Effects of Interdisciplinary Preoperative Preparation, Education, and Follow-up Sessions on Length of Stay in Hospital and Clinical Outcomes of Patients Undergoing Total Hip or Knee Replacement Surgery.
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 163
- 试验地点
- 2
- 主要终点
- Hospital stay
研究概览
简要总结
The shortening of the length of stay implies rethinking the perioperative management (around the operative period), which precedes and immediately follows the operation, in order to ensure a good preparation of the patient and an adequate postoperative follow-up.
The aim of this study is to evaluate the effect on the length of stay of adding an individualized preoperative preparation and education session to the current protocol in the musculoskeletal department at the CHUV in patients undergoing total hip or knee replacement surgery.
The implementation of a targeted, low-impact immediate postoperative follow-up could contribute to improving the detection of complications, preventing avoidable readmissions, improving the management of pain and adverse events, supporting the patient and responding to difficulties encountered in the patient's living environment. However, the actual added value for the patient and for the healthcare system has yet to be specified. As patients' needs and resources vary, it would also be useful to better determine the profile of patients for whom a pre- and postoperative session provides significant added value.
详细描述
In Switzerland, in 2017,12.4% of the Swiss population suffered from osteoarthritis. In 2019, the SIRIS hip and knee implant registry recorded 20,077 total hip replacement (THR) and 15,453 total knee replacement (TKR) implants in Switzerland.
The placement of THR and TKR is one of the major activities of the Department of the Musculoskeletal System of the CHUV (DAL-CHUV), with respectively 282 THR and 218 TKR placed in 2019.
The improvement of global practices in prosthetic surgery, the pressure on health costs and the shift to ambulatory care have led to a shortening of the length of stay.
The shortening of the length of stay implies rethinking the perioperative care (around the operative period), which precedes and immediately follows the operation, in order to ensure good preparation of the patient and adequate postoperative follow-up.
Currently, patients of the DAL-CHUV participate in a pre-operative information session (only before the operation) in a group that informs patients about the procedure, its preparation and its implications in general.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •male and female patients admitted to the CHUV musculoskeletal department during the study period
- •primary total hip replacement or primary total knee replacement
- •a Risk Assessment and Prediction Tool (RAPT) score >6
排除标准
- •a RAPT score <6,
- •knee/hip arthroplasty revision surgery
- •inability to give informed consent or answer questionnaires knowledgeably due to language or cognitive impairment as reported in the medical record
结局指标
主要结局
Hospital stay
时间窗: 2 weeks post-surgery
Length of hospital stay (days)
次要结局
- Destination at discharge(2 weeks post-surgery)
- Joint function of hip or knee(Day of pre-operative surgical consultation, Control at 2 weeks post-surgery, Medical consultation 6 weeks post-surgery)
- Joint function of knee(Day of pre-operative surgical consultation, Control at 2 weeks post-surgery, Medical consultation 6 weeks post-surgery)
- Satisfaction with care(Control at 2 weeks post-surgery)
- Complications(3 days post-surgery, Control at 2 weeks post-surgery, Medical consultation 6 weeks post-surgery)
- Joint function of hip(Day of pre-operative surgical consultation, Control at 2 weeks post-surgery, Medical consultation 6 weeks post-surgery)
- Quality of life EuroQol 5 Dimensions (EQ-5D) questionnaire(Day of pre-operative surgical consultation and Consultation 6 weeks post-op)
- Mobility of hip or knee(Day of pre-operative surgical consultation, Control at 2 weeks post-surgery, Medical consultation 6 weeks post-surgery)
- Expectations concerning the prosthesis and subjective function(Day of pre-operative surgical consultation, 3 days post-surgery)
- Readmission rate(Consultation 6 weeks post-op)
- Postoperative pain(Day of pre-operative surgical consultation, 3 days post-surgery, Control at 2 weeks post-surgery, Medical consultation at 6 weeks post-surgery)
- Anxiety and Depression(Day of pre-operative surgical consultation, 3 days post-surgery, Control at 2 weeks post-surgery, Medical consultation 6 weeks post-surgery)
- Representation of pain(Day of pre-operative surgical consultation, Control at 2 weeks post-surgery, Medical consultation 6 weeks post-surgery)
研究者
Claude Pichonnaz
Associate Professor UAS, Ph.D.
Haute Ecole de Santé Vaud