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Reducing hospital stay for colorectal surgery in ERAS setting by means of perioperative patient education of expected day of discharge
PURPOSE: Despite the enhanced recovery after surgery (ERAS) protocol, length of stay (LOS) after colorectal surgery varies considerably. The majority of longer admissions is often not medically necessary. We aimed to investigate possible reduction of LOS by perioperative education with an expected d...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8195902/ https://www.ncbi.nlm.nih.gov/pubmed/33977333 http://dx.doi.org/10.1007/s00384-021-03948-0 |
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author | Tweed, Thaís T. T. Woortman, Carmen Tummers, Stan Bakens, Maikel J. A. M. van Bastelaar, James Stoot, Jan H. M. B. |
author_facet | Tweed, Thaís T. T. Woortman, Carmen Tummers, Stan Bakens, Maikel J. A. M. van Bastelaar, James Stoot, Jan H. M. B. |
author_sort | Tweed, Thaís T. T. |
collection | PubMed |
description | PURPOSE: Despite the enhanced recovery after surgery (ERAS) protocol, length of stay (LOS) after colorectal surgery varies considerably. The majority of longer admissions is often not medically necessary. We aimed to investigate possible reduction of LOS by perioperative education with an expected discharge date (EDD). METHODS: This single-centre retrospective study included 578 patients who underwent surgery for colorectal cancer in 2016 with standard care (ERAS) and in 2018 with the addition of EDD education program (ERAS+). A comparison was made of a 1-year period prior to and following the implementation of EDD. The EDD was discussed at the outpatient clinic, preoperatively and during admission (with both the patient and family members daily). Standard EDD varied between 3 and 5 days depending on the resection type. Primary outcome was LOS; secondary outcomes were readmission, serious complications and 90-day mortality. RESULTS: Patients in ERAS+ (n = 242) had a shorter median LOS (4.0 vs. 5.0, p < 0.001) compared to patients in the regular ERAS group (n = 336). Fewer patients of ERAS+ experienced postoperative complications (71 (29.3%) vs. 198 (58.9%), p < 0.001). No difference was found in the number of readmissions (23 (9.5%) vs. 34 (10.1%), p = 0.807), reinterventions (25 (10.3%) vs. 30 (8.9%), p = 0.571) or mortality (5 (2.1%) vs. 9 (2.7%), p = 0.261) between the two groups. CONCLUSION: It is possible to reduce LOS within the ERAS program, by better perioperative education and expectation management of patients with use of an EDD. This program ensures better understanding, faster discharge and lower costs for the hospital without added risk of readmissions or complications. |
format | Online Article Text |
id | pubmed-8195902 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-81959022021-06-28 Reducing hospital stay for colorectal surgery in ERAS setting by means of perioperative patient education of expected day of discharge Tweed, Thaís T. T. Woortman, Carmen Tummers, Stan Bakens, Maikel J. A. M. van Bastelaar, James Stoot, Jan H. M. B. Int J Colorectal Dis Original Article PURPOSE: Despite the enhanced recovery after surgery (ERAS) protocol, length of stay (LOS) after colorectal surgery varies considerably. The majority of longer admissions is often not medically necessary. We aimed to investigate possible reduction of LOS by perioperative education with an expected discharge date (EDD). METHODS: This single-centre retrospective study included 578 patients who underwent surgery for colorectal cancer in 2016 with standard care (ERAS) and in 2018 with the addition of EDD education program (ERAS+). A comparison was made of a 1-year period prior to and following the implementation of EDD. The EDD was discussed at the outpatient clinic, preoperatively and during admission (with both the patient and family members daily). Standard EDD varied between 3 and 5 days depending on the resection type. Primary outcome was LOS; secondary outcomes were readmission, serious complications and 90-day mortality. RESULTS: Patients in ERAS+ (n = 242) had a shorter median LOS (4.0 vs. 5.0, p < 0.001) compared to patients in the regular ERAS group (n = 336). Fewer patients of ERAS+ experienced postoperative complications (71 (29.3%) vs. 198 (58.9%), p < 0.001). No difference was found in the number of readmissions (23 (9.5%) vs. 34 (10.1%), p = 0.807), reinterventions (25 (10.3%) vs. 30 (8.9%), p = 0.571) or mortality (5 (2.1%) vs. 9 (2.7%), p = 0.261) between the two groups. CONCLUSION: It is possible to reduce LOS within the ERAS program, by better perioperative education and expectation management of patients with use of an EDD. This program ensures better understanding, faster discharge and lower costs for the hospital without added risk of readmissions or complications. Springer Berlin Heidelberg 2021-05-11 2021 /pmc/articles/PMC8195902/ /pubmed/33977333 http://dx.doi.org/10.1007/s00384-021-03948-0 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Tweed, Thaís T. T. Woortman, Carmen Tummers, Stan Bakens, Maikel J. A. M. van Bastelaar, James Stoot, Jan H. M. B. Reducing hospital stay for colorectal surgery in ERAS setting by means of perioperative patient education of expected day of discharge |
title | Reducing hospital stay for colorectal surgery in ERAS setting by means of perioperative patient education of expected day of discharge |
title_full | Reducing hospital stay for colorectal surgery in ERAS setting by means of perioperative patient education of expected day of discharge |
title_fullStr | Reducing hospital stay for colorectal surgery in ERAS setting by means of perioperative patient education of expected day of discharge |
title_full_unstemmed | Reducing hospital stay for colorectal surgery in ERAS setting by means of perioperative patient education of expected day of discharge |
title_short | Reducing hospital stay for colorectal surgery in ERAS setting by means of perioperative patient education of expected day of discharge |
title_sort | reducing hospital stay for colorectal surgery in eras setting by means of perioperative patient education of expected day of discharge |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8195902/ https://www.ncbi.nlm.nih.gov/pubmed/33977333 http://dx.doi.org/10.1007/s00384-021-03948-0 |
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