89881 20260128112903.0 doi 10.1001/jamasurg.2019.0995 sideral 112336 ART-2019-112336 eng Ripollés-Melchor, Javier Association between use of enhanced recovery after surgery protocol and postoperative complications in colorectal surgery: the postoperative outcomes within enhanced recovery after surgery protocol (power) study 2019 Access copy available to the general public Unrestricted Importance: enhanced Recovery After Surgery (ERAS) care has been reported to be associated with improvements in outcomes after colorectal surgery compared with traditional care. Objective: to determine the association between ERAS protocols and outcomes in patients undergoing elective colorectal surgery. Design, setting, and participants: the Postoperative Outcomes Within Enhanced Recovery After Surgery Protocol (POWER) Study is a multicenter, prospective cohort study of 2084 consecutive adults scheduled for elective colorectal surgery who received or did not receive care in a self-declared ERAS center. Patients were recruited from 80 Spanish centers between September 15 and December 15, 2017. All patients included in this analysis had 1 month of follow-up. Exposures: colorectal surgery and perioperative management were the exposures. Twenty-two individual ERAS items were assessed in all patients, regardless of whether they were included in an established ERAS protocol. Main outcomes and measures: the primary study outcome was moderate to severe postoperative complications within 30 days after surgery. Secondary outcomes included ERAS adherence, mortality, readmissions, reoperation rates, and hospital length of stay. Results: between September 15 and December 15, 2017, 2084 patients were included in the study. Of these, 1286 individuals (61.7%) were men; mean age was 68 years (interquartile range [IQR], 59-77). A total of 879 patients (42.2%) presented with postoperative complications and 566 patients (27.2%) developed moderate to severe complications. The number of patients with moderate or severe complications was lower in the ERAS group (25.2% vs 30.3%; odds ratio [OR], 0.77; 95% CI, 0.63-0.94; P¿=¿.01). The overall rate of adherence to the ERAS protocol was 63.6% (IQR, 54.5%-77.3%), and the rate for patients from hospitals self-declared as ERAS was 72.7% (IQR, 59.1%-81.8%) vs non-ERAS institutions, which was 59.1% (IQR, 50.0%-63.6%; P¿<¿.001). Adherence quartiles among patients receiving the highest and lowest ERAS components showed that the patients with the highest adherence rates had fewer moderate to severe complications (OR, 0.34; 95% CI, 0.25-0.46; P¿<¿.001), overall complications (OR, 0.33; 95% CI, 0.26-0.43; P¿<¿.001), and mortality (OR, 0.27; 95% CI, 0.07-0.97; P¿=¿.06) compared with those who had the lowest adherence rates. Conclusions and relevance: an increase in ERAS adherence appears to be associated with a decrease in postoperative complications. info:eu-repo/semantics/closedAccess All rights reserved http://www.europeana.eu/rights/rr-f/ 13.625 2019 SURGERY 1 / 209 = 0.005 2019 Q1 T1 3.757 2019 Surgery 2019 Q1 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Ramírez-Rodríguez, José M. Universidad de Zaragoza (orcid)0000-0001-7964-1166 Casans-Francés, Rubén Universidad de Zaragoza (orcid)0000-0002-0620-9871 Aldecoa, César Abad-Motos, Ane Logroño-Egea, Margarita García-Erce, José Antonio Camps-Cervantes, Ángels Ferrando-Ortolá, Carlos Suarez de la Rica, Alejandro Cuellar-Martínez, Ana Marmaña-Mezquita, Sandra Abad-Gurumeta, Alfredo Calvo-Vecino, José M. Martínez Ubieto, Javier Universidad de Zaragoza (orcid)0000-0003-2462-1904 POWER Study Investigators Group for the Spanish Perioperative Audit and Research Network (REDGERM) 1004 090 Universidad de Zaragoza Dpto. Cirugía,Ginecol.Obstetr. Área Cirugía 154, 8 (2019), 725-736 JAMA surg. JAMA Surgery 2168-6254 393194 http://zaguan.unizar.es/record/89881/files/texto_completo.pdf Versión publicada 2198580 http://zaguan.unizar.es/record/89881/files/texto_completo.jpg?subformat=icon icon Versión publicada oai:zaguan.unizar.es:89881 articulos driver 2026-01-28-11:24:57 ARTICLE