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Meta-Analysis
. 2021 Feb 27;16(1):162.
doi: 10.1186/s13018-021-02277-w.

The efficacy and safety of fast track surgery (FTS) in patients after hip fracture surgery: a meta-analysis

Mingyang Jiang  1 , Siyi Liu  2 , Huachu Deng  2 , Xuzhi Liang  2 , Zhandong Bo  3
Affiliations
Meta-Analysis

The efficacy and safety of fast track surgery (FTS) in patients after hip fracture surgery: a meta-analysis

Mingyang Jiang et al. J Orthop Surg Res. .

Abstract

Background: Fast track surgery (FTS) has been gradually applied in perioperative management of orthopedic surgery, but there still some research suspected that the prognosis of patients is not as expected and the cost is high, the effect of the FTS still urgently needed for support by evidence-based medicine.

Methods: We retrieved RCTs from medical research literature databases. Risk ratios (RR), standard mean difference (SMD), and 95% confidence intervals (CI) were calculated to compare the primary and safety endpoints.

Results: Overall, a total of 8886 patients were retrieved from 57 articles, of which 4448 patients (50.06%) were randomized to experimental group whereas 4438 patients (49.94%) were randomized to control group. The result showed that FTS could significantly shorten the length of stay (LOS), decrease the visual analog scale (VAS), reduce the leaving bed time and the hospitalization costs, and improve Harris hip joint function score. The incidence of complications such as respiratory system infection, urinary system infection, venous thrombus embolism (VTE), pressure sore, incision infection, constipation, and prosthesis dislocation also has been decreased significantly. Meanwhile, FTS improved patients' satisfaction apparently.

Conclusions: This meta-analysis reveals that FTS could significantly shorten the length of stay, alleviate the pain, reduce the leaving bed time and the hospitalization costs, and improve hip function. The incidence of complications also has been decreased significantly. Meanwhile, FTS has been spoken highly in patients in terms of nursing satisfaction. Its efficacy and safety were proved to be reliable.

Keywords: Enhanced recovery after surgery (ERAS); Fast track surgery (FTS); Hip replacement; Meta-analysis.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of the study selection process. CNKI China national knowledge infrastructure, VIP China Science and Technology Journal Database
Fig. 2
Fig. 2
Comparison of LOS between the experimental group and the control group. SMD standardized mean difference, LOS length of stay
Fig. 3
Fig. 3
Comparison of Harris hip joint function score between the experimental group and the control group. SMD standardized mean difference
Fig. 4
Fig. 4
Comparison of Harris hip joint function score between the experimental group and the control group (subgroup analysis). SMD standardized mean difference
Fig. 5
Fig. 5
Comparison of VAS between the experimental group and the control group. SMD standardized mean difference, VAS visual analog scale
Fig. 6
Fig. 6
Comparison of VAS between the experimental group and the control group. (subgroup analysis). SMD standardized mean difference, VAS visual analog scale
Fig. 7
Fig. 7
Comparison of satisfaction between the experimental group and the control group. RR risk ratio
Fig. 8
Fig. 8
Comparison of the leaving bed time between the experimental group and the control group. SMD standardized mean difference
Fig. 9
Fig. 9
Comparison of cost between the experimental group and the control group. SMD standardized mean difference
Fig. 10
Fig. 10
Incidence of respiratory infection between the experimental group and the control group. RR risk ratio
Fig. 11
Fig. 11
Incidence of urinary tract infection between the experimental group and the control group. RR risk ratio
Fig. 12
Fig. 12
Incidence of VTE between the experimental group and the control group. RR risk ratio, VTE venous thrombus embolism
Fig. 13
Fig. 13
Incidence of pressure sores between the experimental group and the control group. RR risk ratio
Fig. 14
Fig. 14
Incidence of incision infection between the experimental group and the control group. RR risk ratio
Fig. 15
Fig. 15
Incidence of constipation between the experimental group and the control group. RR risk ratio
Fig. 16
Fig. 16
Incidence of dislocation of prosthesis between the experimental group and the control group. RR risk ratio
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