As China's society ages faster, the number of elderly patients undergoing spinal fusion surgery will gradually increase. Since elderly patients are at higher risk of postoperative complications than younger patients, minimizing complications after spinal fusion becomes a priority in postoperative rehabilitation. The purpose of this prospective cohort study is to develop an enhanced recovery after surgery program including individualized perioperative smoking cessation strategies in Chinese elderly undergoing spinal fusion.
With the aging society, elderly population in China has reached 172 million (12%) in 2020 and is predicted to rise to 336 million (26%) by 2050. This will be accompanied by more elderly people with degenerative spinal diseases who may become candidates for spinal surgery (e.g., spinal fusion). Compared with younger patients, elderly patients are more likely to experience complications after spinal fusion (e.g., 9% and 14% for \<65 and ≥ 65 years old in lumbar fusion), which may lead to adverse patient outcomes including worse functional outcomes and satisfaction and increased revision surgery. Recently, enhanced recovery after surgery (ERAS) program for spinal fusion including the pre-, intra-, and post-operative care interventions has been developed. Previous studies have shown that ERAS has multiple benefits for elderly undergoing spinal fusion, such as reduced complications and shorter hospital stays. However, the preoperative smoking cessation protocols varied widely between studies (e.g., at least 4 weeks, 3 months, and 2 weeks before surgery), which may be due to a lack of evidence. Therefore, we plan to conduct a prospective study to improve the perioperative smoking cessation strategy of ERAS and establish an evidence-derived protocol.
Study Type
OBSERVATIONAL
Enrollment
2,000
Recommended pre-, intra-, and post-operative care interventions in the enhanced recovery after surgery.
The Second Hospital of Shandong University
Jinan, Shandong, China
Incidence of any complications
Any major or minor complications occurs during this study will be reported.
Time frame: From the date of surgery until 6 months after surgery or the date of death from any cause, whichever come first.
Length of hospital stay
The period from admission to discharge will be reported.
Time frame: From the date of admission until the date of discharge or the date of death from any cause, whichever come first, assessed up to 6 months.
Prevalence of postoperative pain
Prevalence of postoperative pain will be assessed using the numeric rating scale.
Time frame: From the date of surgery until 6 months after surgery or the date of death from any cause, whichever come first.
Prevalence of pain-related disability
Pain-related disability will be assessed using Oswestry Disability Index (ODI).
Time frame: From the date of surgery until 6 months after surgery or the date of death from any cause, whichever come first.
Level of quality of life
Quality of life after surgery will be evaluated using EuroQol-5-Dimensions-5-Level.
Time frame: From the date of surgery until 6 months after surgery or the date of death from any cause, whichever come first.
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