Impact of Compliance with an Enhanced Recovery After Surgery Program on the Outcomes Among Elderly Patients Undergoing Lumbar Fusion Surgery

Zhong-En Li,1– 3 Shi-Bao Lu,1– 3 Chao Kong,1– 3 Wen-Zhi Sun,1– 3 Peng Wang,1– 3 Si-Tao Zhang1,2 1Department of Orthopedics, Xuanwu Hospital Capital Medical University, Beijing, People’s Republic of China; 2National Clinical Research Center...

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Autores principales:	Li ZE, Lu SB, Kong C, Sun WZ, Wang P, Zhang ST
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	compliance elderly enhanced recovery after surgery lumbar fusion surgery Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/57320f88da96441bb8908052598b3293
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spelling	oai:doaj.org-article:57320f88da96441bb8908052598b32932021-12-02T12:01:06ZImpact of Compliance with an Enhanced Recovery After Surgery Program on the Outcomes Among Elderly Patients Undergoing Lumbar Fusion Surgery1178-1998https://doaj.org/article/57320f88da96441bb8908052598b32932020-12-01T00:00:00Zhttps://www.dovepress.com/impact-of-compliance-with-an-enhanced-recovery-after-surgery-program-o-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Zhong-En Li,1– 3 Shi-Bao Lu,1– 3 Chao Kong,1– 3 Wen-Zhi Sun,1– 3 Peng Wang,1– 3 Si-Tao Zhang1,2 1Department of Orthopedics, Xuanwu Hospital Capital Medical University, Beijing, People’s Republic of China; 2National Clinical Research Center for Geriatric Diseases, Beijing, People’s Republic of China; 3Capital Medical University, Beijing, People’s Republic of ChinaCorrespondence: Shi-Bao Lu Email xuanwuspine@163.comBackground and Aim: The benefits of the enhanced recovery after surgery (ERAS) program to elderly patients have not been evaluated in lumbar fusion surgery. Compliance with the ERAS program is associated with prognosis. There is currently no adequate assessment about the importance of the individual components of ERAS program in lumbar fusion surgery. The aim of the study was to analyze the effect of compliance with our ERAS program and the relative importance of the individual ERAS program components among elderly patients undergoing lumbar fusion surgery.Methods: A retrospective case-review study was conducted from March 2018 to March 2020. The ERAS program for lumbar fusion surgery at our department was implemented. Overall compliance was found to be 92.9%, and this was used as a cutoff for dividing patients into higher compliance and lower compliance groups. Patient characteristics and clinical outcomes were compared between groups.Results: The overall compliance rate was 92.9%, distributing 91 patients into the higher compliance group and 169 patients into the lower compliance group. Patients with higher compliance were younger (p=0.045). The length of stay (LOS) of patients with higher compliance was significantly shorter than that of patients with lower compliance. Patients with higher compliance had significantly fewer complications (p=0.031). A multivariate analysis showed that surgical time (p=0.029), lower compliance (p=0.034), and early oral feeding (p=0.026) were predictors of any postoperative complications. On multivariate analysis, the following items remained correlated with prolonged LOS (LOS≥ 12 days): older age (p=0.010), lower compliance (p< 0.0001), early ambulation (p=0.018), and stick to discharge criteria (p=0.040).Conclusion: Low compliance with ERAS program among elderly patients undergoing lumbar fusion surgery was associated with a higher incidence of complications and prolonged LOS. The failure of early oral feeding was associated with increased complications, and the failure of early ambulation or sticking to discharge criteria was significantly more influential on prolonged LOS.Keywords: compliance, elderly, enhanced recovery after surgery; ERAS, lumbar fusion surgeryLi ZELu SBKong CSun WZWang PZhang STDove Medical Pressarticlecomplianceelderlyenhanced recovery after surgerylumbar fusion surgeryGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 15, Pp 2423-2430 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	compliance elderly enhanced recovery after surgery lumbar fusion surgery Geriatrics RC952-954.6
spellingShingle	compliance elderly enhanced recovery after surgery lumbar fusion surgery Geriatrics RC952-954.6 Li ZE Lu SB Kong C Sun WZ Wang P Zhang ST Impact of Compliance with an Enhanced Recovery After Surgery Program on the Outcomes Among Elderly Patients Undergoing Lumbar Fusion Surgery
description	Zhong-En Li,1– 3 Shi-Bao Lu,1– 3 Chao Kong,1– 3 Wen-Zhi Sun,1– 3 Peng Wang,1– 3 Si-Tao Zhang1,2 1Department of Orthopedics, Xuanwu Hospital Capital Medical University, Beijing, People’s Republic of China; 2National Clinical Research Center for Geriatric Diseases, Beijing, People’s Republic of China; 3Capital Medical University, Beijing, People’s Republic of ChinaCorrespondence: Shi-Bao Lu Email xuanwuspine@163.comBackground and Aim: The benefits of the enhanced recovery after surgery (ERAS) program to elderly patients have not been evaluated in lumbar fusion surgery. Compliance with the ERAS program is associated with prognosis. There is currently no adequate assessment about the importance of the individual components of ERAS program in lumbar fusion surgery. The aim of the study was to analyze the effect of compliance with our ERAS program and the relative importance of the individual ERAS program components among elderly patients undergoing lumbar fusion surgery.Methods: A retrospective case-review study was conducted from March 2018 to March 2020. The ERAS program for lumbar fusion surgery at our department was implemented. Overall compliance was found to be 92.9%, and this was used as a cutoff for dividing patients into higher compliance and lower compliance groups. Patient characteristics and clinical outcomes were compared between groups.Results: The overall compliance rate was 92.9%, distributing 91 patients into the higher compliance group and 169 patients into the lower compliance group. Patients with higher compliance were younger (p=0.045). The length of stay (LOS) of patients with higher compliance was significantly shorter than that of patients with lower compliance. Patients with higher compliance had significantly fewer complications (p=0.031). A multivariate analysis showed that surgical time (p=0.029), lower compliance (p=0.034), and early oral feeding (p=0.026) were predictors of any postoperative complications. On multivariate analysis, the following items remained correlated with prolonged LOS (LOS≥ 12 days): older age (p=0.010), lower compliance (p< 0.0001), early ambulation (p=0.018), and stick to discharge criteria (p=0.040).Conclusion: Low compliance with ERAS program among elderly patients undergoing lumbar fusion surgery was associated with a higher incidence of complications and prolonged LOS. The failure of early oral feeding was associated with increased complications, and the failure of early ambulation or sticking to discharge criteria was significantly more influential on prolonged LOS.Keywords: compliance, elderly, enhanced recovery after surgery; ERAS, lumbar fusion surgery
format	article
author	Li ZE Lu SB Kong C Sun WZ Wang P Zhang ST
author_facet	Li ZE Lu SB Kong C Sun WZ Wang P Zhang ST
author_sort	Li ZE
title	Impact of Compliance with an Enhanced Recovery After Surgery Program on the Outcomes Among Elderly Patients Undergoing Lumbar Fusion Surgery
title_short	Impact of Compliance with an Enhanced Recovery After Surgery Program on the Outcomes Among Elderly Patients Undergoing Lumbar Fusion Surgery
title_full	Impact of Compliance with an Enhanced Recovery After Surgery Program on the Outcomes Among Elderly Patients Undergoing Lumbar Fusion Surgery
title_fullStr	Impact of Compliance with an Enhanced Recovery After Surgery Program on the Outcomes Among Elderly Patients Undergoing Lumbar Fusion Surgery
title_full_unstemmed	Impact of Compliance with an Enhanced Recovery After Surgery Program on the Outcomes Among Elderly Patients Undergoing Lumbar Fusion Surgery
title_sort	impact of compliance with an enhanced recovery after surgery program on the outcomes among elderly patients undergoing lumbar fusion surgery
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/57320f88da96441bb8908052598b3293
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Impact of Compliance with an Enhanced Recovery After Surgery Program on the Outcomes Among Elderly Patients Undergoing Lumbar Fusion Surgery

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