000132777 001__ 132777 000132777 005__ 20240315113107.0 000132777 0247_ $$2doi$$a10.1016/j.jclinane.2022.110752 000132777 0248_ $$2sideral$$a128709 000132777 037__ $$aART-2022-128709 000132777 041__ $$aeng 000132777 100__ $$aRipollés-Melchor, J. 000132777 245__ $$aAssociation between use of enhanced recovery after surgery protocols and postoperative complications in colorectal surgery in Europe: The EuroPOWER international observational study 000132777 260__ $$c2022 000132777 5203_ $$aStudy 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. © 2022 Elsevier Inc. 000132777 540__ $$9info:eu-repo/semantics/openAccess$$aAll rights reserved$$uhttp://www.europeana.eu/rights/rr-f/ 000132777 590__ $$a6.7$$b2022 000132777 591__ $$aANESTHESIOLOGY$$b5 / 35 = 0.143$$c2022$$dQ1$$eT1 000132777 592__ $$a1.019$$b2022 000132777 593__ $$aAnesthesiology and Pain Medicine$$c2022$$dQ1 000132777 594__ $$a6.7$$b2022 000132777 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion 000132777 700__ $$aAbad-Motos, A. 000132777 700__ $$aCecconi, M. 000132777 700__ $$aPearse, R. 000132777 700__ $$aJaber, S. 000132777 700__ $$aSlim, K. 000132777 700__ $$aFrancis, N. 000132777 700__ $$aSpinelli, A. 000132777 700__ $$aJoris, J. 000132777 700__ $$aIoannidis, O. 000132777 700__ $$aZarzava, E. 000132777 700__ $$aSentürk, N.M. 000132777 700__ $$aKoopman, S. 000132777 700__ $$aGoettel, N. 000132777 700__ $$aStundner, O. 000132777 700__ $$aVymazal, T. 000132777 700__ $$aKocián, P. 000132777 700__ $$aEl-Hussuna, A. 000132777 700__ $$aPedziwiatr, M. 000132777 700__ $$aGudaityte, J. 000132777 700__ $$aLatkauskas, T. 000132777 700__ $$aSantos, M.D. 000132777 700__ $$aMachado, H. 000132777 700__ $$aZahorec, R. 000132777 700__ $$aCvetkovic, A. 000132777 700__ $$aMiric, M. 000132777 700__ $$aGeorgiou, M. 000132777 700__ $$aDíez-Remesal, Y. 000132777 700__ $$aJammer, I. 000132777 700__ $$aMena, G E. 000132777 700__ $$aZorrilla-Vaca, A. 000132777 700__ $$aMarino, M.V. 000132777 700__ $$aSuárez-de-la-Rica, A. 000132777 700__ $$aGarcía-Erce, J.A. 000132777 700__ $$aLogroño-Ejea, M. 000132777 700__ $$aFerrando-Ortolá, C. 000132777 700__ $$aDe-Fuenmayor-Valera, M.L. 000132777 700__ $$aUgarte-Sierra, B. 000132777 700__ $$ade Andrés-Ibañez, J. 000132777 700__ $$aAbad-Gurumeta, A. 000132777 700__ $$aPellino, G. 000132777 700__ $$aGómez-Ríos, M.A. 000132777 700__ $$aPoggioli, G. 000132777 700__ $$aMenzo-Wolthuis, A. 000132777 700__ $$aCastellano-Paulis, B. 000132777 700__ $$aGalán-Menéndez, P. 000132777 700__ $$aAldecoa, C. 000132777 700__ $$0(orcid)0000-0001-7964-1166$$aRamírez-Rodríguez, J.M., on behalf of the EuroPOWER Study Investigators Group$$uUniversidad de Zaragoza 000132777 700__ $$aEchazarreta-Gallego, E. 000132777 7102_ $$11013$$2090$$aUniversidad de Zaragoza$$bDpto. Cirugía$$cÁrea Cirugía 000132777 773__ $$g80 (2022), 110752 [10 pp.]$$pJ. clin. anesth.$$tJOURNAL OF CLINICAL ANESTHESIA$$x0952-8180 000132777 8564_ $$s1516815$$uhttps://zaguan.unizar.es/record/132777/files/texto_completo.pdf$$yVersión publicada 000132777 8564_ $$s2467468$$uhttps://zaguan.unizar.es/record/132777/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada 000132777 909CO $$ooai:zaguan.unizar.es:132777$$particulos$$pdriver 000132777 951__ $$a2024-03-15-08:49:21 000132777 980__ $$aARTICLE