Effects of enhanced recovery after surgery clinical pathways on the outcomes of orthognathic surgery: a retrospective study
Journal Title: Journal of Air Force Medical University - Year 2023, Vol 44, Issue 9
Abstract
Objective To explore the effects of enhanced recovery after surgery (ERAS) clinical pathways on the postoperative outcomes of orthognathic surgery (OS) patients, including postoperative hospital stay, patient satisfaction and postoperative complications. Methods In a retrospective study, patients who received OS in Stomatological Hospital, Air Force Medical University from March 2018 to March 2022 were selected as research objects, and their personal basic information, perioperative management, postoperative hospital stay, patient satisfaction, postoperative complications and other information were summarized. Patients were divided into ERAS group and non-ERAS group according to whether ERAS intervention measures were implemented. T-test and chi-square test were used to evaluate the effects of ERAS measures on postoperative outcomes. Then, patients in ERAS group were divided into four subgroups according to the quartile of intervention compliance. Negative binomial regression was used to simulate the relationship between postoperative hospital stay and ERAS compliance. Besides, the interaction model between ERAS compliance and operative time, intraoperative bleeding and operation mode was also fitted. Results A total of 686 patients receiving OS were collected, among which 658 patients met the inclusion criteria, and 170 patients with missing data were excluded. Finally, 362 patients in ERAS group and 126 patients in non-ERAS group were selected as subjects. According to compliance, the sample sizes of ERAS subgroups were 107 cases (compliance rate≤18. 50%), 89 cases (18. 50% < compliance rate≤74. 07%), 89 cases (74. 07% < compliance rate ≤85. 19% ) and 77 cases (compliance rate > 85. 19% ), respectively. The average age of patients was (23. 0 ± 4. 2) years, 60% of them were female, and there was no statistical difference in the baseline data between the groups. ERAS intervention could shorten postoperative hospital stay in OS patients, reduce postoperative complications, and increase patient satisfaction. The better the compliance of patients in ERAS group, the shorter the postoperative hospital stay. For patients undergoing relatively complicated surgeries with a long operative time, the postoperative hospital stay was shortened more significantly. Conclusion ERAS clinical pathway intervention in OS patients is correlated with postoperative hospital stay, patient satisfaction and reduction of postoperative complications. Increasing ERAS compliance in OS significantly reduces postoperative hospital stay.
Authors and Affiliations
HE Danyi, FAN Ze, WU Yufei, WANG Jialin, WANG Xiaoxia, XUN Zemin, SHANG Hongtao, ZHANG Hui
Keywords
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