Use of low-dose opioid- based general anaesthesia and time-directed protocols for fast- track interventions does not increase mortality or postoperative complications in low-moderate-risk patients and has been found to have a reduced time to extubation and shortened ICU stay [ 2].
However, Scotland Yard said it had a number of initiatives to help combat stress, including an in-house counselling service, fast-track interventions and programmes to help staff identify signs of stress.
In a recent review, Zhu et al. came to the conclusion that fast-track interventions have similar risks of mortality and major postoperative complications to conventional (not fast-track) care, and therefore appear to be safe in patients considered to be at low to moderate risk [ 11].
This difference could be attributed to selection of patients into our fast-track intervention, but because the SHAR data resemble our data before implementing fast-track intervention [ 13, 15, 21, 22] the difference in HRQOL may in our opinion mainly be caused by the fast-track intervention.
A fast-track intervention with a short preoperative optimization period and short postoperative hospitalization has a potential for reduced convalescence and thereby a reduced need for postoperative rehabilitation.
If HRQOL is considered the primary outcome after THA, the need for additional postoperative rehabilitation for all THA patients following a fast-track intervention is questionable.
In the study by Larsen et al. [ 15] THA patients who followed an fast-track intervention reached the age and gender specific HRQOL level of 0.87 at 12 weeks postoperatively.
Our implementation of patient triage and a fast track (organisational intervention) in combination with cultural measures (hospital-based action team; involvement of several groups of health professionals) led to decreased treatment costs of emergency outpatients in the newly installed H-GP-unit.
We then compared these between our fast track and standard intervention groups.
Second, we described the scores over time in the two groups, up to interview 5, contrasting the patterns and change in scores for the standard track group before and after the intervention, and for the fast track group after the intervention (up to 24 weeks)[ 33].
This may be explained by technical changes that may result in an increased risk of SSI, such as the broad implementation of fast track programs, and/or early interventions on suspected SSI.
