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Fast-track recovery technique applied to primary total hip and knee replacement surgery. Analysis of costs and complications.
- Source :
-
Revista espanola de cirugia ortopedica y traumatologia [Rev Esp Cir Ortop Traumatol] 2017 Mar - Apr; Vol. 61 (2), pp. 111-116. Date of Electronic Publication: 2017 Jan 08. - Publication Year :
- 2017
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Abstract
- Purpose: To determine the cost reduction and complication rates of using an enhanced recovery pathway (Fast-track) when compared to traditional recovery in primary total hip replacement (THR) and total knee replacement (TKR), as well as to determine if there were significant differences in complication rates.<br />Material and Methods: Retrospective review of 100 primary total arthroplasties using the Fast-track recovery system and another 100 using conventional recovery. Gender, Charlston comorbidity index, ASA score, length of stay and early complications were measured, as well in-hospital complications and those in the first six months, re-admissions and transfusion rates. The total and daily cost of stay was determined and the cost reduction was calculated based on the reduction in the length of stay found between the groups.<br />Results: Both groups where comparable as regards age, gender, ASA score, and Charlston index. The mean reduction in length of stay was 4.5 days for TKR and 2.1 days for THR. The calculated cost reduction was 1266 euros for TKR and 583 euros for THR. There were no statistically significant differences between groups regarding in-hospital complications, transfusion requirements, re-admissions and complication rates in the first six months.<br />Discussion: There are few publications in the literature reviewed that analyse the cost implications of using fast-track recovery protocols in arthroplasty. Several published series comparing recovery protocols found no significant differences in complication rates either. The use of a fast-track recovery protocol resulted in a significant cost reduction of 1266 euros for the TKR group and 583 for the THR group, without affecting complication rates.<br /> (Copyright © 2016 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.)
- Subjects :
- Aged
Aged, 80 and over
Female
Follow-Up Studies
Humans
Length of Stay economics
Male
Middle Aged
Perioperative Care economics
Postoperative Complications economics
Postoperative Complications epidemiology
Retrospective Studies
Spain
Treatment Outcome
Arthroplasty, Replacement, Hip economics
Arthroplasty, Replacement, Knee economics
Hospital Costs statistics & numerical data
Perioperative Care methods
Postoperative Complications prevention & control
Subjects
Details
- Language :
- English; Spanish; Castilian
- ISSN :
- 1988-8856
- Volume :
- 61
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Revista espanola de cirugia ortopedica y traumatologia
- Publication Type :
- Academic Journal
- Accession number :
- 28073671
- Full Text :
- https://doi.org/10.1016/j.recot.2016.10.002