Stephanie D. Talutis, U. Phatak, Angela H. Kuhnen, P. Rosenkranz, D. McAneny, J. Hall
{"title":"结直肠手术后的强化恢复:在安全网医院的一年经验","authors":"Stephanie D. Talutis, U. Phatak, Angela H. Kuhnen, P. Rosenkranz, D. McAneny, J. Hall","doi":"10.4103/wjcs.wjcs_7_20","DOIUrl":null,"url":null,"abstract":"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.","PeriodicalId":90396,"journal":{"name":"World journal of colorectal surgery","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Enhanced recovery after colorectal surgery: 1st year experience in a safety-net hospital\",\"authors\":\"Stephanie D. Talutis, U. Phatak, Angela H. Kuhnen, P. Rosenkranz, D. McAneny, J. Hall\",\"doi\":\"10.4103/wjcs.wjcs_7_20\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"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.\",\"PeriodicalId\":90396,\"journal\":{\"name\":\"World journal of colorectal surgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2020-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World journal of colorectal surgery\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4103/wjcs.wjcs_7_20\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World journal of colorectal surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/wjcs.wjcs_7_20","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
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 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.