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- Title
Enhanced Recovery After Surgery Programs Improve Patient Outcomes and Recovery: A Meta-analysis.
- Authors
Lau, Christine; Chamberlain, Ronald
- Abstract
Introduction: Enhanced recovery after surgery (ERAS) programs have been developed to improve patient outcomes, accelerate recovery after surgery, and reduce healthcare costs. ERAS programs are a multimodal approach, with interventions during all stages of care. This meta-analysis examines the impact of ERAS programs on patient outcomes and recovery. Methods: A comprehensive search of all published randomized control trials (RCTs) assessing the use of ERAS programs in surgical patients was conducted. Outcomes analyzed were length of stay (LOS), overall mortality, 30-day readmission rates, total costs, total complications, time to first flatus, and time to first bowel movement. Results: Forty-two RCTs involving 5241 patients were analyzed. ERAS programs significantly reduced LOS, total complications, and total costs across all types of surgeries ( p < 0.001). Return of gastrointestinal (GI) function was also significantly improved, as measured by earlier time to first flatus and time to first bowel movement, p < 0.001. There was no overall difference in mortality or 30-day readmission rates; however, 30-day readmission rates after upper GI surgeries nearly doubled with the use of ERAS programs (RR = 1.922; p = 0.019). Conclusions: ERAS programs are associated with a significant reduction in LOS, total complications, total costs, as well as earlier return of GI function. Overall mortality and readmission rates remained similar, but there was a significant increase in 30-day readmission rates after upper GI surgeries. ERAS programs are effective and a valuable part in improving patient outcomes and accelerating recovery after surgery.
- Subjects
CONVALESCENCE; SURGICAL complications; MEDICAL care costs; GASTROINTESTINAL function tests; SURGERY
- Publication
World Journal of Surgery, 2017, Vol 41, Issue 4, p899
- ISSN
0364-2313
- Publication type
Article
- DOI
10.1007/s00268-016-3807-4