Association Between Use of Enhanced Recovery After Surgery Protocol and Postoperative Complications in Colorectal Surgery: The Postoperative Outcomes Within Enhanced Recovery After Surgery Protocol (POWER) Study
| Autor: | José Antonio García-Erce, Alejandro Suarez de la Rica, Héctor Berges, Javier Ripollés-Melchor, Fátima Sofía Senra Lorenzana, José Manuel Ramírez Rodríguez, FERNANDO ALCAIDE MATAS, Jaime Zorrilla Ortúzar, Pablo Menéndez Bujan, Francisco Javier Redondo Calvo, Unai De Andres Olabarria, Cesar Aldecoa, Ane Abad-Motos, Ainitze Ibarzabal, Carlos Ferrando, Manuel Ángel Gómez-Ríos, José Ignacio Alonso-Fernández, Álvaro Ramiro, Juan José Segura-Sampedro |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
030230 surgery 03 medical and health sciences 0302 clinical medicine Postoperative Complications Interquartile range medicine Humans In patient Postoperative Period Prospective Studies Prospective cohort study Enhanced recovery after surgery Aged Perioperative management business.industry Incidence (epidemiology) Incidence Correction Odds ratio Length of Stay Middle Aged Colorectal surgery Surgery Survival Rate Treatment Outcome Elective Surgical Procedures Spain 030220 oncology & carcinogenesis Patient Compliance business Enhanced Recovery After Surgery Colorectal Surgery Follow-Up Studies |
| Zdroj: | JAMA Surg |
| ISSN: | 2168-6262 |
| Popis: | Importance: enhanced Recovery After Surgery (ERAS) care has been reported to be associated with improvements in outcomes after colorectal surgery compared with traditional care. Objective: to determine the association between ERAS protocols and outcomes in patients undergoing elective colorectal surgery. Design, setting, and participants: the Postoperative Outcomes Within Enhanced Recovery After Surgery Protocol (POWER) Study is a multicenter, prospective cohort study of 2084 consecutive adults scheduled for elective colorectal surgery who received or did not receive care in a self-declared ERAS center. Patients were recruited from 80 Spanish centers between September 15 and December 15, 2017. All patients included in this analysis had 1 month of follow-up. Exposures: colorectal surgery and perioperative management were the exposures. Twenty-two individual ERAS items were assessed in all patients, regardless of whether they were included in an established ERAS protocol. Main outcomes and measures: the primary study outcome was moderate to severe postoperative complications within 30 days after surgery. Secondary outcomes included ERAS adherence, mortality, readmissions, reoperation rates, and hospital length of stay. Results: between September 15 and December 15, 2017, 2084 patients were included in the study. Of these, 1286 individuals (61.7%) were men; mean age was 68 years (interquartile range [IQR], 59-77). A total of 879 patients (42.2%) presented with postoperative complications and 566 patients (27.2%) developed moderate to severe complications. The number of patients with moderate or severe complications was lower in the ERAS group (25.2% vs 30.3%; odds ratio [OR], 0.77; 95% CI, 0.63-0.94; P¿=¿.01). The overall rate of adherence to the ERAS protocol was 63.6% (IQR, 54.5%-77.3%), and the rate for patients from hospitals self-declared as ERAS was 72.7% (IQR, 59.1%-81.8%) vs non-ERAS institutions, which was 59.1% (IQR, 50.0%-63.6%; P¿ |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|