Objective Enhanced recovery after surgery (ERAS) has been successfully adopted for the improvement of medical quality and efficacy in many diseases, but the effect thereof for ankle fracture patients can vary. The aim of the present study was to explore the short‐term postoperative outcomes of ERAS among ankle fracture patients. Methods The present study was a retrospective cohort study conducted between January 2019 and May 2019. One hundred and sixty ankle fracture participations (58 males and 102 females, aged 41.71 ± 14.51 years) were included. The participants treated with open reduction and internal fixation were divided into two groups (non‐ERAS vs. ERAS) depending on whether ERAS was applied. Postoperative outcomes included American Orthopedic Foot and Ankle Society (AOFAS) score, length of stay (LOS), hospital cost, complications, and consumption of opioids. To assess the association between the groups and outcomes, generalized estimating equation (GEE) modeling and multivariable linear regression analysis were performed. Results The average follow‐up periods of the participations were 24 months postoperatively. No significant differences were detected between the non‐ERAS group and ERAS group with respect to the demographic of patients in terms of gender, age, Danis‐Weber classification of fracture, dislocation of ankle joint, and comorbidity (P > 0.05). Significant differences in terms of a higher AOFAS score were found in the ERAS group compared with the non‐ERAS group (6.73, 95% CI, 5.10–8.37, p < 0.001) at 3 months postoperatively (PO3M) and (4.73, 95% CI, 3.02–6.45, p < 0.001) at 6 months postoperatively (PO6M). However, similar AOFAS scores were found at 12 months postoperatively (PO12M) (0.28, 95% CI, −0.32 to 0.89, P > 0.05) and at 24 months postoperatively (PO24M) (0.56, 95% CI, −0.07 to 1.19, P > 0.05). Additionally, the GEE analysis and group‐by‐time interaction of AOFAS score revealed that the ERAS protocol could facilitate faster recovery for ankle fracture patients, with higher PO3M and PO6M (both P < 0.05). At the same time, significant differences in terms of a shorter length of stay (−3.19, 95% CI, −4.33 to −2.04, P < 0.01) and less hospital cost (−6501.81, 95% CI, −10955.21 to −2048.42, P < 0.01) were found in the ERAS group compared with the non‐ERAS group. Conclusion By reducing LOS and hospital cost, the ERAS protocol might improve the medical quality and efficacy. The present study can provide a realistic evaluation and comparison of the ERAS protocol among ankle fracture patients, and ultimately guide clinical decision making.
Background Ankle fracture is common and the treatment is embarrassed. Enhanced Recovery After Surgery (ERAS) has been successfully adopted for the improvement of efficacy and quality. However, application of ERAS in ankle fracture patients especially at the early stage is variable and remains to be clarified. We intent to explore the effect of ERAS among ankle fracture patients. Methods There were 29 male and 51 female patients aged 41.71 ± 14. 51 years who were consecutively grouped into non-ERAS group (n = 40) and ERAS group (n = 40). Univariate analysis and multiple linear regression analysis were applied to assess the association in outcomes and variables. Results AOFAS at post-operative 3 month (PO3M) and post-operative 6 month (PO6M), costs, length of stay (LOS), and pre-operative LOS were verified significantly in univariate analysis. Multiple linear regression analysis revealed that ERAS can improve American Orthopaedic Foot and Ankle Society (AOFAS) at PO3M (β = 7.06, 95% CI, 4.45–9.65) and PO6M (β = 5.08, 95% CI, 2.35–7.80), reduce costs (β = -6885.13, 95% CI, -12089.40 - -1680.85) and LOS (β = -3.27, 95% CI, -4.97 - -1.57) among ankle fracture patients. With the numbers available, no significant differences were observed (p༞0.05) for the AOFAS at post-operative 12 month (PO12M) and post-operative 24 month (PO24M), complications, or opioids consumption. Conclusion We found ERAS is superior to general protocol among proper ankle fracture patients, which can enhance rehabilitation especially at the early stage and improve medical quality and efficiency by reducing costs and LOS. ERAS protocol may have a promising future and worth promoting.
Background Ankle fracture is common and the treatment is embarrassed. Enhanced Recovery After Surgery (ERAS) has been successfully adopted for the improvement of efficacy and quality. However, application of ERAS in ankle fracture patients especially at the early stage is variable and remains to be clarified. We intent to explore the effect of ERAS among ankle fracture patients. Methods There were 29 male and 51 female patients aged 41.71 ± 14. 51 years who were consecutively grouped into non-ERAS group (n = 40) and ERAS group (n = 40). Univariate analysis and multiple linear regression analysis were applied to assess the association in outcomes and variables. Results AOFAS at post-operative 3 month (PO3M) and PO6M, costs, LOS, and pre-operative LOS were verified significantly in univariate analysis. Multiple linear regression analysis revealed that ERAS can improve AOFAS at PO3M (β = 7.06, 95% CI, 4.45–9.65) and PO6M (β = 5.08, 95% CI, 2.35–7.80), reduce costs (β = -6885.13, 95% CI, -12089.40 - -1680.85), and reduce LOS (β = -3.27, 95% CI, -4.97 - -1.57) among ankle fracture patients. With the numbers available, no significant differences were observed (p༞0.05) for the AOFAS at PO12M and PO24M, complications, or opioids consumption. Conclusion We found ERAS is superior to general protocol among proper ankle fracture patients, which can enhance rehabilitation and improve medical quality and efficiency especially at the early stage. ERAS protocol may have a promising future and worth promoting.
Background: Enhanced recovery after surgery (ERAS) has been successfully adopted for the improvement of medical quality and efficacy in many diseases but the effect among the ankle fracture patients is variable. We intended to explore the short-term outcomes of ERAS among ankle fracture patients.Methods: One hundred sixty ankle fracture participations (41.71 ± 14.51 years-old) grouped into two groups (non-ERAS Vs. ERAS) with an average of 24 months follow-up were included in the retrospective study. Multivariable linear regression analysis and generalized estimating equation (GEE) model were performed to assess the association of outcomes including American Orthopaedic Foot and Ankle Society (AOFAS), length of stay (LOS), and hospital cost.Results: Analysis revealed that the patients in the ERAS group could obtain higher AOFAS score with LOS or hospital cost reduction than that in the ERAS group (p<0.05) at month 3 postoperatively (PO3M) and month 6 postoperatively (PO6M). However, outcomes were comparable at month 12 postoperatively (PO12M) and later.GEE analysis and group by time interaction of AOFAS revealed the ERAS protocol could help ankle fracture patients recover faster and better in the short-term.Conclusions: Ankle fracture patients could recover better with the application of the ERAS protocol, especially in the short-term periods, all patients would obtain comparable function PO12M later. The ERAS protocol might improve medical quality and efficacy by reducing LOS and hospital costs as well. The current study would provide a realistic evaluation and comparison of the ERAS protocol among the ankle fracture patients for the surgeons in the short-term.
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