Impact of ERAS Compliance on the Short-Term Outcomes for Distal Radius Surgery: A Single-Center Retrospective Study

Abstract

Abstract Background Distal radius fractures (DRF) account for one in five bony injuries in both primary and secondary trauma care. Enhanced recovery after surgery (ERAS) has been adopted successfully for improvement and efficacy in numerous diseases; however, no study has demonstrated the different degrees of ERAS compliance on the short-term outcomes for distal radius surgery. We aimed to analyze whether different compliance degrees to the ERAS pathway are associated with improvement in patients with DRF. Methods We analyzed all consecutive patients with ERAS who underwent surgery for DRF at our department between May 2019 and October 2022 retrospectively. Their pre-, peri-, and post-operative compliance with the 22 elements of the ERAS program were assessed. We compared patient complications, the total length of hospitalization, the discharge time after surgery, hospital costs, times for return to preinjury level, times of the visual analogue scale (VAS) pain score > 3 points during hospitalization, disabilities of the arm, shoulder and hand (DASH) scores, and other parameters between low- (< 68.1%) and high-compliance (> 68.1%) groups. We performed multiple linear regression equations to assess the impact of ERAS compliance on the function level of the patients postoperatively (DASH scores). Results No significant differences were detected between the high- and low-compliance groups, with respect to the demographics, including the sex, age, body mass index (BMI), and comorbidity (P > 0.05). We observed significant differences between the high- and low-compliance groups in terms of the DASH score (32.25 ± 9.97 vs. 40.50 ± 15.65, p < 0.05) at 6 months postoperatively, the discharge time after surgery (2.45 ± 1.46 vs. 3.14 ± 1.50, p < 0.05), and times of VAS pain scores > 3 points during hospitalization (0.88, (0.44, 1.31), p < 0.05). Our study demonstrated a significant negative association between ERAS compliance and the function level of the patients postoperatively (DASH scores) when adjusted for the age, comorbidity, sex, and BMI. Conclusion This study can provide a realistic evaluation and comparison of the ERAS protocol among patients with DRF and eventually guide clinical decision making. The ERAS protocol might improve the medical quality and efficacy with high function levels, less pain and time after surgery without increased complication rate and hospital cost.