Effect of nurse-led enhanced recovery care program on short-term postoperative outcomes of older patients undergoing lumbar fusion surgery

To explore the effect of a nurse-led enhanced recovery care (NLERC) program on the short-term postoperative outcomes of elderly patients undergoing lumbar fusion surgery. We retrospectively reviewed a prospectively maintained database and included consecutive elderly patients (≥ 75 years) who underwent lumbar fusion surgery at a single institution from January 2020 to September 2023. All patients were divided into the historical control group (before July 2021) and the NLERC group (after September 2021). During the perioperative period, the NLERC group received enhanced recovery care, while the historical control group received conventional care. Postoperative outcomes, including physiological function recovery, complications, and length of hospital stay (LOS), were collected and compared between the two groups. A total of 168 patients were enrolled, including 92 in the NLERC group and 76 in the historical control group. There were no significant differences between the two groups in terms of demographic data, comorbidities, number of fused segments, or intraoperative blood loss. Compared with the historical control group, the NLERC group had significantly earlier times to first drinking and food intake, first anal flatus and defecation, urinary catheter removal, and first postoperative mobilization (all P < 0.05). Both total and postoperative LOS were significantly shorter in the NLERC group than in the historical control group (P < 0.05). There were no statistically significant differences in the Activities of Daily Living (ADL) scores between the two groups preoperatively and at discharge; however, the NLERC group had significantly better ADL scores than the historical control group at 1 and 3 days postoperatively (P < 0.05). The incidence of postoperative complications was lower in the NLERC group than in the historical control group. The NLERC program is associated with improved postoperative physiological recovery, shorter hospital stays, and a lower incidence of complications in elderly patients undergoing lumbar fusion surgery.