Enhanced Recovery after Colorectal Surgery: 1st Year Experience in a Safety-Net Hospital
Background: Enhanced recovery after surgery (ERAS) is a multidisciplinary pathway of perioperative patient care. Objective: To evaluate the effect of an ERAS program on length-of-stay (LOS) among elective colorectal surgery patients at a safety-net hospital. Design: Retrospective chart review Settin...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2020-04-01
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| Series: | World Journal of Colorectal Surgery |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.4103/WJCS.WJCS_7_20 |
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| Summary: | Background:
Enhanced recovery after surgery (ERAS) is a multidisciplinary pathway of perioperative patient care.
Objective:
To evaluate the effect of an ERAS program on length-of-stay (LOS) among elective colorectal surgery patients at a safety-net hospital.
Design:
Retrospective chart review
Setting:
500+ bed in a safety-net hospital.
Patients and Methods:
Retrospective review of elective colorectal surgery patients comparing those participating in an ERAS protocol to historical-control (HC) patients from the preceding year.
Main Outcome Measures:
The primary outcome was LOS. Secondary outcomes of interest included opioid utilization, fluid balance throughout the hospital stay, return of bowel function, 30-day complications emergency department visits, and readmissions.
Sample Size:
193.
Results:
ERAS (n = 94) and HC groups (n = 99) were similar with regards to demographics and operations performed. ERAS patients had a longer operating room (OR) time (P = 0.010), however, OR fluid rates were lower for ERAS patients (P < 0.001) with more neutral fluid balance at discharge (closer to 0) (P = 0.006). ERAS patients received fewer opioids in the OR (P < 0.001) and throughout the hospital stay (P = 0.043). Median LOS was 4 days for both groups (P = 0.141) and no difference in 30-day emergency department (ED) visits, readmission, or complications.
Conclusions:
Benefits of ERAS may not be immediately evident post-implementation. Further study is needed regarding the maintenance of ERAS interventions over time and the impact on patient outcomes.
Limitations:
Single-center retrospective nature and surgeon turnover during this period.
Conflict of Interest:
None. |
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| ISSN: | 1941-8213 |