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Overnight joint replacement surgery: a pilot Australian study
Background With a stretched healthcare system and elective surgery backlog, measures to improve efficiency and decrease costs associated with surgical procedures need to be prioritized. This study compares the benefits of multi‐disciplinary involvement in an enhanced recovery after surgery (ERAS) pr...
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| Published in: | ANZ journal of surgery 2022-10, Vol.92 (10), p.2683-2687 |
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| Main Authors: | , , , , |
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| cites | cdi_FETCH-LOGICAL-c4437-d7dd9eeb24df9ce0408f9cdde42dd41380c48ede9d2f4ab3c5af5920a6a6df9e3 |
| container_end_page | 2687 |
| container_issue | 10 |
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| container_title | ANZ journal of surgery |
| container_volume | 92 |
| creator | Qurashi, Sol Chinnappa, Jason Aktas, Sam Dabboussi, Abdul Majid Rahman, Md Bayzidur |
| description | Background
With a stretched healthcare system and elective surgery backlog, measures to improve efficiency and decrease costs associated with surgical procedures need to be prioritized. This study compares the benefits of multi‐disciplinary involvement in an enhanced recovery after surgery (ERAS) protocol‐led overnight model following total hip replacement (THR) and total knee replacement (TKR).
Methods
Patients in each of two private hospitals undergoing THR or TKR were prospectively enrolled. One hospital (Overnight) was fully committed to the ERAS protocol implementation on all levels and formed the treatment group while in the other hospital (control), patients only had the anaesthetic and operative procedure as part of the ERAS protocol but did not follow the perioperative measures of the protocol. Outcomes on hospital length of stay (LOS), inpatient rehabilitation, functional outcomes, satisfaction, adverse events and readmission rates were investigated.
Results
Median LOS in the Overnight group was significantly smaller than in the control group (1 vs. 3 days, P |
| doi_str_mv | 10.1111/ans.17977 |
| format | article |
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With a stretched healthcare system and elective surgery backlog, measures to improve efficiency and decrease costs associated with surgical procedures need to be prioritized. This study compares the benefits of multi‐disciplinary involvement in an enhanced recovery after surgery (ERAS) protocol‐led overnight model following total hip replacement (THR) and total knee replacement (TKR).
Methods
Patients in each of two private hospitals undergoing THR or TKR were prospectively enrolled. One hospital (Overnight) was fully committed to the ERAS protocol implementation on all levels and formed the treatment group while in the other hospital (control), patients only had the anaesthetic and operative procedure as part of the ERAS protocol but did not follow the perioperative measures of the protocol. Outcomes on hospital length of stay (LOS), inpatient rehabilitation, functional outcomes, satisfaction, adverse events and readmission rates were investigated.
Results
Median LOS in the Overnight group was significantly smaller than in the control group (1 vs. 3 days, P < 0.0001). The Overnight group had lower rates of inpatient rehabilitation utilization (4% vs. 41.2%, P < 0.0001), similar improvements in functional hip and knee scores and no increased rate of adverse events or readmission. All patients in both groups were satisfied with their treatment.
Conclusion
Overnight THR and TKR can safely be performed in the majority of patients, with a multi‐disciplinary approach protocol and involvement of all perioperative stakeholders.
There are significant public and private elective surgery backlogs as a result of the pandemic measures needed for COVID‐19. Overnight short stay joint replacement is safe and feasible with similar patient functional outcomes as well as satisfaction when an ERAS protocol is implemented with the involvement of all stakeholders. Overnight short‐stay joint replacement surgery will save costs and hospital resources, therefore allowing more patients to undergo surgery within a defined budget.</description><identifier>ISSN: 1445-1433</identifier><identifier>EISSN: 1445-2197</identifier><identifier>DOI: 10.1111/ans.17977</identifier><identifier>PMID: 36221212</identifier><language>eng</language><publisher>Melbourne: John Wiley & Sons Australia, Ltd</publisher><subject>Arthroplasty, Replacement, Hip ; Arthroplasty, Replacement, Knee - rehabilitation ; Australia ; Biomedical materials ; enhanced recovery after surgery ; health care rationing ; health economics ; Health services ; Hip ; Humans ; Knee ; Knee Joint - surgery ; Length of Stay ; Orthopaedic implants ; Orthopaedic Surgery ; Patients ; Recovery (Medical) ; Rehabilitation ; Surgery ; Total hip arthroplasty ; total hip replacement ; total knee replacement</subject><ispartof>ANZ journal of surgery, 2022-10, Vol.92 (10), p.2683-2687</ispartof><rights>2022 The Authors. published by John Wiley & Sons Australia, Ltd on behalf of Royal Australasian College of Surgeons.</rights><rights>2022 The Authors. ANZ Journal of Surgery published by John Wiley & Sons Australia, Ltd on behalf of Royal Australasian College of Surgeons.</rights><rights>2022. This article is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4437-d7dd9eeb24df9ce0408f9cdde42dd41380c48ede9d2f4ab3c5af5920a6a6df9e3</citedby><cites>FETCH-LOGICAL-c4437-d7dd9eeb24df9ce0408f9cdde42dd41380c48ede9d2f4ab3c5af5920a6a6df9e3</cites><orcidid>0000-0002-4077-4938</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27915,27916</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36221212$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Qurashi, Sol</creatorcontrib><creatorcontrib>Chinnappa, Jason</creatorcontrib><creatorcontrib>Aktas, Sam</creatorcontrib><creatorcontrib>Dabboussi, Abdul Majid</creatorcontrib><creatorcontrib>Rahman, Md Bayzidur</creatorcontrib><title>Overnight joint replacement surgery: a pilot Australian study</title><title>ANZ journal of surgery</title><addtitle>ANZ J Surg</addtitle><description>Background
With a stretched healthcare system and elective surgery backlog, measures to improve efficiency and decrease costs associated with surgical procedures need to be prioritized. This study compares the benefits of multi‐disciplinary involvement in an enhanced recovery after surgery (ERAS) protocol‐led overnight model following total hip replacement (THR) and total knee replacement (TKR).
Methods
Patients in each of two private hospitals undergoing THR or TKR were prospectively enrolled. One hospital (Overnight) was fully committed to the ERAS protocol implementation on all levels and formed the treatment group while in the other hospital (control), patients only had the anaesthetic and operative procedure as part of the ERAS protocol but did not follow the perioperative measures of the protocol. Outcomes on hospital length of stay (LOS), inpatient rehabilitation, functional outcomes, satisfaction, adverse events and readmission rates were investigated.
Results
Median LOS in the Overnight group was significantly smaller than in the control group (1 vs. 3 days, P < 0.0001). The Overnight group had lower rates of inpatient rehabilitation utilization (4% vs. 41.2%, P < 0.0001), similar improvements in functional hip and knee scores and no increased rate of adverse events or readmission. All patients in both groups were satisfied with their treatment.
Conclusion
Overnight THR and TKR can safely be performed in the majority of patients, with a multi‐disciplinary approach protocol and involvement of all perioperative stakeholders.
There are significant public and private elective surgery backlogs as a result of the pandemic measures needed for COVID‐19. Overnight short stay joint replacement is safe and feasible with similar patient functional outcomes as well as satisfaction when an ERAS protocol is implemented with the involvement of all stakeholders. Overnight short‐stay joint replacement surgery will save costs and hospital resources, therefore allowing more patients to undergo surgery within a defined budget.</description><subject>Arthroplasty, Replacement, Hip</subject><subject>Arthroplasty, Replacement, Knee - rehabilitation</subject><subject>Australia</subject><subject>Biomedical materials</subject><subject>enhanced recovery after surgery</subject><subject>health care rationing</subject><subject>health economics</subject><subject>Health services</subject><subject>Hip</subject><subject>Humans</subject><subject>Knee</subject><subject>Knee Joint - surgery</subject><subject>Length of Stay</subject><subject>Orthopaedic implants</subject><subject>Orthopaedic Surgery</subject><subject>Patients</subject><subject>Recovery (Medical)</subject><subject>Rehabilitation</subject><subject>Surgery</subject><subject>Total hip arthroplasty</subject><subject>total hip replacement</subject><subject>total knee replacement</subject><issn>1445-1433</issn><issn>1445-2197</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><recordid>eNp1kU1LAzEQhoMotlYP_gFZ8KKH2nztZiMolOIXFHtQzyHdzLYp292a7Fb6701tLSqYOczAPHl5hxehU4KvSHg9XforIqQQe6hNOI-7lEixv50JZ6yFjryfYUySRMaHqMUSSkmoNroZLcGVdjKto1llyzpysCh0BnMIs2_cBNzqOtLRwhZVHfUbXztdWF1Gvm7M6hgd5LrwcLLtHfR2f_c6eOwORw9Pg_6wm3HORNcIYyTAmHKTywwwx2noxgCnxnDCUpzxFAxIQ3OuxyyLdR5LinWik_ADWAfdbnQXzXgOJgvmgg21cHau3UpV2qrfm9JO1aRaKpliLjAPAhdbAVe9N-BrNbc-g6LQJVSNV1RQTplMYxHQ8z_orGpcGc5bUyxJCE9ooC43VOYq7x3kOzMEq3UoKoSivkIJ7NlP9zvyO4UA9DbAhy1g9b-S6j-_bCQ_Ab_rmCM</recordid><startdate>202210</startdate><enddate>202210</enddate><creator>Qurashi, Sol</creator><creator>Chinnappa, Jason</creator><creator>Aktas, Sam</creator><creator>Dabboussi, Abdul Majid</creator><creator>Rahman, Md Bayzidur</creator><general>John Wiley & Sons Australia, Ltd</general><general>Blackwell Publishing Ltd</general><scope>24P</scope><scope>WIN</scope><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>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-4077-4938</orcidid></search><sort><creationdate>202210</creationdate><title>Overnight joint replacement surgery: a pilot Australian study</title><author>Qurashi, Sol ; Chinnappa, Jason ; Aktas, Sam ; Dabboussi, Abdul Majid ; Rahman, Md Bayzidur</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4437-d7dd9eeb24df9ce0408f9cdde42dd41380c48ede9d2f4ab3c5af5920a6a6df9e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Arthroplasty, Replacement, Hip</topic><topic>Arthroplasty, Replacement, Knee - rehabilitation</topic><topic>Australia</topic><topic>Biomedical materials</topic><topic>enhanced recovery after surgery</topic><topic>health care rationing</topic><topic>health economics</topic><topic>Health services</topic><topic>Hip</topic><topic>Humans</topic><topic>Knee</topic><topic>Knee Joint - surgery</topic><topic>Length of Stay</topic><topic>Orthopaedic implants</topic><topic>Orthopaedic Surgery</topic><topic>Patients</topic><topic>Recovery (Medical)</topic><topic>Rehabilitation</topic><topic>Surgery</topic><topic>Total hip arthroplasty</topic><topic>total hip replacement</topic><topic>total knee replacement</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Qurashi, Sol</creatorcontrib><creatorcontrib>Chinnappa, Jason</creatorcontrib><creatorcontrib>Aktas, Sam</creatorcontrib><creatorcontrib>Dabboussi, Abdul Majid</creatorcontrib><creatorcontrib>Rahman, Md Bayzidur</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Wiley Online Library Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>ANZ journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Qurashi, Sol</au><au>Chinnappa, Jason</au><au>Aktas, Sam</au><au>Dabboussi, Abdul Majid</au><au>Rahman, Md Bayzidur</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Overnight joint replacement surgery: a pilot Australian study</atitle><jtitle>ANZ journal of surgery</jtitle><addtitle>ANZ J Surg</addtitle><date>2022-10</date><risdate>2022</risdate><volume>92</volume><issue>10</issue><spage>2683</spage><epage>2687</epage><pages>2683-2687</pages><issn>1445-1433</issn><eissn>1445-2197</eissn><abstract>Background
With a stretched healthcare system and elective surgery backlog, measures to improve efficiency and decrease costs associated with surgical procedures need to be prioritized. This study compares the benefits of multi‐disciplinary involvement in an enhanced recovery after surgery (ERAS) protocol‐led overnight model following total hip replacement (THR) and total knee replacement (TKR).
Methods
Patients in each of two private hospitals undergoing THR or TKR were prospectively enrolled. One hospital (Overnight) was fully committed to the ERAS protocol implementation on all levels and formed the treatment group while in the other hospital (control), patients only had the anaesthetic and operative procedure as part of the ERAS protocol but did not follow the perioperative measures of the protocol. Outcomes on hospital length of stay (LOS), inpatient rehabilitation, functional outcomes, satisfaction, adverse events and readmission rates were investigated.
Results
Median LOS in the Overnight group was significantly smaller than in the control group (1 vs. 3 days, P < 0.0001). The Overnight group had lower rates of inpatient rehabilitation utilization (4% vs. 41.2%, P < 0.0001), similar improvements in functional hip and knee scores and no increased rate of adverse events or readmission. All patients in both groups were satisfied with their treatment.
Conclusion
Overnight THR and TKR can safely be performed in the majority of patients, with a multi‐disciplinary approach protocol and involvement of all perioperative stakeholders.
There are significant public and private elective surgery backlogs as a result of the pandemic measures needed for COVID‐19. Overnight short stay joint replacement is safe and feasible with similar patient functional outcomes as well as satisfaction when an ERAS protocol is implemented with the involvement of all stakeholders. Overnight short‐stay joint replacement surgery will save costs and hospital resources, therefore allowing more patients to undergo surgery within a defined budget.</abstract><cop>Melbourne</cop><pub>John Wiley & Sons Australia, Ltd</pub><pmid>36221212</pmid><doi>10.1111/ans.17977</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0002-4077-4938</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1445-1433 |
| ispartof | ANZ journal of surgery, 2022-10, Vol.92 (10), p.2683-2687 |
| issn | 1445-1433 1445-2197 |
| language | eng |
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| source | Wiley |
| subjects | Arthroplasty, Replacement, Hip Arthroplasty, Replacement, Knee - rehabilitation Australia Biomedical materials enhanced recovery after surgery health care rationing health economics Health services Hip Humans Knee Knee Joint - surgery Length of Stay Orthopaedic implants Orthopaedic Surgery Patients Recovery (Medical) Rehabilitation Surgery Total hip arthroplasty total hip replacement total knee replacement |
| title | Overnight joint replacement surgery: a pilot Australian study |
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