132777 20240315113107.0 doi 10.1016/j.jclinane.2022.110752 sideral 128709 ART-2022-128709 eng Ripollés-Melchor, J. Association between use of enhanced recovery after surgery protocols and postoperative complications in colorectal surgery in Europe: The EuroPOWER international observational study 2022 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. © 2022 Elsevier Inc. info:eu-repo/semantics/closedAccess All rights reserved http://www.europeana.eu/rights/rr-f/ 6.7 2022 ANESTHESIOLOGY 5 / 35 = 0.143 2022 Q1 T1 1.019 2022 Anesthesiology and Pain Medicine 2022 Q1 6.7 2022 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Abad-Motos, A. Cecconi, M. Pearse, R. Jaber, S. Slim, K. Francis, N. Spinelli, A. Joris, J. Ioannidis, O. Zarzava, E. Sentürk, N.M. Koopman, S. Goettel, N. Stundner, O. Vymazal, T. Kocián, P. El-Hussuna, A. Pedziwiatr, M. Gudaityte, J. Latkauskas, T. Santos, M.D. Machado, H. Zahorec, R. Cvetkovic, A. Miric, M. Georgiou, M. Díez-Remesal, Y. Jammer, I. Mena, G E. Zorrilla-Vaca, A. Marino, M.V. Suárez-de-la-Rica, A. García-Erce, J.A. Logroño-Ejea, M. Ferrando-Ortolá, C. De-Fuenmayor-Valera, M.L. Ugarte-Sierra, B. de Andrés-Ibañez, J. Abad-Gurumeta, A. Pellino, G. Gómez-Ríos, M.A. Poggioli, G. Menzo-Wolthuis, A. Castellano-Paulis, B. Galán-Menéndez, P. Aldecoa, C. Ramírez-Rodríguez, J.M., on behalf of the EuroPOWER Study Investigators Group Universidad de Zaragoza (orcid)0000-0001-7964-1166 Echazarreta-Gallego, E. 1013 090 Universidad de Zaragoza Dpto. Cirugía Área Cirugía 80 (2022), 110752 [10 pp.] J. clin. anesth. JOURNAL OF CLINICAL ANESTHESIA 0952-8180 1516815 http://zaguan.unizar.es/record/132777/files/texto_completo.pdf Versión publicada 2467468 http://zaguan.unizar.es/record/132777/files/texto_completo.jpg?subformat=icon icon Versión publicada oai:zaguan.unizar.es:132777 articulos driver 2024-03-15-08:49:21 ARTICLE