ERAS protocol validation in a propensity-matched cohort of patients undergoing colorectal surgery

被引:15
作者
Lemini, Riccardo [1 ]
Spaulding, Aaron C. [2 ]
Naessens, James M. [2 ]
Li, Zhuo [3 ]
Merchea, Amit [1 ]
Crook, Julia E. [3 ]
Larson, David W. [4 ]
Colibaseanu, Dorin T. [1 ,3 ]
机构
[1] Mayo Clin, Sect Colon & Rectal Surg, Jacksonville, FL 32224 USA
[2] Mayo Clin, Robert D & Patricia E Kern Ctr Sci Hlth Care Deli, Jacksonville, FL 32224 USA
[3] Mayo Clin, Dept Hlth Sci Res, Biostat Unit, Jacksonville, FL 32224 USA
[4] Mayo Clin, Div Colon & Rectal Surg, Rochester, MN USA
关键词
Colorectal surgery; Propensity score; Patient readmission; Pain management; Patient discharge; ENHANCED RECOVERY PROGRAMS; HOSPITAL STAY; CARE PATHWAY; IMPLEMENTATION; METAANALYSIS; OUTCOMES; COLON; READMISSION;
D O I
10.1007/s00384-018-3133-4
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
PurposeEnhanced recovery after surgery (ERAS) provides many benefits. However, important knowledge gaps with respect to specific components of enhanced recovery after surgery remain because of limited validation data. The aim of the study was to validate a mature ERAS protocol at a different hospital and in a similar population of patients.MethodsThis is a retrospective analysis of patients undergoing elective colorectal surgery from 2009 through 2016. Patients enrolled in ERAS are compared with those undergoing the standard of care. Patient demographic characteristics, length of stay, pain scores, and perioperative morbidity are described.ResultsPatients (1396) were propensity matched into two equal groups (ERAS vs non-ERAS). No significant difference was observed for age, Charlson Comorbidity Index, American Society of Anesthesiologists score, body mass index, sex, operative approach, and surgery duration. Median length of stay in ERAS and non-ERAS groups was 3 and 5days (P<.001). Mean pain scores were lower in the ERAS group, measured at discharge from the postanesthesia unit (P<.001), on postoperative day 1 (P=.002) and postoperative day 2 (P=.02) but were identical on discharge.ConclusionsThis ERAS protocol was validated in a similar patient population but at a different hospital. ERAS implementation was associated with an improved length of stay and pain scores similar to the original study. Different than most retrospective studies, propensity score matching ensured that groups were evenly matched. To our knowledge, this study is the only ERAS validation study in a propensity-matched cohort of patients undergoing elective colorectal surgery.
引用
收藏
页码:1543 / 1550
页数:8
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