Abstract:
BACKGROUND:Days alive and out of hospital (DAH) has been proposed as a pragmatic outcome measure of surgical quality. However, there is a lack of procedure specific data or data within an optimised fast-track protocol. Furthermore, information about influence of follow-up duration and types of complications on DAH is limited. METHODS:Observational multicentre cohort study of patients undergoing fast-track total hip (THA) and knee arthroplasty (TKA). Prospective information on comorbidity and complete 90 days follow-up was undertaken through the Danish National Patient Register and chart review. RESULTS:For 16 137 procedures, of which 18.6% were high-risk (≥2 preoperative risk factors), the median length of stay was 2 days (inter-quartile range [IQR], 2-3), and 30- and 90-day readmission rates were 5.7% and 8.1%, respectively. Median DAH30 and DAH90 days were 27 (26-28) and 87 (85-88) vs 28 (27-28) and 88 (87-89) (P<0.001) in high-vs low-risk patients, respectively. The fraction with DAH ≤25 at 30 days and DAH ≤85 at 90 days was increased in high-vs low-risk patients: 23.3% vs 6.8% (odds ratio [OR]=4.16; 95% confidence interval [CI], 3.73-4.65) and 26.0% vs 8.6% (OR=3.75; 95% CI, 3.38-4.16). There were relatively fewer 'surgical' complications in high- vs low-risk patients with DAH30 ≤25 (14.6% vs 25.8%) (OR=0.49; 95% CI, 0.37-0.65) and DAH90 ≤85 (16.9% vs 31.89%) (OR=0.43; 95% CI, 0.34-0.56). About 2% of patients had readmissions, but DAH was >25 and >85 at 30 and 90 days after operation, respectively. CONCLUSION:Median DAH in fast-track THA/TKA patients is 28 at 30 days and 88 at 90 days after surgery. DAH in high-risk patients was only slightly reduced compared with low-risk patients, but they have relatively more 'medical' complications.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Jørgensen CC,Petersen PB,Kehlet H,Lundbeck Foundation Center for Fast-track Hip and Knee Replacement Collaborative Group.doi
10.1016/j.bja.2019.07.022subject
Has Abstractpub_date
2019-11-01 00:00:00pages
671-678issue
5eissn
0007-0912issn
1471-6771pii
S0007-0912(19)30599-9journal_volume
123pub_type
杂志文章,多中心研究abstract::Abnormal oxygen use and organ failure in the critically ill may result from 'poisoning' of mitochondrial function. Measurement of arterial ketone body ratio (AKBR) has been proposed to reflect mitochondrial redox state and may provide a useful marker to monitor mitochondrial function in the critically ill. We measured...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/83.2.325
更新日期:1999-08-01 00:00:00
abstract::Five hundred and seventeen women in labour receiving extradural analgesia, using bupivacaine plain solution, were randomly allocated to one of three groups. Group A received 6-8ml of 0.5% solution, group B 10-14ml of 0.25% solution, and group C 6-8 ml of 0.25% solution. Spontaneous delivery occurred in 31.7% of patien...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/53.9.933
更新日期:1981-09-01 00:00:00
abstract::The serum vasopressin (S-AVP) concentration, serum sodium concentration and osmolality, central venous pressure and fluid balance were measured during 10-min periods in 32 patients undergoing transurethral resection of the prostate. Concentration of S-AVP was unaffected by uncomplicated resection; irrigant absorption ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/63.3.330
更新日期:1989-09-01 00:00:00
abstract::The effect of the intrathecal administration of diamorphine on the hyperglycaemic, adrenocortical and cardiovascular responses to major colonic surgery were investigated, and the results compared with those obtained in a similar group of patients receiving low doses of fentanyl. In the group receiving intrathecal diam...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/57.4.389
更新日期:1985-04-01 00:00:00
abstract:BACKGROUND:In critically ill children, monitoring of cardiac output (CO) is essential to guide haemodynamic management and facilitate cardiovascular therapy. The ultrasound dilution technique (UDT), a novel minimally invasive indicator method, was recently introduced to determine CO. We validated UDT against the 'gold ...
journal_title:British journal of anaesthesia
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doi:10.1093/bja/aet382
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journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/86.4.477
更新日期:2001-04-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/70.5.508
更新日期:1993-05-01 00:00:00
abstract:BACKGROUND:Pressure recording analytical method (PRAM) is a novel, arterial pulse contour-based method for measuring cardiac output (CO). Validation studies of PRAM in children are few, and have not assessed both absolute accuracy and ability to track changes in CO across a broad case mix. We aimed to compare CO as mea...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aes420
更新日期:2013-03-01 00:00:00
abstract::The value of the continuous monitoring of end-tidal carbon dioxide concentration as an indicator of the acute intraoperative interruption of pulmonary blood flow, in patients with pre-existing restrictions of pulmonary blood flow undergoing closed heart surgery, is illustrated by two case reports. Decreases in end-tid...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/57.12.1257
更新日期:1985-12-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aem116
更新日期:2007-08-01 00:00:00
abstract::Twenty consecutive patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) were allocated at random to group 1 (n = 10, high inspired oxygen fraction (FIO2) after CPB), or group 2 (n = 10, moderate FIO2 after CPB). The effects of each FIO2 on arterial and mixed venous concentrations of endothelin-1 (ET-1...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/84.5.565
更新日期:2000-05-01 00:00:00
abstract::Arterial PO2 (PaO2) has been related to inspired oxygen concentration (FIO2 range 0.21-0.60) in 20 patients, breathing spontaneously, while recovering from a range of conditions treated in an intensive therapy unit. There was a highly significant linear trend (P < 0.001) for the mean venous admixture ("virtual shunt")...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/72.5.515
更新日期:1994-05-01 00:00:00
abstract::Gastric (GP) and lower oesophageal sphincter pressures (LOSP) were measured in non-pregnant female volunteers (group I) and pregnant women with (group III) or without (group II) heartburn. Patients in early pregnancy had greater gastric pressures than group I. Mean barrier pressure (LOSP-GP) was significantly decrease...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/53.4.381
更新日期:1981-04-01 00:00:00
abstract::Resperatory compliance and resistance were measured during positive pressure ventilation in anaesthtized, paralysed dogs. Airway pressures measured during constant-flow inspiration allowed the calculation of pulmonary and chest-wall resistances, and static and non-static compliances. Contiguous studies of dynamic comp...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/48.12.1157
更新日期:1976-12-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/aeh289
更新日期:2005-01-01 00:00:00
abstract:Background:There is growing evidence that beta-blockade may reduce mortality in selected patients with sepsis. However, it is unclear if a pre-existing, chronic oral beta-blocker therapy should be continued or discontinued during the acute phase of severe sepsis and septic shock. Methods:The present secondary analysis...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aex231
更新日期:2017-10-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/80.1.63
更新日期:1998-01-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 杂志文章
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doi:10.1093/bja/aev110
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journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
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doi:10.1093/bja/aer451
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journal_title:British journal of anaesthesia
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doi:10.1093/bja/85.5.735
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abstract::A 4-year-old girl developed severe hepatitis following the fourth administration of halothane in a period of 5 months. She was shown to have a circulating antibody which acted specifically against rabbit hepatocyte previously sensitized to halothane. The patient made a full recovery from the hepatitis, but 5 months la...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/54.3.349
更新日期:1982-03-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
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pub_type: 杂志文章,多中心研究
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journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/56.5.509
更新日期:1984-05-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aei108
更新日期:2005-05-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeh077
更新日期:2004-03-01 00:00:00