Enhanced Recovery Protocols Reduce Mortality Across Eight Surgical Specialties At Academic and University-Affiliated Community Hospitals

Annals of Surgery
Stephen A EsperAman Mahajan

Abstract

To determine if implementation of a simplified enhanced recovery protocol (ERP) across multiple surgical specialties in different hospitals is associated with improved short and long-term mortality. Secondary aims were to examine ERP effect on LOS, 30-day readmission, discharge disposition, and complications. Enhanced Recovery After Surgery (ERAS) and various derivative ERPs have been successfully implemented. These protocols typically include elaborate sets of multi-modal and multi-disciplinary approaches, which can make implementation challenging or are variable across different specialties. Few studies have shown if a simplified version of ERP implemented across multiple surgical specialties can improve clinical outcomes. A simplified ERP with seven key domains (minimally invasive surgical approach when feasible, pre-/intra-operative multimodal analgesia, postoperative multimodal analgesia, postoperative nausea and vomiting prophylaxis, early diet advancement, early ambulation, and early removal of urinary catheter) was implemented in five academic and community hospitals within a single health system. Patients who underwent non-emergent, major orthopedic or abdominal surgery including hip/knee replacement, hepatobiliary, co...Continue Reading

Citations

Feb 19, 2021·Langenbeck's Archives of Surgery·Karem SlimLaurent Delaunay

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