Wu Jingwei, Wang Peng, Gao Zhihua, Lu Shibao
Department of Orthopedics, Xuanwu Hospital of Capital Medical University, Beijing, 100053, People's Republic of China.
National Clinical Research Center for Geriatric Diseases, Beijing, 100053, People's Republic of China.
Clin Interv Aging. 2025 Aug 22;20:1305-1313. doi: 10.2147/CIA.S527660. eCollection 2025.
Enhanced Recovery After Surgery (ERAS) has been extensively applied across numerous surgical specialties. However, there remains a paucity of research regarding the implementation of ERAS in advanced age patients (≥75 years) who undergo InterTAN nail surgery for intertrochanteric femoral fractures (ITF). This study aimed to assess if our ERAS protocol improves satisfaction and clinical outcomes in such patients.
This was a retrospective cohort study included advanced age patients who underwent InterTAN nail surgery. The ERAS group included patients who underwent surgery between January 2022 and December 2024, while the non - ERAS group consisted of those who had the same surgery between January 2019 and December 2023. Demographics, comorbidities, surgical details, ERAS compliance, outcomes, complications, and length of stay (LOS) were evaluated.
A total of 144 patients were included in the ERAS group and 135 in the non - ERAS group. Analysis of demographic data showed no statistically significant intergroup differences. ERAS compliance was 100%. There were no significant differences between the ERAS and non - ERAS groups in terms of operative side, anesthesia type, operating time, intraoperative blood loss, and postoperative Visual Analogue Scale scores. Moreover, 30 - day follow - up revealed no significant differences in readmission rates and mortality between the two groups. However, the LOS was significantly shorter in the ERAS group (5.68±2.34 days vs 6.54±2.04 days in the non - ERAS group; p = 0.03). The overall complication rate was also significantly lower in the ERAS group (10/144 vs 23/135; P < 0.01).
In this cohort of advanced age patients with ITF managed via our ERAS program, it was evidenced that this program is safe and can effectively reduce the LOS and the incidence of complications.
术后加速康复（ERAS）已在众多外科专业中广泛应用。然而，对于接受InterTAN钉治疗股骨转子间骨折（ITF）的老年患者（≥75岁）实施ERAS的研究仍然匮乏。本研究旨在评估我们的ERAS方案是否能提高此类患者的满意度和临床结局。
这是一项回顾性队列研究，纳入了接受InterTAN钉手术的老年患者。ERAS组包括2022年1月至2024年12月期间接受手术的患者，而非ERAS组由2019年1月至2023年12月期间接受相同手术的患者组成。评估了人口统计学、合并症、手术细节、ERAS依从性、结局、并发症和住院时间（LOS）。
ERAS组共纳入144例患者，非ERAS组纳入135例患者。人口统计学数据分析显示组间无统计学显著差异。ERAS依从率为100%。ERAS组和非ERAS组在手术侧、麻醉类型、手术时间、术中出血量和术后视觉模拟评分方面无显著差异。此外，30天随访显示两组的再入院率和死亡率无显著差异。然而，ERAS组的住院时间显著缩短（5.68±2.34天 vs 非ERAS组的6.54±2.04天；p = 0.03）。ERAS组的总体并发症发生率也显著更低（10/144 vs 23/135；P < 0.01）。
在这组通过我们的ERAS方案管理的老年ITF患者中，证明了该方案是安全的，并且可以有效降低住院时间和并发症发生率。
