Nagra, NS, Hamilton, TW, Strickland, L et al. (39 more authors) (2017) Enhanced recovery programmes for lower limb arthroplasty in the UK. The Annals of The Royal College of Surgeons of England, 99 (8). pp. 631-636. ISSN 0035-8843
Abstract
Introduction: Enhanced recovery programmes (ERPs) reduce patient morbidity and mortality, and provide significant cost savings by reducing length of stay. Currently, no uniform ERP guidelines exist for lower limb arthroplasty in the UK. The aim of this study was to identify variations in ERPs and determine adherence to local policy.
Methods: Hospitals offering elective total knee arthroplasty (TKA) and total hip arthroplasty (THA) (23 and 22 centres respectively) contributed details of their ERPs, and performed an audit (15 patients per centre) to assess compliance.
Results: Contrasting content and detail of ERPs was noted across centres. Adherence to ERPs varied significantly (40–100% for TKA, 17–94% for THA). Analysis identified perioperative use of dexamethasone, tranexamic acid and early mobilisation for TKA, and procedures performed in teaching hospitals for THA as being associated with a reduced length of stay.
Conclusions: This study highlights variation in practice and poor compliance with local ERPs. Given the proven benefits of ERPs, evidence-based guidelines in the context of local skillsets should be established to optimise the patient care pathway.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | This article is protected by copyright. Reproduced in accordance with the publisher's self-archiving policy. |
Keywords: | Enhanced recovery programme; Total knee arthroplasty; Total hip arthroplasty; Length of stay |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Institute of Rheumatology & Musculoskeletal Medicine (LIRMM) (Leeds) > Orthopaedics (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 21 Jan 2019 12:22 |
Last Modified: | 21 Jan 2019 12:23 |
Status: | Published |
Publisher: | Royal College of Surgeons of England |
Identification Number: | 10.1308/rcsann.2017.0124 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:141336 |