Thomas W Wainwright1, Tikki Immins2, Johannes H A Antonis3, Heath Taylor4, Robert G Middleton5. 1. Orthopaedic Research Institute, Bournemouth University, 6th Floor, Executive Business Centre, 89 Holdenhurst Road, Bournemouth, BH8 8EB, UK; Orthopaedic Department, The Royal Bournemouth Hospital, Castle Lane, Bournemouth, BH7 7DW, UK. Electronic address: twainwright@bournemouth.ac.uk. 2. Orthopaedic Research Institute, Bournemouth University, 6th Floor, Executive Business Centre, 89 Holdenhurst Road, Bournemouth, BH8 8EB, UK. Electronic address: timmins@bournemouth.ac.uk. 3. Orthopaedic Research Institute, Bournemouth University, 6th Floor, Executive Business Centre, 89 Holdenhurst Road, Bournemouth, BH8 8EB, UK; Orthopaedic Department, The Royal Bournemouth Hospital, Castle Lane, Bournemouth, BH7 7DW, UK. Electronic address: j.antonis@ocon.nl. 4. Orthopaedic Department, The Royal Bournemouth Hospital, Castle Lane, Bournemouth, BH7 7DW, UK. Electronic address: heath.taylor@rbch.nhs.uk. 5. Orthopaedic Research Institute, Bournemouth University, 6th Floor, Executive Business Centre, 89 Holdenhurst Road, Bournemouth, BH8 8EB, UK; Orthopaedic Department, The Royal Bournemouth Hospital, Castle Lane, Bournemouth, BH7 7DW, UK. Electronic address: rmiddleton@bournemouth.ac.uk.
Abstract
BACKGROUND: Enhanced Recovery After Surgery (ERAS) has been successfully adopted across a range of procedures. This study explores whether there is scope to improve length of stay (LOS) for total ankle replacement surgery (TAR) in the UK by implementing ERAS pathways. METHODS: Hospital Episode Statistics (HES) data (April 2015/March 2016) on LOS for TAR were analysed. A literature search was then carried out to examine whether there were any publications on outpatient TAR and/or the use of ERAS protocols. RESULTS: Mean observed LOS was 3.3days (range 0-17.3) days. Case mix-adjusted expected LOS range was 2.0-5.7 days. It is likely that the wide observed LOS range is due to differences in local processes and pathways. Two papers were found by the literature search. CONCLUSIONS: TAR should aim to be outpatient surgery as the literature, and data demonstrating scope for improvement in LOS, suggest this should be possible.
BACKGROUND: Enhanced Recovery After Surgery (ERAS) has been successfully adopted across a range of procedures. This study explores whether there is scope to improve length of stay (LOS) for total ankle replacement surgery (TAR) in the UK by implementing ERAS pathways. METHODS: Hospital Episode Statistics (HES) data (April 2015/March 2016) on LOS for TAR were analysed. A literature search was then carried out to examine whether there were any publications on outpatient TAR and/or the use of ERAS protocols. RESULTS: Mean observed LOS was 3.3days (range 0-17.3) days. Case mix-adjusted expected LOS range was 2.0-5.7 days. It is likely that the wide observed LOS range is due to differences in local processes and pathways. Two papers were found by the literature search. CONCLUSIONS: TAR should aim to be outpatient surgery as the literature, and data demonstrating scope for improvement in LOS, suggest this should be possible.
Authors: Shahin Kayum; Sahil Kooner; Ryan M Khan; Mansur Halai; Adam Awoke; Asa Kanani; Spencer Montgomery; Alexander Meldrum; Timothy R Daniels Journal: Foot Ankle Orthop Date: 2021-11-23