In recent years, there has been an increased focus on perioperative surgical care. Previous studies have demonstrated that so-called enhanced recovery after surgery (ERAS) programmes that focus on core elements such as pain control, nutrition, fluid management, and mobility, lead to improved processes, but these studies have been limited by sample size, small cohorts and relatively few sites.
Now findings from a new large-scale study show ERAS programmes are associated with significant absolute and relative decreases in hospital length of stay and postoperative complications.
For the study, an ERAS was implemented at 20 hospitals in the US. The programme was delivered to 3,768 patients undergoing elective colorectal resection and 5,002 patients undergoing emergency hip fracture repair. Comparator surgical patients included 5,556 patients undergoing elective gastrointestinal surgery and 1,523 patients undergoing emergency orthopaedic surgery.
Hospital length of stay and postoperative complication rates were significantly lower among patients in the ERAS group. ERAS implementation was also associated with decreased rates of hospital mortality in colorectal resection patients and with increased rates of home discharge in patients with hip fracture.
Writing in JAMA Surgery , the authors said the findings provide evidence that rapid, large-scale implementation of a multidisciplinary ERAS programme is feasible and effective in improving surgical outcomes.