Higher adherence to eras society recommendations is associated with shorter hospital stay without an increase in postoperative complications or readmissions in bariatric surgery

Ripolles-Melchor, Javier ; Sanchez-Santos, Raquel ; Abad-Motos, Ane ; Gimeno-Moro, Ana M. ; Diez-Remesal, Yolanda ; Jove-Albores, Patricia ; Arago-Chofre, Pablo ; Ortiz-Sebastian, Sergio ; Sanchez-Martin, Ruben ; Ramirez-Rodriguez, Jose M. (Universidad de Zaragoza) ; Trullenque-Juan, Ramon ; Valenti-Azcarate, Victor ; Ramiro-Ruiz, Alvaro ; Correa-Chacon, Olga C. ; Batalla, Astrid ; Gimeno-Grauwinkel, Cassandra ; Marti Sanahuja-Blasco, Josep ; Gonzalez-Valverde, Francisco M. ; Galan-Menendez, Patricia ; Diez-Zapirain, Miren J. ; Vilallonga, Ramon ; Zorrilla-Vaca, Andres ; Pascual-Bellosta, Ana M. ; Martinez-Ubieto, Javier (Universidad de Zaragoza) ; Carrascosa-Miron, Teresa ; Ruiz-Escobar, Alicia ; Martin-Garcia-Almenta, Ester ; Suarez-de-la-Rica, Alejandro ; Bausili, Marc ; Palacios-Cordoba, Angela ; Olvera-Garcia, Maria M. ; Meza-Vega, Julio A. ; Sanchez-Pernaute, Andres ; Abad-Gurumeta, Alfredo ; Ferrando-Ortola, Carlos ; Martin-Vaquerizo, Beatriz ; Torres-Alfonso, Jose R. ; Aguado-Sanchez, Sandra ; Sanchez-Cabezudo-Noguera, Fatima ; Garcia-Erce, Jose A. ; Aldecoa, Cesar

Resumen: Purpose: The effectiveness of enhanced recovery after surgery (ERAS) pathways in patients undergoing bariatric surgery remains unclear. Our objective was to determine the effect of the ERAS elements on patient outcomes following elective bariatric surgery. Materials and Methods: Prospective cohort study in adult patients undergoing elective bariatric surgery. Each participating center selected a single 3-month data collection period between October 2019 and September 2020. We assessed the 24 individual components of the ERAS pathways in all patients. We used a multivariable and multilevel logistic regression model to adjust for baseline risk factors, ERAS elements, and center differences. Results: We included 1419 patients. One hundred and fourteen patients (8%) developed postoperative complications. There were no differences in the incidence of overall postoperative complications between the self-designated ERAS and non-ERAS groups (54 (8.7%) vs. 60 (7.6%); OR, 1.14; 95% CI, 0.73–1.79; P = .56), neither for moderate-to-severe complications, readmissions, re-interventions, mortality, or hospital stay (2 [IQR 2–3] vs. 3 [IQR 2–4] days, 0.85; 95% CI, 0.62–1.17; P = .33) Adherence to the ERAS elements in the highest adherence quartile (Q1) was greater than 72.2%, while in the lowest adherence quartile (Q4) it was less than 55%. Patients with the highest adherence rates had shorter hospital stay (2 [IQR 2–3] vs. 3 [IQR 2–4] days, 1.54; 95% CI, 1.09–2.17; P = .015), while there were no differences in the other outcomesConclusionsHigher adherence to ERAS Society® recommendations was associated with a shorter hospital stay without an increase in postoperative complications or readmissions.

Idioma: Inglés

DOI: 10.1007/s11695-022-05949-6

Año: 2022

Publicado en: Obesity surgery 32 (2022), 1289–1299
ISSN: 0960-8923

Factor impacto JCR: 2.9 (2022)

Categ. JCR: SURGERY rank: 63 / 213 = 0.296 (2022) - Q2 - T1

Factor impacto CITESCORE: 5.8 - Nursing (Q1) - Medicine (Q1)

Factor impacto SCIMAGO: 1.127 - Endocrinology, Diabetes and Metabolism (Q1) - Surgery (Q1) - Nutrition and Dietetics (Q1)

Tipo y forma: Artículo (PostPrint)

Área (Departamento): Área Cirugía (Dpto. Cirugía)