Skip to main content
Top
Published in: International Orthopaedics 1/2023

13-10-2022 | Hip-TEP | Original Paper

Enhanced recovery after surgery for primary total hip arthroplasty: analysis of post-operative blood indexes

Authors: Xiaoguang Wang, Yinyin Chen, Jianzong Zhao, Bo Wang, Zhiping Chen

Published in: International Orthopaedics | Issue 1/2023

Login to get access

Abstract

Introduction

To explore the clinical efficacy of the enhanced recovery after surgery (ERAS) program in terms of blood management for primary hip arthroplasty patients.

Method

Ninety cases of total hip arthroplasty in our hospital from October 2020 to January 2022 were selected as the research objects, 45 cases as the control group, and 45 cases as the ERAS group. The control group was given routine care after operation, while the ERAS group was given ERAS management. The leucocytes, haemoglobin, platelets, albumin, D-dimer, C-reactive protein (CRP), total length of stay (LOS), and estimated blood loss after operation were compared between the two groups.

Results

The results showed that the Hb, TPO, and Alb of the ERAS group before operation, one day and three days after operation were significantly higher than those of the control group (P < 0.05). The WBC, CRP, and D-dimer in ERAS group were significantly lower than those in the control group (P < 0.05). The LOS in ERAS group was significantly less than that in control group (P < 0.05).

Discussion

ERAS scheme can reduce the loss of blood and nutrients from surgery in patients. WBC, CRP, and D-dimer in ERAS group were significantly lower than those in the control group. Humane care from ERAS programs can relieve patients’ anxiety to some extent.

Conclusion

ERAS management contributes to the recovery of hip function in patients undergoing THA, reduces blood loss during peri-operative period, and reduces the effect of operation on blood system.
Literature
1.
go back to reference Kehlet H (1997) Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth 78(5):606–617CrossRef Kehlet H (1997) Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth 78(5):606–617CrossRef
2.
go back to reference Frassanito L, Vergari A, Nestorini R, Cerulli G, Placella G, Pace V, Rossi M (2020) Enhanced recovery after surgery (ERAS) in hip and knee replacement surgery: description of a multidisciplinary program to improve management of the patients undergoing major orthopedic surgery. Musculoskelet Surg 104(1):87–92CrossRef Frassanito L, Vergari A, Nestorini R, Cerulli G, Placella G, Pace V, Rossi M (2020) Enhanced recovery after surgery (ERAS) in hip and knee replacement surgery: description of a multidisciplinary program to improve management of the patients undergoing major orthopedic surgery. Musculoskelet Surg 104(1):87–92CrossRef
3.
go back to reference Marson BA, Shah J, Deglurkar M (2015) Blood transfusion in hip and knee arthroplasties: the end of the pre-operative group and save? Eur J Orthop Surg Traumatol: Orthop Traumatol 25(5):871–875CrossRef Marson BA, Shah J, Deglurkar M (2015) Blood transfusion in hip and knee arthroplasties: the end of the pre-operative group and save? Eur J Orthop Surg Traumatol: Orthop Traumatol 25(5):871–875CrossRef
4.
go back to reference Memtsoudis SG, Fiasconaro M, Soffin EM, Liu J, Wilson LA, Poeran J, Bekeris J, Kehlet H (2020) Enhanced recovery after surgery components and perioperative outcomes: a nationwide observational study[J]. Br J Anaesth 124(5):638–647CrossRef Memtsoudis SG, Fiasconaro M, Soffin EM, Liu J, Wilson LA, Poeran J, Bekeris J, Kehlet H (2020) Enhanced recovery after surgery components and perioperative outcomes: a nationwide observational study[J]. Br J Anaesth 124(5):638–647CrossRef
5.
go back to reference Olson KA, Fleming RYD, Fox AW et al (2020) The enhanced recovery after surgery (ERAS) Elements that most greatly impact length of stay and readmission. Am Surg 87(3):3134820951440–3134820951440 Olson KA, Fleming RYD, Fox AW et al (2020) The enhanced recovery after surgery (ERAS) Elements that most greatly impact length of stay and readmission. Am Surg 87(3):3134820951440–3134820951440
6.
go back to reference Memba R, Llàcer-Millán E, Estalella L, Pavel MC, Julià E, Carrillo L, Ferreres E, Moliné A, Velasco C, Casanova R, Jorba R (2021) Implementation and outcomes of an enhanced recovery after surgery (ERAS) programme in a newly established unit of pancreatic surgery[J]. HPB 23(S3):S809–S809CrossRef Memba R, Llàcer-Millán E, Estalella L, Pavel MC, Julià E, Carrillo L, Ferreres E, Moliné A, Velasco C, Casanova R, Jorba R (2021) Implementation and outcomes of an enhanced recovery after surgery (ERAS) programme in a newly established unit of pancreatic surgery[J]. HPB 23(S3):S809–S809CrossRef
7.
go back to reference Qin PP, Jin JY, Min S et al (2022) Association Between Health Literacy and Enhanced Recovery After Surgery Protocol Adherence and Postoperative Outcomes Among Patients Undergoing Colorectal Cancer Surgery: A Prospective Cohort Study[J]. Anesth Analg 134(2):330–340 Qin PP, Jin JY, Min S et al (2022) Association Between Health Literacy and Enhanced Recovery After Surgery Protocol Adherence and Postoperative Outcomes Among Patients Undergoing Colorectal Cancer Surgery: A Prospective Cohort Study[J]. Anesth Analg 134(2):330–340
8.
go back to reference Naito Y, Kanazawa H, Okada Y et al (2020) Adoption of enhanced recovery after surgery (eras) protocol for the management of patients undergoing radical cystectomy in Japan[J]. Nihon Hinyokika Gakkai Zasshi 111(1):9–15 Naito Y, Kanazawa H, Okada Y et al (2020) Adoption of enhanced recovery after surgery (eras) protocol for the management of patients undergoing radical cystectomy in Japan[J]. Nihon Hinyokika Gakkai Zasshi 111(1):9–15
9.
go back to reference Brooks NA, Kokorovic A, McGrath JS et al (2020) Critical analysis of quality of life and cost-effectiveness of enhanced recovery after surgery (ERAS) for patient’s undergoing urologic oncology surgery: a systematic review. World J Urol 40(6):1–18 Brooks NA, Kokorovic A, McGrath JS et al (2020) Critical analysis of quality of life and cost-effectiveness of enhanced recovery after surgery (ERAS) for patient’s undergoing urologic oncology surgery: a systematic review. World J Urol 40(6):1–18
10.
go back to reference Najjar PA, Fields AC, Maldonado LJ et al (2020) Differential index-hospitalization cost center impact of enhanced recovery after surgery program implementation. Dis Colon Rectum 63(6):837–841CrossRef Najjar PA, Fields AC, Maldonado LJ et al (2020) Differential index-hospitalization cost center impact of enhanced recovery after surgery program implementation. Dis Colon Rectum 63(6):837–841CrossRef
11.
go back to reference Li NY, Gruppuso PA, Kalagara S, Eltorai AEM, DePasse JM, Daniels AH (2019) Critical assessment of the contemporary orthopaedic surgery residency application process. J Bone Joint Surg Am 101(21):e114CrossRef Li NY, Gruppuso PA, Kalagara S, Eltorai AEM, DePasse JM, Daniels AH (2019) Critical assessment of the contemporary orthopaedic surgery residency application process. J Bone Joint Surg Am 101(21):e114CrossRef
12.
go back to reference Clyne R, Forde N, White C (2021) Enhanced recovery after surgery: what are the nutritional outcomes?[J]. Clin Nutr ESPEN 46:S786–S786 Clyne R, Forde N, White C (2021) Enhanced recovery after surgery: what are the nutritional outcomes?[J]. Clin Nutr ESPEN 46:S786–S786
13.
go back to reference Zhang X, Li G, Li X, Liang Z, Lan X, Mou T, Xu Z, Fu J, Wu M, Li G, Wang Y (2021) Effect of single-incision plus one port laparoscopic surgery assisted with enhanced recovery after surgery on colorectal cancer: study protocol for a single-arm trial. Transl Cancer Res 10(12):5443–5453 Zhang X, Li G, Li X, Liang Z, Lan X, Mou T, Xu Z, Fu J, Wu M, Li G, Wang Y (2021) Effect of single-incision plus one port laparoscopic surgery assisted with enhanced recovery after surgery on colorectal cancer: study protocol for a single-arm trial. Transl Cancer Res 10(12):5443–5453
14.
go back to reference Tan JHS, Bhatia K, Sharma V, Swamy M, Van Dellen D, Dhanda R, Khambalia H (2022) Enhanced recovery after surgery recommendations for renal transplantation: guidelines. Br J Surg 9:325 Tan JHS, Bhatia K, Sharma V, Swamy M, Van Dellen D, Dhanda R, Khambalia H (2022) Enhanced recovery after surgery recommendations for renal transplantation: guidelines. Br J Surg 9:325
15.
go back to reference Zafar MS, Shahid K, Gobe GC, Yasmin R, Naseem N, Shahzad M (2022) Suppression of cytokine storm and associated inflammatory mediators by salicylaldehyde derivative of pregabalin: an innovative perspective for alleviating airway inflammation and lung remodeling. J King Saud Univ - Sci 34(3):1018–3647 Zafar MS, Shahid K, Gobe GC, Yasmin R, Naseem N, Shahzad M (2022) Suppression of cytokine storm and associated inflammatory mediators by salicylaldehyde derivative of pregabalin: an innovative perspective for alleviating airway inflammation and lung remodeling. J King Saud Univ - Sci 34(3):1018–3647
16.
go back to reference Wang H, Wang L-L, Zhao S-J, Lin X-X, Liao A-H (2022) IL-10: A bridge between immune cells and metabolism during pregnancy. J Reprod Immunol 154:103750–103750 Wang H, Wang L-L, Zhao S-J, Lin X-X, Liao A-H (2022) IL-10: A bridge between immune cells and metabolism during pregnancy. J Reprod Immunol 154:103750–103750
17.
go back to reference Ahmed MA, Askar GA, Farghaly HS, Ahmed AO, Kamal DT, Ahmed SS, Mohamad IL (2022) Accuracy of cerebrospinal fluid C-reactive protein and multiplex polymerase chain reaction and serum procalcitonin in diagnosis of bacterial and viral meningitis in children. Acta Neurologica Taiwanica 31(2):61–71 Ahmed MA, Askar GA, Farghaly HS, Ahmed AO, Kamal DT, Ahmed SS, Mohamad IL (2022) Accuracy of cerebrospinal fluid C-reactive protein and multiplex polymerase chain reaction and serum procalcitonin in diagnosis of bacterial and viral meningitis in children. Acta Neurologica Taiwanica 31(2):61–71
18.
go back to reference Tshering T, Tashi W, Choning Z, Tshering W, Karma T (2021) The successful implementation of the enhanced recovery after surgery (ERAS) program among caesarean deliveries in Bhutan to reduce the postoperative length of hospital stay[J]. BMC Pregnancy Childbirth 21(1):637–637CrossRef Tshering T, Tashi W, Choning Z, Tshering W, Karma T (2021) The successful implementation of the enhanced recovery after surgery (ERAS) program among caesarean deliveries in Bhutan to reduce the postoperative length of hospital stay[J]. BMC Pregnancy Childbirth 21(1):637–637CrossRef
19.
go back to reference Mowla A, Zarei V, Pani A (2020) What antipsychotic medications and risk factors are associated with more relapses in chronic schizophrenia patients? J Neurol Res 10(5):183–187CrossRef Mowla A, Zarei V, Pani A (2020) What antipsychotic medications and risk factors are associated with more relapses in chronic schizophrenia patients? J Neurol Res 10(5):183–187CrossRef
20.
go back to reference Li S, Bercow AS, Falzone M, Kalyanaraman R, Worley MJ, Feltmate CM, Pelletier A, Elias KM (2021) Risk of venous thromboembolism for ovarian cancer patients during first-line therapy after implementation of an enhanced recovery after surgery (ERAS) protocol. Gynecol Oncol 162(2):353–359CrossRef Li S, Bercow AS, Falzone M, Kalyanaraman R, Worley MJ, Feltmate CM, Pelletier A, Elias KM (2021) Risk of venous thromboembolism for ovarian cancer patients during first-line therapy after implementation of an enhanced recovery after surgery (ERAS) protocol. Gynecol Oncol 162(2):353–359CrossRef
Metadata
Title
Enhanced recovery after surgery for primary total hip arthroplasty: analysis of post-operative blood indexes
Authors
Xiaoguang Wang
Yinyin Chen
Jianzong Zhao
Bo Wang
Zhiping Chen
Publication date
13-10-2022
Publisher
Springer Berlin Heidelberg
Keywords
Hip-TEP
Hip-TEP
Published in
International Orthopaedics / Issue 1/2023
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-022-05606-8

Other articles of this Issue 1/2023

International Orthopaedics 1/2023 Go to the issue