Enhanced recovery after surgery (ERAS ® ) protocol adapted to the Brazilian reality: a prospective cohort study for thoracic patients.

Autor:	Abrão FC; Thoracic Surgery Department, Hospital Santa Marcelina, São Paulo, Brazil.; Thoracic Department, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil., Araujo de França S; IPSPAC Research Department - Instituto Paulista de Saúde para Alta Complexidade, Santo Andre, Brazil., de Abreu IRLB; Thoracic Surgery Department, Hospital Santa Marcelina, São Paulo, Brazil.; Thoracic Surgery Department, Hospital São Camilo, São Paulo, Brazil., das Neves Pereira JC; Thoracic Surgery of Hospital Européen Georges Pompidou, Paris, France., Del Massa EC; Anesthesiology Department, Hospital Santa Marcelina, São Paulo, Brazil., Oliver A; Physiotherapy Department, Hospital Santa Marcelina, São Paulo, Brazil., Cavalcante MGC; Thoracic Surgery Department, Hospital Santa Marcelina, São Paulo, Brazil.; Thoracic Surgery Department, Hospital São Camilo, São Paulo, Brazil.
Jazyk:	angličtina
Zdroj:	Journal of thoracic disease [J Thorac Dis] 2021 Sep; Vol. 13 (9), pp. 5439-5447.
DOI:	10.21037/jtd-21-920
Abstrakt:	Background: In Low-Middle Income Countries (LMICs), resource optimization and infrastructure availability are recurrently in debate. In order to assist the development and implementation of guidelines, LMICs often exemplify from High-Income Countries protocols. At the final, it will be: content adaption is often needed. In this study, we demonstrated the preliminary analysis of the Brazilian experience by adapting the ERAS ® Protocol for thoracic surgery patients (PROSM). Methods: Patients' data were extracted from the surgical group database that operated in the city of Sao Paulo. Patients' data were organized for analysis after the institution's ethics committee gave their approval. Patients' variables were analyzed and compared to a control group. Subgroup analysis included patients without ICU Admission. Results: PROSM patients had reduced ICU length of stay (LOS) (Mean of 0.3±0.58 days, 1.2±1.65 days, P=0.001), Hospital LOS (Mean of 1.6±1.32 days, 3.9±3.25 days, P=0.001) and Chest Drain duration (Median 1.0±1.00 days, 3.0±3.00 days, P=0.001). Analyses of patients that were not admitted to the ICU demonstrated reduced Hospital LOS and Chest drain duration. Cost analysis, such as procedure, daily, and post-surgical costs were also significantly lower towards PROSM group. Conclusions: This study revealed important aspects for improvement of the delivered care quality and opportunity for expenditure management. We expect to assist more countries to improve knowledge under the implementation of enhanced protocols. Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://dx.doi.org/10.21037/jtd-21-920). The authors have no conflicts of interest to declare. (2021 Journal of Thoracic Disease. All rights reserved.)
Databáze:	MEDLINE
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