Reducing complication rates and hospital readmissions while revising the enhanced recovery after bariatric surgery (ERABS) protocol
Background To optimize the postoperative phase following bariatric surgery, the enhanced recovery after bariatric surgery pathway (ERABS) has been developed. The aim of ERABS is to create a care path that is as safe, efficient and patient-friendly as possible. Continuous evaluation and optimization...
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| Veröffentlicht in: | Surgical endoscopy 2021-02, Vol.35 (2), p.612-619 |
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| creator | Leeman, Marjolijn van Mil, Stefanie R. Biter, L. Ulas Apers, Jan A. Verhoef, Kees Dunkelgrun, Martin |
| description | Background
To optimize the postoperative phase following bariatric surgery, the enhanced recovery after bariatric surgery pathway (ERABS) has been developed. The aim of ERABS is to create a care path that is as safe, efficient and patient-friendly as possible. Continuous evaluation and optimization of ERABS are important to ensure a safe treatment path and may result in better outcomes. The objective of this study was to compare the clinical outcomes of patients undergoing bariatric surgery over 2014–2017, during which the ERABS protocol was continuously evaluated and optimized.
Methods
This is a retrospective cohort study. Data were collected from patients undergoing a primary Roux-en-Y gastric bypass or sleeve gastrectomy between January 2014 and December 2017. Outcomes were early complications, unplanned hospital revisits, readmissions, duration of surgery and length of hospital stay.
Results
2889 patients underwent a primary bariatric procedure in a single center. There was a significant decrease in minor complications over the years from 7.0 to 1.9% (
p
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| doi_str_mv | 10.1007/s00464-020-07422-w |
| format | Article |
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To optimize the postoperative phase following bariatric surgery, the enhanced recovery after bariatric surgery pathway (ERABS) has been developed. The aim of ERABS is to create a care path that is as safe, efficient and patient-friendly as possible. Continuous evaluation and optimization of ERABS are important to ensure a safe treatment path and may result in better outcomes. The objective of this study was to compare the clinical outcomes of patients undergoing bariatric surgery over 2014–2017, during which the ERABS protocol was continuously evaluated and optimized.
Methods
This is a retrospective cohort study. Data were collected from patients undergoing a primary Roux-en-Y gastric bypass or sleeve gastrectomy between January 2014 and December 2017. Outcomes were early complications, unplanned hospital revisits, readmissions, duration of surgery and length of hospital stay.
Results
2889 patients underwent a primary bariatric procedure in a single center. There was a significant decrease in minor complications over the years from 7.0 to 1.9% (
p
< 0.001). Hospital revisit rates decreased after 2015 (
p
< 0.001). Readmission rates decreased over time (
p
< 0.001). The mean duration of surgery decreased from 52 (in 2014) to 41 (in 2017) minutes (
p
< 0.001). Median length of hospital stay decreased from 1.8 to 1.5 days in 2015 (
p
= 0.002) and remained stable since.
Conclusion
An improvement of the ERABS protocol was associated with a decrease in minor complication rates, number of unplanned hospital revisits and readmission rates after primary bariatric procedures.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-020-07422-w</identifier><identifier>PMID: 32052150</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abdominal Surgery ; Data collection ; Endoscopy ; Gastroenterology ; Gastrointestinal surgery ; Gynecology ; Hepatology ; Hospitals ; Laparoscopy ; Medicine ; Medicine & Public Health ; Obesity ; Outpatient care facilities ; Patients ; Proctology ; Psychologists ; Recovery (Medical) ; Surgeons ; Surgery ; Weight control</subject><ispartof>Surgical endoscopy, 2021-02, Vol.35 (2), p.612-619</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2020</rights><rights>Springer Science+Business Media, LLC, part of Springer Nature 2020.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-fe565a6f4d741825e0ba2518b403fea92e06e4b405158e8f69beb234eb7acf003</citedby><cites>FETCH-LOGICAL-c375t-fe565a6f4d741825e0ba2518b403fea92e06e4b405158e8f69beb234eb7acf003</cites><orcidid>0000-0001-7747-0500</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-020-07422-w$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-020-07422-w$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32052150$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Leeman, Marjolijn</creatorcontrib><creatorcontrib>van Mil, Stefanie R.</creatorcontrib><creatorcontrib>Biter, L. Ulas</creatorcontrib><creatorcontrib>Apers, Jan A.</creatorcontrib><creatorcontrib>Verhoef, Kees</creatorcontrib><creatorcontrib>Dunkelgrun, Martin</creatorcontrib><title>Reducing complication rates and hospital readmissions while revising the enhanced recovery after bariatric surgery (ERABS) protocol</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Background
To optimize the postoperative phase following bariatric surgery, the enhanced recovery after bariatric surgery pathway (ERABS) has been developed. The aim of ERABS is to create a care path that is as safe, efficient and patient-friendly as possible. Continuous evaluation and optimization of ERABS are important to ensure a safe treatment path and may result in better outcomes. The objective of this study was to compare the clinical outcomes of patients undergoing bariatric surgery over 2014–2017, during which the ERABS protocol was continuously evaluated and optimized.
Methods
This is a retrospective cohort study. Data were collected from patients undergoing a primary Roux-en-Y gastric bypass or sleeve gastrectomy between January 2014 and December 2017. Outcomes were early complications, unplanned hospital revisits, readmissions, duration of surgery and length of hospital stay.
Results
2889 patients underwent a primary bariatric procedure in a single center. There was a significant decrease in minor complications over the years from 7.0 to 1.9% (
p
< 0.001). Hospital revisit rates decreased after 2015 (
p
< 0.001). Readmission rates decreased over time (
p
< 0.001). The mean duration of surgery decreased from 52 (in 2014) to 41 (in 2017) minutes (
p
< 0.001). Median length of hospital stay decreased from 1.8 to 1.5 days in 2015 (
p
= 0.002) and remained stable since.
Conclusion
An improvement of the ERABS protocol was associated with a decrease in minor complication rates, number of unplanned hospital revisits and readmission rates after primary bariatric procedures.</description><subject>Abdominal Surgery</subject><subject>Data collection</subject><subject>Endoscopy</subject><subject>Gastroenterology</subject><subject>Gastrointestinal surgery</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Hospitals</subject><subject>Laparoscopy</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Obesity</subject><subject>Outpatient care facilities</subject><subject>Patients</subject><subject>Proctology</subject><subject>Psychologists</subject><subject>Recovery (Medical)</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Weight control</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kU1P3DAQhi3Uqmxp_wAHZKkXekg7_oqTIyA-KiFVgvZsOc6ENcrGW9thxZk_Xi9LqdRDT5ZnnvedsV9CDhl8YQD6awKQtayAQwVacl5t9siCScErzlnzhiygFVBx3cp98j6leyh8y9Q7si84KM4ULMjTDfaz89MddWG1Hr2z2YeJRpsxUTv1dBnS2mc70oi2X_mUSjvRzdKPWEoPPm21eYkUp6WdHPal6sIDxkdqh4yRdjZ6m6N3NM3xbls_Pr85Ob39TNcx5ODC-IG8HeyY8OPLeUB-Xpz_OLuqrr9ffjs7ua6c0CpXA6pa2XqQvZas4Qqhs1yxppMgBrQtR6hRlptiqsFmqNsOOy4kdtq6AUAckOOdbxn8a8aUTXmPw3G0E4Y5GS6U1KLmShf00z_ofZjjVLYzXOpWad3oLcV3lIshpYiDWUe_svHRMDDbiMwuIlMiMs8RmU0RHb1Yz90K-1fJn0wKIHZAKq2p_Njf2f-x_Q1OD55s</recordid><startdate>20210201</startdate><enddate>20210201</enddate><creator>Leeman, Marjolijn</creator><creator>van Mil, Stefanie R.</creator><creator>Biter, L. Ulas</creator><creator>Apers, Jan A.</creator><creator>Verhoef, Kees</creator><creator>Dunkelgrun, Martin</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7747-0500</orcidid></search><sort><creationdate>20210201</creationdate><title>Reducing complication rates and hospital readmissions while revising the enhanced recovery after bariatric surgery (ERABS) protocol</title><author>Leeman, Marjolijn ; van Mil, Stefanie R. ; Biter, L. Ulas ; Apers, Jan A. ; Verhoef, Kees ; Dunkelgrun, Martin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-fe565a6f4d741825e0ba2518b403fea92e06e4b405158e8f69beb234eb7acf003</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Abdominal Surgery</topic><topic>Data collection</topic><topic>Endoscopy</topic><topic>Gastroenterology</topic><topic>Gastrointestinal surgery</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Hospitals</topic><topic>Laparoscopy</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Obesity</topic><topic>Outpatient care facilities</topic><topic>Patients</topic><topic>Proctology</topic><topic>Psychologists</topic><topic>Recovery (Medical)</topic><topic>Surgeons</topic><topic>Surgery</topic><topic>Weight control</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Leeman, Marjolijn</creatorcontrib><creatorcontrib>van Mil, Stefanie R.</creatorcontrib><creatorcontrib>Biter, L. Ulas</creatorcontrib><creatorcontrib>Apers, Jan A.</creatorcontrib><creatorcontrib>Verhoef, Kees</creatorcontrib><creatorcontrib>Dunkelgrun, Martin</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>ProQuest Health and Medical</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Leeman, Marjolijn</au><au>van Mil, Stefanie R.</au><au>Biter, L. Ulas</au><au>Apers, Jan A.</au><au>Verhoef, Kees</au><au>Dunkelgrun, Martin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Reducing complication rates and hospital readmissions while revising the enhanced recovery after bariatric surgery (ERABS) protocol</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2021-02-01</date><risdate>2021</risdate><volume>35</volume><issue>2</issue><spage>612</spage><epage>619</epage><pages>612-619</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><abstract>Background
To optimize the postoperative phase following bariatric surgery, the enhanced recovery after bariatric surgery pathway (ERABS) has been developed. The aim of ERABS is to create a care path that is as safe, efficient and patient-friendly as possible. Continuous evaluation and optimization of ERABS are important to ensure a safe treatment path and may result in better outcomes. The objective of this study was to compare the clinical outcomes of patients undergoing bariatric surgery over 2014–2017, during which the ERABS protocol was continuously evaluated and optimized.
Methods
This is a retrospective cohort study. Data were collected from patients undergoing a primary Roux-en-Y gastric bypass or sleeve gastrectomy between January 2014 and December 2017. Outcomes were early complications, unplanned hospital revisits, readmissions, duration of surgery and length of hospital stay.
Results
2889 patients underwent a primary bariatric procedure in a single center. There was a significant decrease in minor complications over the years from 7.0 to 1.9% (
p
< 0.001). Hospital revisit rates decreased after 2015 (
p
< 0.001). Readmission rates decreased over time (
p
< 0.001). The mean duration of surgery decreased from 52 (in 2014) to 41 (in 2017) minutes (
p
< 0.001). Median length of hospital stay decreased from 1.8 to 1.5 days in 2015 (
p
= 0.002) and remained stable since.
Conclusion
An improvement of the ERABS protocol was associated with a decrease in minor complication rates, number of unplanned hospital revisits and readmission rates after primary bariatric procedures.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>32052150</pmid><doi>10.1007/s00464-020-07422-w</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-7747-0500</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Surgical endoscopy, 2021-02, Vol.35 (2), p.612-619 |
| issn | 0930-2794 1432-2218 |
| language | eng |
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| source | SpringerLink_现刊 |
| subjects | Abdominal Surgery Data collection Endoscopy Gastroenterology Gastrointestinal surgery Gynecology Hepatology Hospitals Laparoscopy Medicine Medicine & Public Health Obesity Outpatient care facilities Patients Proctology Psychologists Recovery (Medical) Surgeons Surgery Weight control |
| title | Reducing complication rates and hospital readmissions while revising the enhanced recovery after bariatric surgery (ERABS) protocol |
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