日间手术踝关节置换术：它们安全且具有成本效益吗？一项单中心病例对照研究。
Day case ankle arthroplasty: are they safe and cost effective? A single-centre case-control study.
作者信息
Elbashir Mohamed, Uzoigwe Chika, Kurup Harish
机构信息
Pilgrim Hospital, Boston, PE21 9QS, UK.
Harcourt House, Sheffield, UK.
出版信息
J Clin Orthop Trauma. 2022 Jun 13;30:101919. doi: 10.1016/j.jcot.2022.101919. eCollection 2022 Jul.
BACKGROUND
Most patients who have an ankle replacement in the United Kingdom stay in hospital for 2-4 days. This study looked at the safety & cost-effectiveness of a day case ankle replacement pathway.
METHODS
This was a retrospective case-control study looking at day case pathway for ankle replacements set up in collaboration with anaesthetists, nurses and physiotherapists. Patients practiced mobilization with crutches before surgery. Patients were discharged home with enough analgesia, and reviewed within 2-5 days of discharge.
RESULTS
Twenty ankle replacements done between November 2017 and November 2019 were reviewed with a mean follow up of 38.4 months. None of these patients required to be readmitted within the first 28 days. No complications were related to the surgery being done as day case. Except one, all patients described the experience as excellent or good.
CONCLUSION
Per case the cost savings are estimated to be £880 in comparison to 20 matched inpatient ankle replacements. We conclude that ankle replacements can be safely carried out as day case with appropriate patient selection, pre-operative education and a multi-disciplinary approach.
背景
在英国，大多数接受踝关节置换术的患者住院2至4天。本研究探讨了日间手术踝关节置换路径的安全性和成本效益。
方法
这是一项回顾性病例对照研究，研究了与麻醉师、护士和物理治疗师合作建立的踝关节置换日间手术路径。患者在手术前练习使用拐杖进行活动。患者出院时携带足够的镇痛药物，并在出院后2至5天内接受复查。
结果
对2017年11月至2019年11月期间进行的20例踝关节置换手术进行了回顾，平均随访38.4个月。这些患者中没有一人在术后28天内需要再次入院。没有并发症与日间手术相关。除一人外，所有患者都将此次经历描述为优秀或良好。
结论
与20例匹配的住院踝关节置换手术相比，每例估计节省成本880英镑。我们得出结论，通过适当的患者选择、术前教育和多学科方法，踝关节置换术可以作为日间手术安全进行。
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