Optimal results through enhanced recovery: Achieving textbook outcomes with high compliance in elective liver surgery.

IF 2.3 3区医学 Q2 SURGERY

World Journal of Surgery Pub Date : 2024-10-10 DOI:10.1002/wjs.12345

Juliette Gosse, Pascale Mariani, Eddy Cotte, Guillaume Passot, Adeline Germain, Olivier Detry, Abdourahamane Kaba, Aurélien Dupre, Toufik Bouhadiba, Ahmet Ayav, Gabriel Thierry, Prisca Combari-Ancellin, Aziz Atallah, Daniele Sommacale, Giuliana Amaddeo, Karem Slim, Raffaele Brustia

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引用次数: 0

Abstract

Background: Existing studies suggest a positive correlation between high compliance with enhanced recovery programs (ERP) and improved outcomes. While individual outcome measures have advantages, composite benchmarks, such as textbook outcome (TO), offer a more comprehensive assessment of healthcare performance. Given the link between ERP and postoperative outcomes, this study aims to investigate the impact of ERP on TO attainment after liver surgery (LS).

Methods: A prospective multicenter cohort of patients undergoing LS and exposed to ERP from 2016 to 2022 in France was analyzed. The primary outcome was to compare the rates of TO achieved between patients with high ERP compliance (>70%) and those with low ERP compliance (<70%) after LS.

Results: A total of 706 patients were included in the study, and 217 (30.7%) achieved TO: 170 patients with high ERP compliance (24%) versus 47 patients (6.6%) with low ERP compliance attained TO (p < 0.001). High ERP compliance was associated to an increased likelihood of achieving TO [odds ratio (OR) = 1.49 (95% CI: 1.01, 2.24); p = 0.049], while cholangiocarcinoma [OR = 0.11 (95% CI: 0.02, 0.39); p = 0.003], high complexity LS [OR = 0.22 (95% CI: 0.13, 0.36); p < 0.001], intraoperative hypotension requiring vasopressors [OR = 0.29 (95% CI: 0.10, 0.68); p = 0.010], and post-operative ileus [OR = 0.08 (95% CI: 0.00, 0.37); p = 0.013] were negatively associated to the likelihood of achieving TO.

Conclusions: Patients with high ERP compliance after LS experience elevated rates of TO, compared to those with low ERP compliance.

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通过加强恢复达到最佳效果：在择期肝脏手术中实现教科书般的高依从性结果。

背景：现有研究表明，加强康复计划（ERP）的高依从性与疗效改善之间存在正相关。虽然单项结果测量具有优势，但教科书结果（TO）等综合基准可对医疗保健绩效进行更全面的评估。鉴于ERP与术后结果之间的联系，本研究旨在调查ERP对肝脏手术（LS）后达到TO的影响：方法：对法国 2016 年至 2022 年期间接受肝脏手术并接触过 ERP 的患者进行前瞻性多中心队列分析。主要结果是比较ERP依从性高（>70%）的患者和ERP依从性低的患者的TO达标率：共有 706 名患者参与研究，其中 217 人（30.7%）实现了 TO：170名ERP依从性高的患者（24%）与47名ERP依从性低的患者（6.6%）获得了TO（P 结论：ERP依从性高的患者在LS后可获得TO：与ERP依从性低的患者相比，LS术后ERP依从性高的患者获得TO的比例更高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

World Journal of Surgery 医学-外科

CiteScore

5.10

自引率

3.80%

发文量

460

审稿时长

3 months

期刊介绍： World Journal of Surgery is the official publication of the International Society of Surgery/Societe Internationale de Chirurgie (iss-sic.com). Under the editorship of Dr. Julie Ann Sosa, World Journal of Surgery provides an in-depth, international forum for the most authoritative information on major clinical problems in the fields of clinical and experimental surgery, surgical education, and socioeconomic aspects of surgical care. Contributions are reviewed and selected by a group of distinguished surgeons from across the world who make up the Editorial Board.