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

dc.contributor.author Anstrom, Kevin J
dc.contributor.author Edwards, R
dc.contributor.author Eisenstein, EL
dc.contributor.author Enhanced Recovery Study Group
dc.contributor.author Gan, Tong Joo
dc.contributor.author Jin, Juying
dc.contributor.author Mantyh, Christopher Ritchie
dc.contributor.author Migaly, J
dc.contributor.author Miller, Timothy Ellis
dc.contributor.author Moon, Richard Edward
dc.contributor.author Roche, Anthony Michael
dc.contributor.author Thacker, Julie K Marosky
dc.contributor.author White, WD
dc.coverage.spatial United States
dc.date.accessioned 2014-04-28T15:00:30Z
dc.date.issued 2014-05
dc.identifier http://www.ncbi.nlm.nih.gov/pubmed/24781574
dc.identifier 00000539-201405000-00026
dc.identifier.uri https://hdl.handle.net/10161/8598
dc.description.abstract 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.
dc.language eng
dc.relation.ispartof Anesth Analg
dc.relation.isversionof 10.1213/ANE.0000000000000206
dc.subject Adult
dc.subject Aged
dc.subject Analgesia, Epidural
dc.subject Blood Substitutes
dc.subject Clinical Protocols
dc.subject Colorectal Surgery
dc.subject Cost Savings
dc.subject Costs and Cost Analysis
dc.subject Digestive System Surgical Procedures
dc.subject Female
dc.subject Humans
dc.subject Laparoscopy
dc.subject Length of Stay
dc.subject Linear Models
dc.subject Male
dc.subject Middle Aged
dc.subject Pain Measurement
dc.subject Pain, Postoperative
dc.subject Perioperative Care
dc.subject Sample Size
dc.subject Survival
dc.subject Treatment Outcome
dc.subject United States
dc.title Reduced length of hospital stay in colorectal surgery after implementation of an enhanced recovery protocol.
dc.type Journal article
pubs.author-url http://www.ncbi.nlm.nih.gov/pubmed/24781574
pubs.begin-page 1052
pubs.end-page 1061
pubs.issue 5
pubs.organisational-group Anesthesiology
pubs.organisational-group Anesthesiology, Critical Care Medicine
pubs.organisational-group Anesthesiology, General, Vascular, High Risk Transplant & Critical Care
pubs.organisational-group Basic Science Departments
pubs.organisational-group Biostatistics & Bioinformatics
pubs.organisational-group Clinical Science Departments
pubs.organisational-group Community and Family Medicine
pubs.organisational-group Duke
pubs.organisational-group Duke Cancer Institute
pubs.organisational-group Duke Clinical Research Institute
pubs.organisational-group Faculty
pubs.organisational-group Institutes and Centers
pubs.organisational-group Medicine
pubs.organisational-group Medicine, Cardiology
pubs.organisational-group Medicine, Pulmonary, Allergy, and Critical Care Medicine
pubs.organisational-group School of Medicine
pubs.organisational-group School of Nursing
pubs.organisational-group School of Nursing - Secondary Group
pubs.organisational-group Surgery
pubs.publication-status Published
pubs.volume 118
dc.identifier.eissn 1526-7598


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