Enhanced Recovery Program in High-Risk Patients Undergoing Colorectal Surgery: Results from the PeriOperative Italian Society Registry

Autor: Braga, Marco, Pecorelli, Nicolò, Scatizzi, Marco, Borghi, Felice, Missana, Giancarlo, Radrizzani, Danilo, Azzola, Marco, Beretta, Luigi, Bima, Carlo, Bona, Stefano, Bouzari, Hedayat, Casiraghi, Umberto, Ceretti, Andrea Pisani, Crespi, Michele, Ficari, Ferdinando, Iuliani, Riccardo, Maspero, Marianna, Monzani, Roberta, Muratore, Andrea, Pellegrino, Luca
Přispěvatelé: Braga, M, Pecorelli, N, Scatizzi, M, Borghi, F, Missana, G, Radrizzani, D, Azzola, M, Beretta, L, Bima, C, Bona, S, Bouzari, H, Casiraghi, U, Ceretti, A, Crespi, M, Ficari, F, Iuliani, R, Maspero, M, Monzani, R, Muratore, A, Pellegrino, L, on behalf of the PeriOperative Italian, Society
Rok vydání: 2016
Předmět:
Male
Registrie
Health Status
Health Statu
Postoperative Complications
0302 clinical medicine
Clinical Protocols
Risk Factors
Retrospective Studie
Medicine
Age Factor
Registries
Postoperative Period
Laparoscopy
Dietary Carbohydrate
Colectomy
Early Ambulation
Aged
80 and over
medicine.diagnostic_test
Age Factors
Nausea
Middle Aged
Colorectal surgery
Analgesia
Epidural
Italy
Elective Surgical Procedures
Cardiothoracic surgery
030220 oncology & carcinogenesis
Female
030211 gastroenterology & hepatology
Guideline Adherence
Elective Surgical Procedure
Human
Urinary Catheter
medicine.medical_specialty
Vomiting
Urinary Catheters
Perioperative Care
03 medical and health sciences
Dietary Carbohydrates
Humans
Clinical Protocol
Device Removal
Retrospective Studies
Aged
business.industry
Risk Factor
Retrospective cohort study
Recovery of Function
Perioperative
Length of Stay
Vascular surgery
Surgery
Postoperative Complication
business
Abdominal surgery
Zdroj: World Journal of Surgery. 41:860-867
ISSN: 1432-2323
0364-2313
DOI: 10.1007/s00268-016-3766-9
Popis: Background: Enhanced recovery after surgery (ERAS) pathways represent the optimal approach for patients undergoing colorectal surgery. Elderly or low physical status patients have been often excluded from ERAS pathways because considered at high risk. The aim of this study is to assess the adherence to ERAS protocol and its impact on short-term postoperative outcome in patients with different surgical risk undergoing elective colorectal resection. Methods: Prospectively collected data entered in an electronic Italian registry specifically designed for ERAS were reviewed. Patients were divided into four groups according to age (70-year-old cutoff) and preoperative physical status as measured by the ASA grade (I–II vs. III–IV). Adherence to 18 ERAS elements and postoperative outcomes were compared between groups. Regression analysis was used to identify independent factors associated with improved outcomes. Results: Eleven Italian hospitals reported data on 706 patients undergoing elective colorectal surgery within an ERAS protocol. Patients with low physical status had reduced adherence to preoperative carbohydrate loading, epidural analgesia, PONV prophylaxis, and early urinary catheter removal. No difference was found between groups for adherence to other perioperative elements. Major complications occurred in 37 (5.2 %) patients without significant differences among groups (p = 0.384). Median (IQR) time to readiness for discharge (TRD) was 4 (3–6) days, length of hospital stay (LOS) was 6 (4–7) days, and both were significantly shorter by only 1 day in the groups of younger patients (p
Databáze: OpenAIRE
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