دورية أكاديمية
Association between use of enhanced recovery after surgery protocols and postoperative complications in colorectal surgery in Europe: The EuroPOWER international observational study.
| العنوان: | Association between use of enhanced recovery after surgery protocols and postoperative complications in colorectal surgery in Europe: The EuroPOWER international observational study. |
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| المؤلفون: | Ripollés-Melchor, Javier, Abad-Motos, Ane, Cecconi, Maurizio, Pearse, Rupert, Jaber, Samir, Slim, Karem, Francis, Nader, Spinelli, Antonino, Joris, Jean, Ioannidis, Orestis, Zarzava, Eirini, Şentürk, Nüzhet Mert, Koopman, Seppe, Goettel, Nicolai, Stundner, Ottokar, Vymazal, Tomas, Kocián, Petr, El-Hussuna, Alaa, Pędziwiatr, Michał, Gudaityte, Jurate, Latkauskas, Tadas, Santos, Marisa D, Machado, Humberto, Zahorec, Roman, Cvetković, Ana, Miric, Mirjana, Georgiou, Maria, Díez-Remesal, Yolanda, Jammer, Ib, Mena, Gabriel E, Zorrilla-Vaca, Andrés, Marino, Marco V, Suárez-de-la-Rica, Alejandro, García-Erce, José A, Logroño-Ejea, Margarita, Ferrando-Ortolá, Carlos, De-Fuenmayor-Valera, María L, Ugarte-Sierra, Bakarne, de Andrés-Ibañez, José, Abad-Gurumeta, Alfredo, Pellino, Gianluca, Gómez-Ríos, Manuel A, Poggioli, Gilberto, Menzo-Wolthuis, Albert, Castellano-Paulis, Berta, Galán-Menéndez, Patricia, Aldecoa, César, Ramírez-Rodríguez, José M, EuroPOWER Study Investigators Group, Spanish Perioperative Audit and Research Network (RedGERM-SPARN, Francophone Group for Enhanced Recovery After Surgery (GRACE |
| المصدر: | Journal of Clinical Anesthesia, 80, 110752 (2022) |
| بيانات النشر: | Elsevier Inc., 2022. |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | Colorectal surgery, ERAS, Enhanced recovery, Optimization, Perioperative management, Postoperative complications, Adult, Elective Surgical Procedures/adverse effects, Humans, Length of Stay, Observational Studies as Topic, Perioperative Care/methods, Postoperative Complications/epidemiology, Postoperative Complications/etiology, Prospective Studies, Colorectal Surgery/adverse effects, Enhanced Recovery After Surgery, Elective Surgical Procedures, Perioperative Care, Anesthesiology and Pain Medicine, Human health sciences, Anesthesia & intensive care, Surgery, Sciences de la santé humaine, Anesthésie & soins intensifs, Chirurgie |
| الوصف: | STUDY OBJECTIVE: Assess the relationship between the Enhanced Recovery After Surgery (ERAS®) pathway and routine care and 30-day postoperative outcomes.DESIGN: Prospective cohort study.SETTING: European centers (185 hospitals) across 21 countries.PATIENTS: A total of 2841 adult patients undergoing elective colorectal surgery. Each hospital had a 1-month recruitment period between October 2019 and September 2020.INTERVENTIONS: Routine perioperative care.MEASUREMENTS: Twenty-four components of the ERAS pathway were assessed in all patients regardless of whether they were treated in a formal ERAS pathway. A multivariable and multilevel logistic regression model was used to adjust for baseline risk factors, ERAS elements and country-based differences.RESULTS: A total of 1835 patients (65%) received perioperative care at a self-declared ERAS center, 474 (16.7%) developed moderate-to-severe postoperative complications, and 63 patients died (2.2%). There was no difference in the primary outcome between patients who were or were not treated in self-declared ERAS centers (17.1% vs. 16%; OR 1.00; 95%CI, 0.79-1.27; P = 0.986). Hospital stay was shorter among patients treated in self-declared ERAS centers (6 [5-9] vs. 8 [6-10] days; OR 0.82; 95%CI, 0.78-0.87; P < 0.001). Median adherence to 24 ERAS elements was 57% [48%-65%]. Adherence to ERAS-pathway quartiles (≥65% vs. <48%) suggested that patients with the highest adherence rates experienced a lower risk of moderate-to-severe complications (15.9% vs. 17.8%; OR 0.71; 95%CI, 0.53-0.96; P = 0.027), lower risk of death (0.3% vs. 2.9%; OR 0.10; 95%CI, 0.02-0.42; P = 0.002) and shorter hospital stay (6 [4-8] vs. 7 [5-10] days; OR 0.74; 95%CI, 0.69-0.79; P < 0.001).CONCLUSIONS: Treatment in a self-declared ERAS center does not improve outcome after colorectal surgery. Increased adherence to the ERAS pathway is associated with a significant reduction in overall postoperative complications, lower risk of moderate-to-severe complications, shorter length of hospital stay and lower 30-day mortality. |
| نوع الوثيقة: | journal article http://purl.org/coar/resource_type/c_6501Test article peer reviewed |
| اللغة: | English |
| العلاقة: | https://api.elsevier.com/content/article/PII:S095281802200109X?httpAccept=text/xmlTest; urn:issn:0952-8180 |
| DOI: | 10.1016/j.jclinane.2022.110752 |
| الوصول الحر: | https://orbi.uliege.be/handle/2268/296079Test |
| حقوق: | restricted access http://purl.org/coar/access_right/c_16ecTest info:eu-repo/semantics/restrictedAccess |
| رقم الانضمام: | edsorb.296079 |
| قاعدة البيانات: | ORBi |
| DOI: | 10.1016/j.jclinane.2022.110752 |
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