Assessment on patient outcomes of primary hip replacement: an interrupted time series analysis from ‘The National Joint Registry of England and Wales’
<p><strong>Objectives</strong> Effects of the UK Department of Health’s national Enhanced Recovery After Surgery (ERAS) Programme on outcomes after primary hip replacement.</p> <p><strong>Design</strong> Natural experimental study using interrupted time seri...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Journal article |
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BMJ Publishing Group
2019
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| _version_ | 1797072553183805440 |
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| author | Garriga-Fuentes, C Murphy, J Leal, J Arden, N Price, A Prieto-Alhambra, D Carr, A Rangan, A Cooper, C Peat, G Fitzpatrick, R Barker, K Judge, A |
| author_facet | Garriga-Fuentes, C Murphy, J Leal, J Arden, N Price, A Prieto-Alhambra, D Carr, A Rangan, A Cooper, C Peat, G Fitzpatrick, R Barker, K Judge, A |
| author_sort | Garriga-Fuentes, C |
| collection | OXFORD |
| description | <p><strong>Objectives</strong> Effects of the UK Department of Health’s national Enhanced Recovery After Surgery (ERAS) Programme on outcomes after primary hip replacement.</p> <p><strong>Design</strong> Natural experimental study using interrupted time series to assess the changes in trends before, during and after ERAS implementation (April 2009 to March 2011).</p> <p><strong>Setting</strong> Surgeries in the UK National Joint Registry were linked with Hospital Episode Statistics containing inpatient episodes from National Health Service trusts in England and patient reported outcome measures.</p> <p><strong>Participants</strong> Patients aged ≥18 years from 2008 to 2016.</p> <p><strong>Main outcome measures</strong> Regression coefficients of monthly means of length of hospital stay, bed day cost, change in Oxford Hip Scores (OHS) 6 months post-surgery, complications 6 months post-surgery and revision rates 5 years post-surgery.</p> <p><strong>Results</strong> 438 921 primary hip replacements were identified. Hospital stays shortened from 5.6 days in April 2008 to 3.6 in December 2016. There were also improvements in bed day costs (£7573 in April 2008 to £5239 in December 2016), positive change in self-reported OHS from baseline to 6 months post-surgery (17.7 points in April 2008 to 22.9 points in December 2016), complication rates (4.1% in April 2008 to 1.7% March 2016) and 5 year revision rates (5.9 per 1000 implant-years (95% CI 4.8 to 7.2) in April 2008 to 2.9 (95% CI 2.2 to 3.9) in December 2011). The positive trends in all outcomes started before ERAS was implemented and continued during and after the programme.</p> <p><strong>Conclusions</strong> Patient outcomes after hip replacement have improved over the last decade. A national ERAS programme maintained this improvement but did not alter the existing rate of change.</p> |
| first_indexed | 2024-03-06T23:09:22Z |
| format | Journal article |
| id | oxford-uuid:64f08856-a7eb-40c0-a4b2-d0742a1d442c |
| institution | University of Oxford |
| last_indexed | 2024-03-06T23:09:22Z |
| publishDate | 2019 |
| publisher | BMJ Publishing Group |
| record_format | dspace |
| spelling | oxford-uuid:64f08856-a7eb-40c0-a4b2-d0742a1d442c2022-03-26T18:22:14ZAssessment on patient outcomes of primary hip replacement: an interrupted time series analysis from ‘The National Joint Registry of England and Wales’Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:64f08856-a7eb-40c0-a4b2-d0742a1d442cSymplectic Elements at OxfordBMJ Publishing Group2019Garriga-Fuentes, CMurphy, JLeal, JArden, NPrice, APrieto-Alhambra, DCarr, ARangan, ACooper, CPeat, GFitzpatrick, RBarker, KJudge, A<p><strong>Objectives</strong> Effects of the UK Department of Health’s national Enhanced Recovery After Surgery (ERAS) Programme on outcomes after primary hip replacement.</p> <p><strong>Design</strong> Natural experimental study using interrupted time series to assess the changes in trends before, during and after ERAS implementation (April 2009 to March 2011).</p> <p><strong>Setting</strong> Surgeries in the UK National Joint Registry were linked with Hospital Episode Statistics containing inpatient episodes from National Health Service trusts in England and patient reported outcome measures.</p> <p><strong>Participants</strong> Patients aged ≥18 years from 2008 to 2016.</p> <p><strong>Main outcome measures</strong> Regression coefficients of monthly means of length of hospital stay, bed day cost, change in Oxford Hip Scores (OHS) 6 months post-surgery, complications 6 months post-surgery and revision rates 5 years post-surgery.</p> <p><strong>Results</strong> 438 921 primary hip replacements were identified. Hospital stays shortened from 5.6 days in April 2008 to 3.6 in December 2016. There were also improvements in bed day costs (£7573 in April 2008 to £5239 in December 2016), positive change in self-reported OHS from baseline to 6 months post-surgery (17.7 points in April 2008 to 22.9 points in December 2016), complication rates (4.1% in April 2008 to 1.7% March 2016) and 5 year revision rates (5.9 per 1000 implant-years (95% CI 4.8 to 7.2) in April 2008 to 2.9 (95% CI 2.2 to 3.9) in December 2011). The positive trends in all outcomes started before ERAS was implemented and continued during and after the programme.</p> <p><strong>Conclusions</strong> Patient outcomes after hip replacement have improved over the last decade. A national ERAS programme maintained this improvement but did not alter the existing rate of change.</p> |
| spellingShingle | Garriga-Fuentes, C Murphy, J Leal, J Arden, N Price, A Prieto-Alhambra, D Carr, A Rangan, A Cooper, C Peat, G Fitzpatrick, R Barker, K Judge, A Assessment on patient outcomes of primary hip replacement: an interrupted time series analysis from ‘The National Joint Registry of England and Wales’ |
| title | Assessment on patient outcomes of primary hip replacement: an interrupted time series analysis from ‘The National Joint Registry of England and Wales’ |
| title_full | Assessment on patient outcomes of primary hip replacement: an interrupted time series analysis from ‘The National Joint Registry of England and Wales’ |
| title_fullStr | Assessment on patient outcomes of primary hip replacement: an interrupted time series analysis from ‘The National Joint Registry of England and Wales’ |
| title_full_unstemmed | Assessment on patient outcomes of primary hip replacement: an interrupted time series analysis from ‘The National Joint Registry of England and Wales’ |
| title_short | Assessment on patient outcomes of primary hip replacement: an interrupted time series analysis from ‘The National Joint Registry of England and Wales’ |
| title_sort | assessment on patient outcomes of primary hip replacement an interrupted time series analysis from the national joint registry of england and wales |
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