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, Machado, Humberto, Zahorec, Roman, Cvetković, Ana, Miric, Mirjana, Georgiou, Maria, Díez-Remesal, Yolanda, Jammer, Ib, Mena, Gabriel, Zorrilla-Vaca, Andrés, Marino, Marco, Suárez-De-La-Rica, Alejandro, García-Erce, José, Logroño-Ejea, Margarita, Ferrando-Ortolá, Carlos, De-Fuenmayor-Valera, María, Ugarte-Sierra, Bakarne, de Andrés-Ibañez, José, Abad-Gurumeta, Alfredo, Pellino, Gianluca, Gómez-Ríos, Manuel, Poggioli, Gilberto, Menzo-Wolthuis, Albert, Castellano-Paulis, Berta, Galán-Menéndez, Patricia, Aldecoa, César, Ramírez-Rodríguez, José |
| المساهمون: | Physiologie & médecine expérimentale du Cœur et des Muscles U 1046 (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier), CHU Clermont-Ferrand |
| المصدر: | ISSN: 0952-8180 ; Journal of Clinical Anesthesia ; https://hal.science/hal-03638152Test ; Journal of Clinical Anesthesia, 2022, 80, pp.110752. ⟨10.1016/j.jclinane.2022.110752⟩. |
| بيانات النشر: | HAL CCSD Elsevier |
| سنة النشر: | 2022 |
| المجموعة: | Université de Montpellier: HAL |
| مصطلحات موضوعية: | ERAS, Colorectal surgery, Optimization, Enhanced recovery, Postoperative complications, Perioperative management, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie |
| الوصف: | International audience ; 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 ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | hal-03638152; https://hal.science/hal-03638152Test; https://hal.science/hal-03638152/documentTest; https://hal.science/hal-03638152/file/2022%20Ripolles%20Melchor%20et%20al.,%20Association%20between.pdfTest |
| DOI: | 10.1016/j.jclinane.2022.110752 |
| الإتاحة: | https://doi.org/10.1016/j.jclinane.2022.110752Test https://hal.science/hal-03638152Test https://hal.science/hal-03638152/documentTest https://hal.science/hal-03638152/file/2022%20Ripolles%20Melchor%20et%20al.,%20Association%20between.pdfTest |
| حقوق: | info:eu-repo/semantics/OpenAccess |
| رقم الانضمام: | edsbas.CE49FCE9 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1016/j.jclinane.2022.110752 |
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