Enhanced recovery after surgery for hip fractures: a systematic review and meta-analysis.
Enhanced recovery after surgery for hip fractures: a systematic review and meta-analysis.
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髋部骨折手术后的恢复增强：系统评价和荟萃分析。
DOI：
10.1186/s13741-021-00201-8
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发表时间：
2021-09-13
期刊：
影响因子：
--
通讯作者：
Zhang PX
中科院分区：
文献类型：
--
作者：
Liu SY;Li C;Zhang PX
手术后增强恢复（ERAS）计划在许多外科专业中取得了可喜的成果。然而，关于ERAS对髋部骨折的影响仍然存在不确定性。本综述的目的是从（1）医院相关终点（至手术时间[TTS]、住院时间[LOS]）、（2）再入院率、（3）并发症和（4）死亡率方面研究ERAS项目的临床预后。在PubMed、EMBASE和科克伦图书馆数据库中检索已发表文献。所有纳入的研究均符合纳入标准。主要结局为TTS和LOS。次要结局包括30天再入院率、总体并发症率、特定并发症率（谵妄和尿路感染）以及30天和1年死亡率。语言仅限于英语。数据分析由Review Manager 5.3进行。最终共纳入了7项已发表的研究（9869例患者），均为队列研究。荟萃分析显示，与对照组相比，ERAS组的TTS、LOS和总体并发症发生率显著降低（p < 0.01）。此外，30天再入院率或30天和1年死亡率无显著变化。ERAS显著降低了TTS、LOS和并发症发生率，而没有增加再入院率和死亡率，这进一步证明了ERAS的实施有利于接受髋部骨折修复手术的患者。
Enhanced recovery after surgery (ERAS) programs have achieved promising results in many surgical specialties. However, uncertainty still remains regarding the effect of ERAS on hip fractures. The objective of this review was to investigate the clinical prognosis of ERAS programs in terms of (1) hospital-related endpoints (time to surgery [TTS], length of stay [LOS]), (2) readmission rate, (3) complications, and (4) mortality. Published literature was searched in the PubMed, EMBASE, and Cochrane Library databases. All of the included studies met the inclusion criteria. The primary outcomes were TTS and LOS. The secondary outcomes included the 30-day readmission rate, overall complication rate, specific complication rate (delirium and urinary tract infection), and 30-day and 1-year mortality. Language was restricted to English. The data analysis was carried out by Review Manager 5.3. A total of 7 published studies (9869 patients) were finally included, and these were all cohort studies. The meta-analysis showed that the TTS, LOS, and overall complication rate were significantly reduced in the ERAS group compared with the control group (p < 0.01). Moreover, no significant change was found in the 30-day readmission rate or 30-day and 1-year mortality. ERAS significantly decreases the TTS, LOS, and complication rate without increasing readmission rate and mortality, which adds to the evidence that the implementation of ERAS is beneficial to patients undergoing hip fracture repair surgeries.
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