| Autor: |
Charles M. Oliver, Samantha Warnakulasuriya, Dermot McGuckin, Georgina Singleton, Peter Martin, Cristel Santos, James Bedford, Duncan Wagstaff, Arun Sahni, David Gilhooly, Jonathan Wilson, Kylie Edwards, Rachel Baumber, Cecilia Vindrola-Padros, Jenny Dorey, Irene Leeman, Hannah Boyd-Carson, Ravi Vohra, Pritam Singh, Matthew Bedford, Abigail Vallance, Giuseppe Aresu, Olga Tucker, Michael Swart, Monty G. Mythen, Suneetha R. Moonesinghe |
| Rok vydání: |
2022 |
| Předmět: |
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| Zdroj: |
Oliver, C M, Warnakulasuriya, S, McGuckin, D, Singleton, G, Vallance, A E & Moonesinghe, S R 2022, ' Delivery of drinking, eating and mobilising (DrEaMing) and its association with length of hospital stay after major noncardiac surgery : observational cohort study ', British Journal of Anaesthesia, vol. 129, no. 1, pp. 114-126 . https://doi.org/10.1016/j.bja.2022.03.021 |
| ISSN: |
0007-0912 |
| DOI: |
10.1016/j.bja.2022.03.021 |
| Popis: |
Background: Enhanced recovery pathways are associated with improved postoperative outcomes. However, as enhancedrecovery pathways have become more complex and varied, compliance has reduced. The ‘DrEaMing’ bundle re-prioritises early postoperative delivery of drinking, eating, and mobilising. We investigated relationships betweenDrEaMing compliance, postoperative hospital length of stay (LOS), and complications in a prospective multicentre majorsurgical cohort.Methods: We interrogated the UK Perioperative Quality Improvement Programme dataset. Analyses were conducted infour stages. In an exploratory cohort, we identified independent predictors of DrEaMing. We quantified the associationbetween delivery of DrEaMing (and its component variables) and prolonged LOS in a homogenous colorectal subgroup and assessed generalisability in multispecialty patients. Finally, LOS and complications were compared across hospitals,stratified by DrEaMing compliance.Results: The exploratory cohort comprised 22 218 records, the colorectal subgroup 7230, and the multispecialty subgroup5713. DrEaMing compliance was 59% (13 112 patients), 60% (4341 patients), and 60% (3421), respectively, but variedsubstantially between hospitals. Delivery of DrEaMing predicted reduced odds of prolonged LOS in colorectal (odds ratio0.51 [0.43e0.59], Pcations were not the primary determinant of LOS after colorectal surgery, but consistent delivery of DrEaMing wasassociated with significantly shorter LOS.Conclusions: Delivery of bundled and unbundled DrEaMing was associated with substantial reductions in postoperativeLOS, independent of the effects of confounder variables. Consistency of process delivery, and not complications, pre-dicted shorter hospital-level length of stay. DrEaMing may be adopted by perioperative health systems as a quality metricto support improved patient outcomes and reduced hospital length of stay. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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