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Open Access 01-06-2008

Length of Stay: An Inappropriate Readout of the Success of Enhanced Recovery Programs

Authors: J. M. C. Maessen, C. H. C. Dejong, A. G. H. Kessels, M. F. von Meyenfeldt, on behalf of the Enhanced Recovery After Surgery (ERAS) Group

Published in: World Journal of Surgery | Issue 6/2008

Abstract

Background

Enhanced recovery after surgery (ERAS) programs are designed to reduce hospital length of stay by shortening the postoperative recovery period. The intended effect of an accelerated recovery on the length of stay may be frustrated by a delayed discharge. This study was designed to assess the influence of an ERAS program on the proportion, appropriateness, and extent of delay in discharge.

Methods

Patients who enrolled in the ERAS program (n = 121) between 2003 and 2006 were compared with 52 patients who were managed traditionally in 2001.

Results

Ninety percent of the pre-ERAS patients and 87% of the ERAS patients were not discharged on the day that discharge criteria were fulfilled. The additional stay of 59% of the pre-ERAS patients and 69% of the ERAS patients was inappropriate. Wound care (15% in the pre-ERAS and 3% of the ERAS group) and observation of any symptoms pointing to an anastomotic leakage (10% in both groups) were the most important reasons for a medical appropriate delay of discharge. The extent of delay in discharge decreased significantly from a median of two days in the pre-ERAS group to a median of 1 day in the ERAS group (p = 0.004).

Conclusions

Reductions in length of stay up to a median of 2 days after start of an enhanced recovery program may relate to changes in organization of care and not to a shorter recovery period. Recovery statistics should replace or at least be added to the length of stay as outcome of enhanced recovery programs.

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Title: Length of Stay: An Inappropriate Readout of the Success of Enhanced Recovery Programs
Authors: J. M. C. Maessen
C. H. C. Dejong
A. G. H. Kessels
M. F. von Meyenfeldt
on behalf of the Enhanced Recovery After Surgery (ERAS) Group
Publication date: 01-06-2008
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 6/2008
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-007-9404-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Length of Stay: An Inappropriate Readout of the Success of Enhanced Recovery Programs

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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