Perioperative rehabilitation approaches based on the concept of Enhanced Recovery After Surgery for pelvic fractures: a prospective randomized control trial
10.3760/cma.j.cn115530-20210918-00418
- VernacularTitle:加速康复外科理念下骨盆骨折的围手术期康复措施：一项前瞻性随机对照研究
- Author:
Jinhui WANG
1
;
Yufeng GE
;
Xianfeng GUO
;
Li TAO
;
Xiaohua LIU
;
Qiang LI
;
Yuzhang WANG
;
Minghui YANG
;
Shiwen ZHU
;
Zhenzhong WANG
;
Lin JIN
;
Zhiyong HOU
;
Jian JIA
;
Liancheng WANG
;
Bin YU
;
Xinbao WU
Author Information
1. 北京积水潭医院创伤骨科 100035
- Keywords:
Pelvis;
Fractures, bone;
Enhanced recovery after surgery;
Orthopedic rehabilitation;
Randomized control trial
- From:
Chinese Journal of Orthopaedic Trauma
2021;23(10):850-855
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy and safety of perioperative rehabilitation approaches based on the concept of Enhanced Recovery After Surgery (ERAS) for pelvic fractures.Methods:A prospective randomized control trial was conducted to include 114 emergency patients who had been admitted to Department of Orthopaedic Trauma, Beijing Jishuitan Hospital for surgical treatment of pelvic fractures from June 2019 to December 2020. Of them, 57 were assigned into an intervention group according to a random digits table. They were 42 males and 15 females, aged from 18 to 77 years and subjected to management of pelvic fractures with tentative perioperative ERAS approaches which were adjusted at different stages. The other random 57 patients were assigned into a control group. They were 40 males and 17 females, aged from 17 to 70 years and subjected to management of pelvic fractures with conventional rehabilitation approaches which included postoperative in-hospital consultation and guidance by rehabilitation physicians. The 2 groups were compared in terms of Majeed pelvis scores and Barthel indexes at postoperative 2, 6, 12 and 24 weeks, and visual analogue scale (VAS) pain scores and SF36 scores at postoperative 12 and 24 weeks.Results:A total of 105 patients (55 in the intervention group and 50 in the control group) were completely followed up for 151 to 254 d (mean, 177 d). The 2 groups were comparable due to no significant difference between them in the preoperative general data ( P>0.05). The Majeed scores (44±13, 67±16, 86±14 and 98±7) and Barthel indexes (57±13, 79±16, 95±8 and 100±2) at postoperative 2, 6, 12 and 24 weeks in the intervention group were significantly higher than those in the control group [(35±16, 51±16, 73±14 and 91±12) and (45±19, 67±18, 86±12 and 98±4)] (all P<0.05). At postoperative 12 and 24 weeks, the SF-36 scores (129±15 and 141±6) in the intervention group were significantly higher than those in the control group (114±15 and 131±12) ( P<0.05). There was no significant difference in the pain degree between the 2 groups ( P>0.05). Conclusion:In management of pelvic fractures, compared with conventional perioperative rehabilitation approaches, the perioperative ERAS rehabilitation approaches may improve early functional outcomes and thus help the patients restore their activities of daily living earlier.
