Effectiveness of an Enhanced Recovery After Surgery (ERAS) Program in Hip Arthroplasty in a Developing Country: A Propensity Score-Matched Study from Vietnam.

BACKGROUND

Delayed recovery and adverse outcomes frequently follow hip arthroplasty, often due to comorbidities in elderly patients and the invasive nature of the surgery. Although Enhanced Recovery After Surgery (ERAS) programs are widely recommended in developed nations, their effectiveness in developing countries remains under-researched.

OBJECTIVE

This study aims to evaluate the effectiveness of the ERAS program in improving outcomes for patients undergoing hip arthroplasty.

PATIENTS AND

METHODS

This retrospective observational study was conducted at a single university medical center. Propensity score matching was employed to ensure comparability between the ERAS and routine care groups. The primary outcome measured was the post-operative length of stay. Secondary outcomes focused on rates of complications. Tertiary outcomes included other clinical events and symptoms.

RESULTS

The study initially enrolled 769 participants and retained 548 after matching. In the primary outcome, the ERAS group had a shorter length of stay, with a median of 6.1 compared to 7.0 days (Hodges-Lehmann estimate of 0.9 days, 95% confidence interval of 0.2 to 1.0 days, p<0.001). In secondary outcomes, the ERAS group showed lower incidences of composite complications (25.6% vs 33.6%, p=0.040) and respiratory complications (6.9% vs 13.1%, p=0.023). In tertiary outcomes, the ERAS group had lower rates of constipation (27.0% vs 38.3%, p=0.006) and perioperative hyponatremia (21.5% vs 29.6%, p=0.040). No statistically significant differences were observed in the remaining outcomes.

CONCLUSION

The ERAS program improved patient outcomes by reducing length of stay and complications for those undergoing hip arthroplasty in our country. Therefore, this study confirms the effectiveness of ERAS programs and advocates for their broader implementation in similar healthcare settings.