Un programa de optimización en el perioperatorio puede mejorar los resultados y disminuir el tiempo de hospitalización en artroplastia de cadera y rodilla: experiencia en Chile

Q3 Medicine Revista Espanola de Cirugia Ortopedica y Traumatologia Pub Date : 2025-11-01 Epub Date: 2025-03-18 DOI:10.1016/j.recot.2025.03.002

J.M. Luarte , J.T. Vizcaya , D. Munita , E. Stocker , R. Núñez , J.A. Merino , C. Rojas

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Abstract

Background and objective

Perioperative optimization programs have been shown to improve outcomes in total hip and knee arthroplasty; however, the evidence in Latin America is limited. Our objective is to evaluate the impact of implementing a multidisciplinary optimization program in prosthetic surgery at a Latin American center.

Materials and methods

A retrospective cohort study evaluating elective hip and knee prosthesis surgeries between 2016 and 2023 at a private hospital. We compared pre-intervention (2016–2018) and post-intervention (2019–2023) groups following the implementation of a multidisciplinary perioperative optimization program in 2019. The impact of the program on hospital length of stay and 90-day readmission rates was assessed.

Results

A total of 1,462 patients (1,636 surgeries) were included, with 429 surgeries in the pre-intervention group and 1,207 in the post-intervention group. Hospital length of stay decreased from 3.5 to 2.22 days (p < 0.05). The 90-day readmission rate decreased from 2.56 to 2.24% (p = 0.71), with a significant reduction in knee arthrofibrosis (from 0.9 to 0.2%, p < 0.05). The optimization program was the main factor contributing to the reduction in hospital length of stay.

Conclusions

The multidisciplinary perioperative program implemented significantly reduced hospital stay without increasing 90-day readmission rates. Furthermore, it equated outcomes between patients with public and private insurance.

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围手术期优化方案可以改善髋关节和膝关节置换术的效果并缩短住院时间：智利的经验。

背景和目的：围手术期优化方案已被证明可以改善全髋关节和膝关节置换术的预后；然而，拉丁美洲的证据有限。我们的目标是评估在拉丁美洲中心实施多学科优化方案在假肢手术中的影响。材料和方法：一项回顾性队列研究，评估2016年至2023年在一家私立医院进行的选择性髋关节和膝关节假体手术。在2019年实施多学科围手术期优化方案后，我们比较了干预前（2016-2018年）和干预后（2019-2023年）组。评估了该计划对住院时间和90天再入院率的影响。结果：共纳入1462例患者（1636例手术），其中干预前组429例，干预后组1207例。住院时间从3.5天减少到2.22天(结论：多学科围手术期方案的实施显著减少了住院时间，而没有增加90天的再入院率。此外，它将公共保险和私人保险患者之间的结果等同起来。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Revista Espanola de Cirugia Ortopedica y Traumatologia Medicine-Surgery

CiteScore

1.10

自引率

0.00%

发文量

156

审稿时长

51 weeks

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