ERAS protocol in colorectal surgery is effective in octogenarians: A retrospective cohort study

Purpose: Evaluate the effectiveness of implementing an ERAS protocol in octogenarians. Methods: This retrospective cohort study analyzed patients undergoing colorectal surgery under the ERAS protocol at Boca Raton Regional Hospital from December 1, 2019 to October 30, 2021. Patients under the age of...

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Main Authors: Justin Dourado, MD, Ariel Wolf, MD, Maria Herrera Rodriguez, DO, Shruti Agarwal, BS, Karin Blumofe, MD, Jordan Moseson, DO, Jose Yeguez, MD, Andrew Ross, MD, Avraham Belizon, MD
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:Surgery Open Science
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Online Access:http://www.sciencedirect.com/science/article/pii/S2589845025000211
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author Justin Dourado, MD
Ariel Wolf, MD
Maria Herrera Rodriguez, DO
Shruti Agarwal, BS
Karin Blumofe, MD
Jordan Moseson, DO
Jose Yeguez, MD
Andrew Ross, MD
Avraham Belizon, MD
author_facet Justin Dourado, MD
Ariel Wolf, MD
Maria Herrera Rodriguez, DO
Shruti Agarwal, BS
Karin Blumofe, MD
Jordan Moseson, DO
Jose Yeguez, MD
Andrew Ross, MD
Avraham Belizon, MD
author_sort Justin Dourado, MD
collection DOAJ
description Purpose: Evaluate the effectiveness of implementing an ERAS protocol in octogenarians. Methods: This retrospective cohort study analyzed patients undergoing colorectal surgery under the ERAS protocol at Boca Raton Regional Hospital from December 1, 2019 to October 30, 2021. Patients under the age of 18, undergoing emergency surgery, and with incomplete data were excluded. A p < 0.05 was considered statistically significant and analyses were done using EZR and R software. Results: 299 patients met inclusion criteria with 60 (20.1 %) over the age of 80 and 239 (79.9 %) younger than 80. 140 (46.8 %) of the cohort were male. When comparing octogenarians with younger patients there were no differences in compliance with ERAS protocols such as pre-operative medication (p = 1) and oral carbohydrate drink consumption (p = 0.574), oral intake in PACU (p = 0.832), PACU sit and dangle (p = 0.619), or adherence to a narcotic sparing regimen (p = 0.365). Additionally, there were no differences in complications (p = 1), time until bowel function (p = 0.401), or time to first ambulation (p = 0.883). Octogenarians were more likely to have a longer LOS (4.89 v 3.0 days; p = 0.006), disposition requiring either home health care or a skilled nursing facility (SNF) (52.5 % v 28.3 %; p = 0.008), and readmission (42.3 % v 20.8 %; p = 0.042). Conclusion: The ERAS protocol is safe and effective when used in the octogenarian without decreased compliance or increased complications. Increased LOS, care needed on disposition, and readmission are in-line with other published data of all patients and are likely related to increased frailty among this group and not to the addition of the ERAS protocol.
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spelling doaj-art-1d06b38bebd34b1a8c140fad5a209bc32025-08-20T03:01:42ZengElsevierSurgery Open Science2589-84502025-03-0124869110.1016/j.sopen.2025.03.004ERAS protocol in colorectal surgery is effective in octogenarians: A retrospective cohort studyJustin Dourado, MD0Ariel Wolf, MD1Maria Herrera Rodriguez, DO2Shruti Agarwal, BS3Karin Blumofe, MD4Jordan Moseson, DO5Jose Yeguez, MD6Andrew Ross, MD7Avraham Belizon, MD8Florida Atlantic University, College of Medicine, Department of General Surgery, Boca Raton Regional Hospital-Baptist Health South Florida, 777 Glades Road BC-71, Boca Raton, FL 33431, USA; Corresponding author at: Florida Atlantic University, College of Medicine, 777 Glades Road, BC-71, Boca Raton, FL 33431, USA.Florida Atlantic University, College of Medicine, Department of General Surgery, Boca Raton Regional Hospital-Baptist Health South Florida, 777 Glades Road BC-71, Boca Raton, FL 33431, USAFlorida Atlantic University, College of Medicine, Department of General Surgery, Boca Raton Regional Hospital-Baptist Health South Florida, 777 Glades Road BC-71, Boca Raton, FL 33431, USAFlorida Atlantic University, College of Medicine, 777 Glades Road BC-71, Boca Raton, FL 33431, USAFlorida Atlantic University, College of Medicine, Department of General Surgery, Boca Raton Regional Hospital-Baptist Health South Florida, 777 Glades Road BC-71, Boca Raton, FL 33431, USAFlorida Atlantic University, College of Medicine, Department of General Surgery, Boca Raton Regional Hospital-Baptist Health South Florida, 777 Glades Road BC-71, Boca Raton, FL 33431, USAFlorida Atlantic University, College of Medicine, Department of General Surgery, Boca Raton Regional Hospital-Baptist Health South Florida, 777 Glades Road BC-71, Boca Raton, FL 33431, USAFlorida Atlantic University, College of Medicine, Department of General Surgery, Boca Raton Regional Hospital-Baptist Health South Florida, 777 Glades Road BC-71, Boca Raton, FL 33431, USAFlorida Atlantic University, College of Medicine, Department of General Surgery, Boca Raton Regional Hospital-Baptist Health South Florida, 777 Glades Road BC-71, Boca Raton, FL 33431, USAPurpose: Evaluate the effectiveness of implementing an ERAS protocol in octogenarians. Methods: This retrospective cohort study analyzed patients undergoing colorectal surgery under the ERAS protocol at Boca Raton Regional Hospital from December 1, 2019 to October 30, 2021. Patients under the age of 18, undergoing emergency surgery, and with incomplete data were excluded. A p < 0.05 was considered statistically significant and analyses were done using EZR and R software. Results: 299 patients met inclusion criteria with 60 (20.1 %) over the age of 80 and 239 (79.9 %) younger than 80. 140 (46.8 %) of the cohort were male. When comparing octogenarians with younger patients there were no differences in compliance with ERAS protocols such as pre-operative medication (p = 1) and oral carbohydrate drink consumption (p = 0.574), oral intake in PACU (p = 0.832), PACU sit and dangle (p = 0.619), or adherence to a narcotic sparing regimen (p = 0.365). Additionally, there were no differences in complications (p = 1), time until bowel function (p = 0.401), or time to first ambulation (p = 0.883). Octogenarians were more likely to have a longer LOS (4.89 v 3.0 days; p = 0.006), disposition requiring either home health care or a skilled nursing facility (SNF) (52.5 % v 28.3 %; p = 0.008), and readmission (42.3 % v 20.8 %; p = 0.042). Conclusion: The ERAS protocol is safe and effective when used in the octogenarian without decreased compliance or increased complications. Increased LOS, care needed on disposition, and readmission are in-line with other published data of all patients and are likely related to increased frailty among this group and not to the addition of the ERAS protocol.http://www.sciencedirect.com/science/article/pii/S2589845025000211Enhanced Recovery After SurgeryERASColorectal surgeryOutcomesGeriatricsOctogenarian
spellingShingle Justin Dourado, MD
Ariel Wolf, MD
Maria Herrera Rodriguez, DO
Shruti Agarwal, BS
Karin Blumofe, MD
Jordan Moseson, DO
Jose Yeguez, MD
Andrew Ross, MD
Avraham Belizon, MD
ERAS protocol in colorectal surgery is effective in octogenarians: A retrospective cohort study
Surgery Open Science
Enhanced Recovery After Surgery
ERAS
Colorectal surgery
Outcomes
Geriatrics
Octogenarian
title ERAS protocol in colorectal surgery is effective in octogenarians: A retrospective cohort study
title_full ERAS protocol in colorectal surgery is effective in octogenarians: A retrospective cohort study
title_fullStr ERAS protocol in colorectal surgery is effective in octogenarians: A retrospective cohort study
title_full_unstemmed ERAS protocol in colorectal surgery is effective in octogenarians: A retrospective cohort study
title_short ERAS protocol in colorectal surgery is effective in octogenarians: A retrospective cohort study
title_sort eras protocol in colorectal surgery is effective in octogenarians a retrospective cohort study
topic Enhanced Recovery After Surgery
ERAS
Colorectal surgery
Outcomes
Geriatrics
Octogenarian
url http://www.sciencedirect.com/science/article/pii/S2589845025000211
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