Enhanced Recovery after Surgery for Knee Arthroplasty in the Era of COVID-19.

Autor: Ding BTK; Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore, Singapore., Ng J; Department of Anaesthesiology, Intensive Care and Pain Medicine, Tan Tock Seng Hospital, Singapore, Singapore., Tan KG; Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore, Singapore.
Jazyk: angličtina
Zdroj: The journal of knee surgery [J Knee Surg] 2022 Mar; Vol. 35 (4), pp. 424-433. Date of Electronic Publication: 2020 Aug 24.
DOI: 10.1055/s-0040-1715125
Abstrakt: Enhanced recovery after surgery (ERAS) represents a paradigm shift in perioperative care, aimed at achieving early recovery for surgical patients, reducing length of hospital stay, and complications. The purpose of this study was to provide an insight of the impact of the COVID-19 on ERAS protocols for knee arthroplasty patients in a tertiary hospital and potential strategy changes for postpandemic practice. We retrospectively reviewed all cases that underwent surgery utilizing ERAS protocols in the quarter prior to the pandemic (fourth quarter of 2019) and during the first quarter of 2020 when the pandemic started. A review of the literature on ERAS protocols for knee arthroplasty during the COVID-19 pandemic was also performed and discussed. A total of 199 knee arthroplasties were performed in fourth quarter of 2019 as compared with 76 in the first quarter of 2020 during the COVID-19 outbreak. Patients who underwent surgery in the first quarter of 2020 had shorter inpatient stays (3.8 vs. 4.5 days), larger percentage of discharges by postoperative day 5 (86.8 vs. 74.9%), and a larger proportion of patients discharged to their own homes (68 vs. 54%). The overall complication rate (1.3 vs. 3%) and readmission within 30 days (2.6 vs. 2%) was similar between both groups. ERAS protocols appear to reduce hospital lengths of stay for patients undergoing knee arthroplasty without increasing the risk of short-term complications and readmissions. The beneficial effects of ERAS appear to be amplified by and are synchronous with the requirements of operating in the era of a pandemic.
Competing Interests: None declared.
(Thieme. All rights reserved.)
Databáze: MEDLINE