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Reduced length of hospital stay in colorectal surgery after implementation of an enhanced recovery protocol.

Publication ,  Journal Article
Miller, TE; Thacker, JK; White, WD; Mantyh, C; Migaly, J; Jin, J; Roche, AM; Eisenstein, EL; Edwards, R; Anstrom, KJ; Moon, RE; Gan, TJ ...
Published in: Anesth Analg
May 2014

BACKGROUND: Enhanced recovery after surgery (ERAS) is a multimodal approach to perioperative care that combines a range of interventions to enable early mobilization and feeding after surgery. We investigated the feasibility, clinical effectiveness, and cost savings of an ERAS program at a major U. S. teaching hospital. METHODS: Data were collected from consecutive patients undergoing open or laparoscopic colorectal surgery during 2 time periods, before and after implementation of an ERAS protocol. Data collected included patient demographics, operative, and perioperative surgical and anesthesia data, need for analgesics, complications, inpatient medical costs, and 30-day readmission rates. RESULTS: There were 99 patients in the traditional care group, and 142 in the ERAS group. The median length of stay (LOS) was 5 days in the ERAS group compared with 7 days in the traditional group (P < 0.001). The reduction in LOS was significant for both open procedures (median 6 vs 7 days, P = 0.01), and laparoscopic procedures (4 vs 6 days, P < 0.0001). ERAS patients had fewer urinary tract infections (13% vs 24%, P = 0.03). Readmission rates were lower in ERAS patients (9.8% vs 20.2%, P = 0.02). DISCUSSION: Implementation of an enhanced recovery protocol for colorectal surgery at a tertiary medical center was associated with a significantly reduced LOS and incidence of urinary tract infection. This is consistent with that of other studies in the literature and suggests that enhanced recovery programs could be implemented successfully and should be considered in U.S. hospitals.

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Published In

Anesth Analg

DOI

EISSN

1526-7598

Publication Date

May 2014

Volume

118

Issue

5

Start / End Page

1052 / 1061

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Survival
  • Sample Size
  • Perioperative Care
  • Pain, Postoperative
  • Pain Measurement
  • Middle Aged
  • Male
  • Linear Models
 

Citation

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Miller, T. E., Thacker, J. K., White, W. D., Mantyh, C., Migaly, J., Jin, J., … Enhanced Recovery Study Group. (2014). Reduced length of hospital stay in colorectal surgery after implementation of an enhanced recovery protocol. Anesth Analg, 118(5), 1052–1061. https://doi.org/10.1213/ANE.0000000000000206
Miller, Timothy E., Julie K. Thacker, William D. White, Christopher Mantyh, John Migaly, Juying Jin, Anthony M. Roche, et al. “Reduced length of hospital stay in colorectal surgery after implementation of an enhanced recovery protocol.Anesth Analg 118, no. 5 (May 2014): 1052–61. https://doi.org/10.1213/ANE.0000000000000206.
Miller TE, Thacker JK, White WD, Mantyh C, Migaly J, Jin J, et al. Reduced length of hospital stay in colorectal surgery after implementation of an enhanced recovery protocol. Anesth Analg. 2014 May;118(5):1052–61.
Miller, Timothy E., et al. “Reduced length of hospital stay in colorectal surgery after implementation of an enhanced recovery protocol.Anesth Analg, vol. 118, no. 5, May 2014, pp. 1052–61. Pubmed, doi:10.1213/ANE.0000000000000206.
Miller TE, Thacker JK, White WD, Mantyh C, Migaly J, Jin J, Roche AM, Eisenstein EL, Edwards R, Anstrom KJ, Moon RE, Gan TJ, Enhanced Recovery Study Group. Reduced length of hospital stay in colorectal surgery after implementation of an enhanced recovery protocol. Anesth Analg. 2014 May;118(5):1052–1061.

Published In

Anesth Analg

DOI

EISSN

1526-7598

Publication Date

May 2014

Volume

118

Issue

5

Start / End Page

1052 / 1061

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Survival
  • Sample Size
  • Perioperative Care
  • Pain, Postoperative
  • Pain Measurement
  • Middle Aged
  • Male
  • Linear Models