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Enhanced Recovery After Surgery for Total Knee Arthroplasty, Left Colectomy and Hysterectomy

Conditions
Hysterectomy
Surgery
Total Knee Arthroplasty
Colectomy
Interventions
Procedure: One year before awareness-raising phase in favour of Enhanced Recovery After Surgery
Procedure: No specific program toward improving practices
Procedure: One year after awareness-raising phase in favour of Enhanced Recovery After Surgery
Registration Number
NCT03552913
Lead Sponsor
Assistance Publique - Hôpitaux de Paris
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.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
1710
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
2015 Total knee arthroplasty, hysterectomy or left colectomyOne year before awareness-raising phase in favour of Enhanced Recovery After SurgeryGroup of patients having a total knee arthroplasty, hysterectomy or left colectomy in 2015
2017 Total hip prosthesis, ovariectomy or gastrectomyNo specific program toward improving practicesGroup of patients having total hip prosthesis, ovariectomy or gastrectomy in 2017
2015 Total hip prosthesis, ovariectomy or gastrectomyNo specific program toward improving practicesGroup of patients having total hip prosthesis, ovariectomy or gastrectomy in 2015
2017 Total knee arthroplasty, hysterectomy or left colectomyOne year after awareness-raising phase in favour of Enhanced Recovery After SurgeryGroup of patients having a total knee arthroplasty, hysterectomy or left colectomy in 2017
Primary Outcome Measures
NameTimeMethod
Duration of hospital staythrough 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 Outcome Measures
NameTimeMethod
Compliance with modalities of Enhanced Recovery After Surgery programthrough 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.

Costs per patientthrough 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.

Number of surgery related complicationsthrough study completion, an average of 1 year

Benefits on lowering complications rates

Trial Locations

Locations (1)

Service d'anesthésie-réanimation chirurgicale, Hopital Ambroise Paré

🇫🇷

Boulogne-Billancourt, Hauts-de-seine, France

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