative Outcomes Within Enhanced Recovery After Surgery Protocol in Elective Total Hip and Knee Arthroplasty Study (POWER2) |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-19T01%3A27%3A28IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Association%20Between%20Use%20of%20Enhanced%20Recovery%20After%20Surgery%20Protocol%20and%20Postoperative%20Complications%20in%20Total%20Hip%20and%20Knee%20Arthroplasty%20in%20the%20Postoperative%20Outcomes%20Within%20Enhanced%20Recovery%20After%20Surgery%20Protocol%20in%20Elective%20Total%20Hip%20and%20Knee%20Arthroplasty%20Study%20(POWER2)&rft.jtitle=Archives%20of%20surgery%20(Chicago.%201960)&rft.au=Ripoll%C3%A9s-Melchor,%20Javier&rft.aucorp=Postoperative%20Outcomes%20Within%20Enhanced%20Recovery%20After%20Surgery%20Protocol%20in%20Elective%20Total%20Hip%20and%20Knee%20Arthroplasty%20(POWER2)%20Study%20Investigators%20Group%20for%20the%20Spanish%20Perioperative%20Audit%20and%20Research%20Network%20(REDGERM)&rft.date=2020-04-01&rft.volume=155&rft.issue=4&rft.spage=e196024&rft.epage=e196024&rft.pages=e196024-e196024&rft.issn=2168-6254&rft.eissn=2168-6262&rft_id=info:doi/10.1001/jamasurg.2019.6024&rft_dat=%3Cproquest_pubme%3E2397677839%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2397677839&rft_id=info:pmid/32049352&rft_ama_id=2760956&rfr_iscdi=true |