Adrien Lampilas1, Benjamin Bouyer2, Emmanuelle Ferrero1, Marc Khalifé1, Angélique Bergeot1, Pierre Guigui1, Guillaume Lonjon3. 1. Service de chirurgie orthopédique et traumatologique, unité rachis, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France. 2. Service de chirurgie orthopédique et traumatologique, unité rachis, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France; Service de chirurgie orthopédique, hôpital Pellegrin, rue de la Pelouse-de-Douet, 33000 Bordeaux, France. 3. Service de chirurgie orthopédique et traumatologique, unité rachis, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France; Groupe Orthosud, clinique Saint-Jean, 1, rond-point de l'Europe, 34430 Saint-Jean-de-Védas, France. Electronic address: dr.guillaume.lonjon@gmail.com.
Abstract
INTRODUCTION: Enhanced recovery after surgery (ERAS) has been well described in many surgical specialties, including orthopedics. Application in spine surgery, on the other hand, is more recent and not yet precisely assessed. The present study aimed to assess the implementation of an ERAS program in a European spine surgery department and its impact on length of hospital stay and complications rate. MATERIALS AND METHODS: A comparative observational study was conducted on patient progression with and without ERAS. As of the launch date of the program, all eligible patients were included over a 6-month period. A retrospective control group comprised patients managed over the same 6-month period of the previous year, matched for pathology, comorbidity and individual surgeon. Endpoints comprised mean length of stay and major complications (i.e., requiring readmission or revision surgery within 90days). RESULTS: Eighty-eight patients were included: 44 per group. Demographic characteristics did not significantly differ between groups. Mean length of stay, taking all pathologies together, was 3.3days in ERAS versus 6days in the control group (p<0.001). Complications rates did not significantly differ between groups (p=1). DISCUSSION: The introduction of the ERAS program gave care teams the opportunity to think over good practices and set up a number of concomitant measures generally agreed to be effective in isolation. The present study showed ERAS to be perfectly feasible in a public-sector structure, reducing length of stay without increasing the rate of complications. LEVEL OF EVIDENCE: IV CEBM.
INTRODUCTION: Enhanced recovery after surgery (ERAS) has been well described in many surgical specialties, including orthopedics. Application in spine surgery, on the other hand, is more recent and not yet precisely assessed. The present study aimed to assess the implementation of an ERAS program in a European spine surgery department and its impact on length of hospital stay and complications rate. MATERIALS AND METHODS: A comparative observational study was conducted on patient progression with and without ERAS. As of the launch date of the program, all eligible patients were included over a 6-month period. A retrospective control group comprised patients managed over the same 6-month period of the previous year, matched for pathology, comorbidity and individual surgeon. Endpoints comprised mean length of stay and major complications (i.e., requiring readmission or revision surgery within 90days). RESULTS: Eighty-eight patients were included: 44 per group. Demographic characteristics did not significantly differ between groups. Mean length of stay, taking all pathologies together, was 3.3days in ERAS versus 6days in the control group (p<0.001). Complications rates did not significantly differ between groups (p=1). DISCUSSION: The introduction of the ERAS program gave care teams the opportunity to think over good practices and set up a number of concomitant measures generally agreed to be effective in isolation. The present study showed ERAS to be perfectly feasible in a public-sector structure, reducing length of stay without increasing the rate of complications. LEVEL OF EVIDENCE: IV CEBM.