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. 2025 May 16:18:2731-2747.
doi: 10.2147/JMDH.S521828. eCollection 2025.

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

Phan Ton Ngoc Vu  1   2 , Bui Hong Thien Khanh  3   4 , Ha Quoc Hung  5 , Nguyen Thi Ngoc Dao  1   5 , Le Nhat Sang  3 , Nguyen Van Chien  6 , Ho Tat Bang  2   7
Affiliations

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

Phan Ton Ngoc Vu et al. J Multidiscip Healthc. .

Abstract

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.

Keywords: complications; healthcare burdens; hip arthroplasty; length of stays; propensity score matching.

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Conflict of interest statement

All authors report no conflicts of interest in this work.

Figures

None
Graphical abstract
Figure 1
Figure 1
Core components in consensus statement for perioperative care in total Hip replacement and total knee replacement surgery by ERAS Society.
Figure 2
Figure 2
Flow chart of this study.
Figure 3
Figure 3
Propensity score matching model assessment. (A). Balance of demographic and baseline characteristics before and after matching. (B). Distribution of propensity scores before and after matching.
Figure 4
Figure 4
Post-operative primary complication comparisons after propensity score matching.
Figure 5
Figure 5
Post-operative secondary complication comparisons after propensity score matching. (A) Complications were classified by major organ complications. (B) Complications were classified by the Dindo-Clavien scale.
Figure 6
Figure 6
Post-operative tertiary complication comparisons after propensity score matching.
See this image and copyright information in PMC

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