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World Journal of Surgery
Published in: World Journal of Surgery 4/2017

01-04-2017 | Original Scientific Report

Enhanced Recovery After Surgery Programs Improve Patient Outcomes and Recovery: A Meta-analysis

Authors: Christine S. M. Lau, Ronald S. Chamberlain

Published in: World Journal of Surgery | Issue 4/2017

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Abstract

Introduction

Enhanced recovery after surgery (ERAS) programs have been developed to improve patient outcomes, accelerate recovery after surgery, and reduce healthcare costs. ERAS programs are a multimodal approach, with interventions during all stages of care. This meta-analysis examines the impact of ERAS programs on patient outcomes and recovery.

Methods

A comprehensive search of all published randomized control trials (RCTs) assessing the use of ERAS programs in surgical patients was conducted. Outcomes analyzed were length of stay (LOS), overall mortality, 30-day readmission rates, total costs, total complications, time to first flatus, and time to first bowel movement.

Results

Forty-two RCTs involving 5241 patients were analyzed. ERAS programs significantly reduced LOS, total complications, and total costs across all types of surgeries (p < 0.001). Return of gastrointestinal (GI) function was also significantly improved, as measured by earlier time to first flatus and time to first bowel movement, p < 0.001. There was no overall difference in mortality or 30-day readmission rates; however, 30-day readmission rates after upper GI surgeries nearly doubled with the use of ERAS programs (RR = 1.922; p = 0.019).

Conclusions

ERAS programs are associated with a significant reduction in LOS, total complications, total costs, as well as earlier return of GI function. Overall mortality and readmission rates remained similar, but there was a significant increase in 30-day readmission rates after upper GI surgeries. ERAS programs are effective and a valuable part in improving patient outcomes and accelerating recovery after surgery.
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Metadata
Title
Enhanced Recovery After Surgery Programs Improve Patient Outcomes and Recovery: A Meta-analysis
Authors
Christine S. M. Lau
Ronald S. Chamberlain
Publication date
01-04-2017
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 4/2017
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-016-3807-4

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