| Autor: |
Burkely P. Smith, MD, Robert H. Hollis, MD, MSPH, Connie C. Shao, MD, MSPH, Lauren Gleason, MD, Lauren Wood, MPSH, Marshall C. McLeod, MS, PhD, Danielle I. Kay, MD, Gabriela R. Oates, PhD, Maria Pisu, PhD, Daniel I. Chu, MD, MSPH, FACS, FASCRS |
| Jazyk: |
angličtina |
| Rok vydání: |
2023 |
| Předmět: |
|
| Zdroj: |
Surgery Open Science, Vol 13, Iss , Pp 1-8 (2023) |
| Druh dokumentu: |
article |
| ISSN: |
2589-8450 |
| DOI: |
10.1016/j.sopen.2023.03.007 |
| Popis: |
Background: Enhanced recovery programs (ERPs) improve outcomes, but over 20 % of patients fail ERP and the contribution of social vulnerability is unknown. This study aimed to characterize the association between social vulnerability and ERP adherence and failure. Methods: This was a retrospective cohort study of colorectal surgery patients between 2015 and 2020 utilizing ACS-NSQIP data. Patients who failed ERP (LOS > 6 days) were compared to patients not failing ERP. The CDC's social vulnerability index (SVI) was used to assess social vulnerability. Result: 273 of 1191 patients (22.9 %) failed ERP. SVI was a significant predictor of ERP failure (OR 4.6, 95 % CI 1.3–16.8) among those with >70 % ERP component adherence. SVI scores were significantly higher among patients non-adherent with 3 key ERP components: preoperative block (0.58 vs. 0.51, p 70 % of ERP components. Social vulnerability needs to be recognized, addressed, and included in efforts to further improve ERPs. Key message: Social vulnerability is associated with non-adherence to enhanced recovery components and ERP failure among those with high ERP adherence. Social vulnerability needs to be addressed in efforts to improve ERPs. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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