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...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2020-04-01
|
| Series: | World Journal of Colorectal Surgery |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.4103/WJCS.WJCS_7_20 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849711782731448320 |
|---|---|
| author | Stephanie D. Talutis Uma R. Phatak Angela H. Kuhnen Pamela Rosenkranz David McAneny Jason F. Hall |
| author_facet | Stephanie D. Talutis Uma R. Phatak Angela H. Kuhnen Pamela Rosenkranz David McAneny Jason F. Hall |
| author_sort | Stephanie D. Talutis |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-56ac0064d0844476a1446366121e882f |
| institution | DOAJ |
| issn | 1941-8213 |
| language | English |
| publishDate | 2020-04-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | World Journal of Colorectal Surgery |
| spelling | doaj-art-56ac0064d0844476a1446366121e882f2025-08-20T03:14:32ZengWolters Kluwer Medknow PublicationsWorld Journal of Colorectal Surgery1941-82132020-04-0192172110.4103/WJCS.WJCS_7_20Enhanced Recovery after Colorectal Surgery: 1st Year Experience in a Safety-Net HospitalStephanie D. TalutisUma R. PhatakAngela H. KuhnenPamela RosenkranzDavid McAnenyJason F. HallBackground: 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.https://journals.lww.com/10.4103/WJCS.WJCS_7_20erasenhanced recoverycolorectal surgeryfluid balanceopioids |
| spellingShingle | Stephanie D. Talutis Uma R. Phatak Angela H. Kuhnen Pamela Rosenkranz David McAneny Jason F. Hall Enhanced Recovery after Colorectal Surgery: 1st Year Experience in a Safety-Net Hospital World Journal of Colorectal Surgery era senhanced recovery colorectal surgery fluid balance opioids |
| title | Enhanced Recovery after Colorectal Surgery: 1st Year Experience in a Safety-Net Hospital |
| title_full | Enhanced Recovery after Colorectal Surgery: 1st Year Experience in a Safety-Net Hospital |
| title_fullStr | Enhanced Recovery after Colorectal Surgery: 1st Year Experience in a Safety-Net Hospital |
| title_full_unstemmed | Enhanced Recovery after Colorectal Surgery: 1st Year Experience in a Safety-Net Hospital |
| title_short | Enhanced Recovery after Colorectal Surgery: 1st Year Experience in a Safety-Net Hospital |
| title_sort | enhanced recovery after colorectal surgery 1st year experience in a safety net hospital |
| topic | era senhanced recovery colorectal surgery fluid balance opioids |
| url | https://journals.lww.com/10.4103/WJCS.WJCS_7_20 |
| work_keys_str_mv | AT stephaniedtalutis enhancedrecoveryaftercolorectalsurgery1styearexperienceinasafetynethospital AT umarphatak enhancedrecoveryaftercolorectalsurgery1styearexperienceinasafetynethospital AT angelahkuhnen enhancedrecoveryaftercolorectalsurgery1styearexperienceinasafetynethospital AT pamelarosenkranz enhancedrecoveryaftercolorectalsurgery1styearexperienceinasafetynethospital AT davidmcaneny enhancedrecoveryaftercolorectalsurgery1styearexperienceinasafetynethospital AT jasonfhall enhancedrecoveryaftercolorectalsurgery1styearexperienceinasafetynethospital |