术后加速康复对全关节置换术的影响：系统评价与荟萃分析方案
The Impact of Enhanced Recovery After Surgery on Total Joint Arthroplasty: Protocol for a Systematic Review and Meta-analysis.
作者信息
Rele Siddharth, Shadbolt Cade, Schilling Chris, Taylor Nicholas F, Dowsey Michelle M, Choong Peter F M
机构信息
Department of Surgery, St Vincent's Hospital, University of Melbourne, Melbourne, Australia.
Melbourne Medical School, University of Melbourne, Melbourne, Australia.
出版信息
JMIR Res Protoc. 2021 Mar 12;10(3):e25581. doi: 10.2196/25581.
BACKGROUND
The number of total joint arthroplasties (TJAs) being performed is increasing worldwide. To match this increasing demand, there has been focus on hastening patients' recovery of function. This effort has culminated in the formulation of enhanced recovery after surgery (ERAS) strategies. However, with evolving ERAS programs and new recommendations, a review of current evidence is required to provide clinicians with up-to-date information about its effect on outcomes for TJA.
OBJECTIVE
The objective of this study is to assess the utility of ERAS programs on patient, health service, and economic outcomes for primary, elective total hip arthroplasty (THA) and total knee arthroplasty (TKA).
METHODS
A systematic search will be conducted in Medline (Ovid), EMCARE (Ovid), EMBASE (Ovid), Web of Science, CINAHL, National Health Service Economic Evaluations Database, and the Cochrane Library. Analytical, observational, and experimental designs will be included in this systematic review. Only studies including patients undergoing primary TKA and THA comparing ERAS programs with conventional surgery and postoperative care will be included. Data related to patient outcomes, health service outcomes, safety, and economic evaluation will be extracted.
RESULTS
The search terms and primary database searches have been finalized. Findings will be reported in narrative and tabular form. Where appropriate, random effects meta-analyses will be conducted for each outcome, and heterogeneity quantified with Cochran Q test and I2 statistic. Measures of effect or mean differences will be reported with 95% confidence intervals. The results of this systematic review will be disseminated in a peer-reviewed journal.
CONCLUSIONS
This protocol will guide a systematic review assessing outcomes associated with ERAS surgery in primary THA and TKA.
TRIAL REGISTRATION
Open Science Framework osf.io/y4bhs; https://osf.io/y4bhs.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/25581.
背景
全球范围内全关节置换术（TJA）的实施数量正在增加。为了满足这一不断增长的需求，人们一直致力于加速患者功能的恢复。这一努力最终形成了术后加速康复（ERAS）策略。然而，随着ERAS方案的不断发展和新建议的提出，需要对当前证据进行综述，以便为临床医生提供有关其对TJA结局影响的最新信息。
目的
本研究的目的是评估ERAS方案对初次择期全髋关节置换术（THA）和全膝关节置换术（TKA）患者、卫生服务及经济结局的效用。
方法
将在Medline（Ovid）、EMCARE（Ovid）、EMBASE（Ovid）、科学网、护理学与健康领域数据库、英国国家卫生服务体系经济评估数据库以及Cochrane图书馆进行系统检索。该系统综述将纳入分析性、观察性和实验性设计。仅纳入包括初次TKA和THA患者且将ERAS方案与传统手术及术后护理进行比较的研究。将提取与患者结局、卫生服务结局、安全性和经济评估相关的数据。
结果
检索词和主要数据库检索已最终确定。研究结果将以叙述和表格形式报告。适当时，将对每个结局进行随机效应荟萃分析，并用Cochrane Q检验和I²统计量对异质性进行量化。效应量或均值差异将报告95%置信区间。本系统综述的结果将在同行评审期刊上发表。
结论
本方案将指导一项系统综述，评估初次THA和TKA中与ERAS手术相关的结局。
试验注册
开放科学框架osf.io/y4bhs；https://osf.io/y4bhs。
国际注册报告识别码（IRRID）：PRR1-10.2196/25581。
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