Colectomy, Hysterectomy, Surgery, Total Knee Arthroplasty
Conditions
Keywords
Enhanced Recovery After Surgery, Fast track, Surgery, Hysterectomy, Left colectomy, Total knee arthroplasty
Brief summary
The objective of the study is to assess retrospectively the effect of an awareness-raising phase in favour of Enhanced Recovery After Surgery across the Assistance Publique-Hopitaux Paris institution and to explore the determinants of compliance with modalities of Enhanced Recovery After Surgery. This multicenter study is performed for three types of surgery: total knee arthroplasty, left colectomy and hysterectomy.
Detailed description
The primary goal of the study is to quantify the effect of an awareness-raising phase in favour of Enhanced Recovery After Surgery which was organized in 2016 within the public hospitals in Paris (Assistance Publique - Hôpitaux de Paris). The study aims to document and compare the compliance with fast track modalities and its impact for the year before (2015) and the year following (2017) the awareness-raising phase. Durations of hospital stay, compliance with recommendations, benefits on lowering complication rates and cost reductions will be studied for three types of interventions: total knee arthroplasty, left colectomy and hysterectomy. Preoperative information provided to patients, counselling and physical optimisation will be evaluated through a survey among physicians whereas compliance with pre-, intra- and postoperative patient management guidelines will be retrospectively retrieved from the medical records of randomly selected patients. Survival and hospital trajectories will be obtained through the centralised national medical data system. Three groups of patients having underwent total hip prosthesis, ovariectomy or gastrectomy in the same years (2015 and 2017) will serve as control groups, as for these surgeries no specific program has been implemented toward any practice change.
Interventions
PROCEDUREOne year before awareness-raising phase in favour of Enhanced Recovery After Surgery
One year before awareness-raising phase in favour of Enhanced Recovery After Surgery
PROCEDUREOne year after awareness-raising phase in favour of Enhanced Recovery After Surgery
One year after awareness-raising phase in favour of Enhanced Recovery After Surgery
PROCEDURENo specific program toward improving practices
No specific program toward improving practices
Sponsors
Assistance Publique - Hôpitaux de Paris
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* Patient aged \> 18 years; * Resident in France; * Patient who underwent surgery in 2015 or 2017
Exclusion criteria
* Patient operated in emergency.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Duration of hospital stay | through study completion, an average of 1 year | The average duration of hospital stay will be compared for the year before (2015) and following (2017) the awareness-raising program implemented in 2016 for patients with knee arthroplasty, hysterectomy or left colectomy. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Compliance with modalities of Enhanced Recovery After Surgery program | through study completion, an average of 1 year | Modalities of Enhanced Recovery After Surgery recommendations will be compared between the year before (2015) and the year following (2017) the awareness-raising program implemented in 2016. |
| Number of surgery related complications | through study completion, an average of 1 year | Benefits on lowering complications rates |
| Costs per patient | through study completion, an average of 1 year | To determine if the awareness-raising program implemented in 2016 has produced a significant cost per patient reduction. The total cost for hospitalization, readmission and surgery related complications will be assessed. |
Countries
France
Contacts
Primary ContactDominique Fletcher, MD, PhD
Backup ContactAnissa Belbachir, MD
Outcome results
None listed