TY - JOUR
T1 - Improvement in fast-track hip and knee arthroplasty
T2 - a prospective multicentre study of 36,935 procedures from 2010 to 2017
AU - Petersen, Pelle Baggesgaard
AU - Kehlet, Henrik
AU - the Lundbeck Foundation Centre for Fast-track Hip and Knee Replacement Collaborative Group
AU - Jørgensen, Christoffer Calov
A2 - Madsen, Frank
A2 - Hansen, Torben Bæk
A2 - Gromov, Kirill
A2 - Laursen, Mogens
A2 - Hansen, Lars Tambour
A2 - Kjærsgaard-Andersen, Per
A2 - Solgaard, Soren
A2 - Krarup, Niels Harry
A2 - Bagger, Jens
PY - 2020/12/4
Y1 - 2020/12/4
N2 - “Fast-track” protocols has improved surgical care with a reduction in length of hospital stay (LOS) in total hip (THA) and knee arthroplasty (TKA). However, the effects of continuous refinement of perioperative care lack detailed assessment. We studied time-related changes in LOS and morbidity after THA and TKA within a collaboration with continuous scientific refinement of perioperative care. Prospective multicentre consecutive cohort study between 2010 and 2017 from nine high-volume orthopaedic centres with established fast-track THA and TKA protocols. Prospective collection of comorbidities and complete 90-day follow-up from the Danish National Patient Registry and medical records. Of 36,935 procedures median age was 69 [62 to 75] years and 58% women. LOS declined from three [two to three] days in 2010 to one [one to two] day in 2017. LOS > 4 days due to “medical” or “surgical” complications, and “with no recorded morbidity” declined from 4.4 to 2.7%, 1.5 to 0.6%, and 3.8 to 1.3%, respectively. 90-days readmission rate declined from 8.6 to 7.7%. Our multicentre study in a socialized healthcare setting was associated with a continuous reduction in LOS and morbidity after THA and TKA.
AB - “Fast-track” protocols has improved surgical care with a reduction in length of hospital stay (LOS) in total hip (THA) and knee arthroplasty (TKA). However, the effects of continuous refinement of perioperative care lack detailed assessment. We studied time-related changes in LOS and morbidity after THA and TKA within a collaboration with continuous scientific refinement of perioperative care. Prospective multicentre consecutive cohort study between 2010 and 2017 from nine high-volume orthopaedic centres with established fast-track THA and TKA protocols. Prospective collection of comorbidities and complete 90-day follow-up from the Danish National Patient Registry and medical records. Of 36,935 procedures median age was 69 [62 to 75] years and 58% women. LOS declined from three [two to three] days in 2010 to one [one to two] day in 2017. LOS > 4 days due to “medical” or “surgical” complications, and “with no recorded morbidity” declined from 4.4 to 2.7%, 1.5 to 0.6%, and 3.8 to 1.3%, respectively. 90-days readmission rate declined from 8.6 to 7.7%. Our multicentre study in a socialized healthcare setting was associated with a continuous reduction in LOS and morbidity after THA and TKA.
UR - http://www.scopus.com/inward/record.url?scp=85097042439&partnerID=8YFLogxK
U2 - 10.1038/s41598-020-77127-6
DO - 10.1038/s41598-020-77127-6
M3 - Journal article
AN - SCOPUS:85097042439
SN - 2045-2322
VL - 10
JO - Scientific Reports
JF - Scientific Reports
IS - 1
M1 - 21233
ER -