An enhanced recovery after surgery program in orthopedic surgery: a systematic review and meta-analysis

作者：Zhichao Hu, Lin-Jie He, Dong Chen, Xiaobin Li, Zhenhua Feng, Chengwei Fu, Jiangwei Xuan, Wen-Fei Ni, Aimin Wu · 发表于：Journal of Orthopaedic Surgery and Research · 年份：2019 · DOI：10.1186/s13018-019-1116-y · 被引用次数：74 · 研究领域：Enhanced Recovery After Surgery、Nausea and vomiting management、Dietary Effects on Health

OBJECTIVES: There is an increased interest in enhanced recovery after surgery (ERAS) minimizing adverse events after orthopedic surgery. Little consensus supports the effectiveness of these interventions. The purpose of present systematic review and meta-analysis is to comprehensively analyze and evaluate the significance of ERAS interventions for postoperative outcomes after orthopedic surgery. METHODS: PubMed, EMBASE, and Cochrane databases were totally searched from the inception dates to May 31, 2018. Two reviewers independently extracted the data from the selected articles using a standardized form and assessed the risk of bias. The analysis was performed using STATA 12.0. RESULTS: A total of 15 published studies fulfilled the requirements of inclusion criteria. We found that the ERAS group showed a significant association with lower incidence of postoperative complications (OR, 0.70; 95% CI, 0.64 to 0.78). Meanwhile, ERAS was also associated with the decline in 30-day mortality rate and Oswestry Disability Index (ODI). However, no significant differences were identified between the two groups regarding the 30-day readmission rate (P = 0.397). CONCLUSIONS: Our meta-analysis suggested that the ERAS group had more advantages in reducing incidence of postoperative complications, 30-day mortality rate, and ODI after orthopedic surgery, but not of 30-day readmission rate. However, further research with standardized, unbiased methods and larger sample sizes is required for dee...