The analysis of the experience gained by the multidisciplinary team during the 5 year work in compliance with the protocol of FAST-TRAC - therapy following the surgical interventions for total endoprosthetics of the hip and knee joints based at the clinic of the federal state autonomous facility “Therapeutic and Rehabilitative Centre”, Russian Ministry of Health

Abstract

This article was designed to report the results of the analysis of the duration of the hospital stay for the patients admitted to a surgical department and its grading taking into consideration the experience of the surgeons. It was shown that the patients operated on by the surgeons having the total period of service below 5 years had the shortest time of hospitalization because many of them presented with concomitant diseases and had to be referred for the further treatment to the more experienced specialists. The questionnaire study carried out within 3-6 weeks after surgery has demonstrated that 31% of the patients treated in compliance with the principles of fast-track therapy remained fully mobile without any restrictions on the distances they were able to cover. The mobility of 53% of the treated patients was confined to their personal apartments and the adjacent courtyards while 31% of them could move only within their apartments. The analysis of the degree of satisfaction of the patients with the medical assistance provided to them showed that 26% of the patients experienced the substantial improvement of their health status, 74% described the improvement as moderate, and 4% appeared unsatisfied with the outcome of the treatment. The analysis of pain sensations in the treated patients revealed the absence of pain in 46% of them whereas 36% estimated the intensity of pain syndrome as 1-5 scores based on the NRS scale whereas 17% estimated pain intensity as being higher than 5 scores. The analysis of the social competence and household skills of the treated patients showed that 38% of them expressed the desire to resume their routine professional activities within 1-2 months after the completion of the treatment, another 34% were prepared to do the same within 2-4 months, and the remaining 27% were ready to work again within 6 months after surgery. Only 2% of the patients did not plan to return to their habitual mode of life. The article expounds the main differences of the concept of fast-track therapy being realized at the clinic of the federal state autonomous facility “Therapeutic and Rehabilitative Centre”, Russian Ministry of Health, from that adopted in analogous foreign healthcare facilities. It is concluded that the modified concept based at our clinic provides a safe and efficient tool for the management of surgical patients.

Keywords

endoprosthetics / FAST-TRAC - therapy / “accelerated treatment’’ / duration of hospital stay / satisfaction of patients / pain syndrome / social competence and household skills / mobility / supporting ability

References

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