Does ERAS benefit higher BMI patients? A single institutional review
Enhanced recovery after surgery (ERAS) is increasingly used in plastic surgery to optimize patient care. Mitigating the risk of postoperative complications is particularly important in patients with risk factors, such as obesity. The objective of this study is to evaluate the impact of the ERAS path...
Gespeichert in:
| Veröffentlicht in: | Journal of plastic, reconstructive & aesthetic surgery reconstructive & aesthetic surgery, 2021-03, Vol.74 (3), p.475-479 |
|---|---|
| Hauptverfasser: | , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 479 |
|---|---|
| container_issue | 3 |
| container_start_page | 475 |
| container_title | Journal of plastic, reconstructive & aesthetic surgery |
| container_volume | 74 |
| creator | Shin, Hope D. Rodriguez, Abigail M. Abraham, Jasson T. Cargile, John C. Brown, Candace N. Altman, Andrew M. Saint-Cyr, Michel H. |
| description | Enhanced recovery after surgery (ERAS) is increasingly used in plastic surgery to optimize patient care. Mitigating the risk of postoperative complications is particularly important in patients with risk factors, such as obesity. The objective of this study is to evaluate the impact of the ERAS pathway in patients, stratified by BMI, undergoing free flap breast reconstruction on length of stay and complications.
A retrospective review of all patients who underwent abdominally based free flap breast reconstruction from January 2014 to December 2017 was performed. Data collected include participation in the ERAS protocol, patient demographics, length of stay (LOS), complications (minor and major), and 30-day reoperation rates.
A total of 123 patients met the inclusion criteria, with 36 non-ERAS and 87 ERAS patients. ERAS patients had a shorter length of stay than non-ERAS patients (4.14 vs. 4.69, p = 0.049). Higher BMI patients progressively benefited from their involvement in an ERAS pathway: class I obese patients had an LOS decrease of 0.99 days (p = 0.048) and class II+ obese patients had an LOS decrease of 1.35 days (p = 0.093). Minor complications, major complications, and reoperation rates were similar between ERAS and non-ERAS patients (p>0.05).
Utilization of an ERAS protocol for free flap breast reconstruction safely decreases LOS, especially with increasing BMI. Patients benefit from an ERAS protocol without increasing risk of postoperative complications, compared to non-ERAS patients of similar BMIs. |
| doi_str_mv | 10.1016/j.bjps.2020.08.098 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2446662344</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S1748681520304812</els_id><sourcerecordid>2446662344</sourcerecordid><originalsourceid>FETCH-LOGICAL-c356t-97d6f3fa51c0eb70d5f3dbddfc27f6c5fbb9262f22e32bfa2a4d16673085b4603</originalsourceid><addsrcrecordid>eNp9kEtLxDAUhYMovv-AC8nSTWteTVsQZHwLiuBjHZrkRjN02jHJKP57M4y6dHXv4jsHzofQASUlJVQeT0s9nceSEUZK0pSkbdbQNm3qpiAVb9fzX4umkA2tttBOjFNCBKei2kRbnLU1y-A2urgYIeLLx8kT1jCA8wm_-dc3CPjs_hbPu-RhSPEUT3D0w2sP2A8x-bRIfhy6Hgf48PC5hzZc10fY_7m76OXq8vn8prh7uL49n9wVhlcyFW1tpeOuq6ghoGtiK8etttYZVjtpKqd1yyRzjAFn2nWsE5ZKWXPSVFpIwnfR0ap3Hsb3BcSkZj4a6PtugHERFRNCSsm4EBllK9SEMcYATs2Dn3XhS1GilvbUVC3tqaU9RRqV7eXQ4U__Qs_A_kV-dWXgZAVAXpmXBxVNFmTA-gAmKTv6__q_Af3agEg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2446662344</pqid></control><display><type>article</type><title>Does ERAS benefit higher BMI patients? A single institutional review</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals Complete</source><creator>Shin, Hope D. ; Rodriguez, Abigail M. ; Abraham, Jasson T. ; Cargile, John C. ; Brown, Candace N. ; Altman, Andrew M. ; Saint-Cyr, Michel H.</creator><creatorcontrib>Shin, Hope D. ; Rodriguez, Abigail M. ; Abraham, Jasson T. ; Cargile, John C. ; Brown, Candace N. ; Altman, Andrew M. ; Saint-Cyr, Michel H.</creatorcontrib><description>Enhanced recovery after surgery (ERAS) is increasingly used in plastic surgery to optimize patient care. Mitigating the risk of postoperative complications is particularly important in patients with risk factors, such as obesity. The objective of this study is to evaluate the impact of the ERAS pathway in patients, stratified by BMI, undergoing free flap breast reconstruction on length of stay and complications.
A retrospective review of all patients who underwent abdominally based free flap breast reconstruction from January 2014 to December 2017 was performed. Data collected include participation in the ERAS protocol, patient demographics, length of stay (LOS), complications (minor and major), and 30-day reoperation rates.
A total of 123 patients met the inclusion criteria, with 36 non-ERAS and 87 ERAS patients. ERAS patients had a shorter length of stay than non-ERAS patients (4.14 vs. 4.69, p = 0.049). Higher BMI patients progressively benefited from their involvement in an ERAS pathway: class I obese patients had an LOS decrease of 0.99 days (p = 0.048) and class II+ obese patients had an LOS decrease of 1.35 days (p = 0.093). Minor complications, major complications, and reoperation rates were similar between ERAS and non-ERAS patients (p>0.05).
Utilization of an ERAS protocol for free flap breast reconstruction safely decreases LOS, especially with increasing BMI. Patients benefit from an ERAS protocol without increasing risk of postoperative complications, compared to non-ERAS patients of similar BMIs.</description><identifier>ISSN: 1748-6815</identifier><identifier>EISSN: 1878-0539</identifier><identifier>DOI: 10.1016/j.bjps.2020.08.098</identifier><identifier>PMID: 32972878</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Adult ; Autologous breast reconstruction ; Body Mass Index ; Breast reconstruction ; Clinical Protocols ; Diep ; Enhanced Recovery After Surgery - standards ; ERAS ; Female ; Free flap ; Free Tissue Flaps - adverse effects ; Free Tissue Flaps - statistics & numerical data ; Humans ; Length of stay ; Length of Stay - statistics & numerical data ; Mammaplasty - adverse effects ; Mammaplasty - methods ; Mammaplasty - rehabilitation ; Microsurgery ; Middle Aged ; mstram ; Obesity - diagnosis ; Obesity - surgery ; Outcome and Process Assessment, Health Care ; Patient Acceptance of Health Care ; Postoperative Complications - etiology ; Postoperative Complications - surgery ; Reoperation - methods ; Reoperation - statistics & numerical data ; Retrospective Studies</subject><ispartof>Journal of plastic, reconstructive & aesthetic surgery, 2021-03, Vol.74 (3), p.475-479</ispartof><rights>2020 Elsevier Ltd</rights><rights>Copyright © 2020 Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-97d6f3fa51c0eb70d5f3dbddfc27f6c5fbb9262f22e32bfa2a4d16673085b4603</citedby><cites>FETCH-LOGICAL-c356t-97d6f3fa51c0eb70d5f3dbddfc27f6c5fbb9262f22e32bfa2a4d16673085b4603</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1748681520304812$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32972878$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shin, Hope D.</creatorcontrib><creatorcontrib>Rodriguez, Abigail M.</creatorcontrib><creatorcontrib>Abraham, Jasson T.</creatorcontrib><creatorcontrib>Cargile, John C.</creatorcontrib><creatorcontrib>Brown, Candace N.</creatorcontrib><creatorcontrib>Altman, Andrew M.</creatorcontrib><creatorcontrib>Saint-Cyr, Michel H.</creatorcontrib><title>Does ERAS benefit higher BMI patients? A single institutional review</title><title>Journal of plastic, reconstructive & aesthetic surgery</title><addtitle>J Plast Reconstr Aesthet Surg</addtitle><description>Enhanced recovery after surgery (ERAS) is increasingly used in plastic surgery to optimize patient care. Mitigating the risk of postoperative complications is particularly important in patients with risk factors, such as obesity. The objective of this study is to evaluate the impact of the ERAS pathway in patients, stratified by BMI, undergoing free flap breast reconstruction on length of stay and complications.
A retrospective review of all patients who underwent abdominally based free flap breast reconstruction from January 2014 to December 2017 was performed. Data collected include participation in the ERAS protocol, patient demographics, length of stay (LOS), complications (minor and major), and 30-day reoperation rates.
A total of 123 patients met the inclusion criteria, with 36 non-ERAS and 87 ERAS patients. ERAS patients had a shorter length of stay than non-ERAS patients (4.14 vs. 4.69, p = 0.049). Higher BMI patients progressively benefited from their involvement in an ERAS pathway: class I obese patients had an LOS decrease of 0.99 days (p = 0.048) and class II+ obese patients had an LOS decrease of 1.35 days (p = 0.093). Minor complications, major complications, and reoperation rates were similar between ERAS and non-ERAS patients (p>0.05).
Utilization of an ERAS protocol for free flap breast reconstruction safely decreases LOS, especially with increasing BMI. Patients benefit from an ERAS protocol without increasing risk of postoperative complications, compared to non-ERAS patients of similar BMIs.</description><subject>Adult</subject><subject>Autologous breast reconstruction</subject><subject>Body Mass Index</subject><subject>Breast reconstruction</subject><subject>Clinical Protocols</subject><subject>Diep</subject><subject>Enhanced Recovery After Surgery - standards</subject><subject>ERAS</subject><subject>Female</subject><subject>Free flap</subject><subject>Free Tissue Flaps - adverse effects</subject><subject>Free Tissue Flaps - statistics & numerical data</subject><subject>Humans</subject><subject>Length of stay</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Mammaplasty - adverse effects</subject><subject>Mammaplasty - methods</subject><subject>Mammaplasty - rehabilitation</subject><subject>Microsurgery</subject><subject>Middle Aged</subject><subject>mstram</subject><subject>Obesity - diagnosis</subject><subject>Obesity - surgery</subject><subject>Outcome and Process Assessment, Health Care</subject><subject>Patient Acceptance of Health Care</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Complications - surgery</subject><subject>Reoperation - methods</subject><subject>Reoperation - statistics & numerical data</subject><subject>Retrospective Studies</subject><issn>1748-6815</issn><issn>1878-0539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kEtLxDAUhYMovv-AC8nSTWteTVsQZHwLiuBjHZrkRjN02jHJKP57M4y6dHXv4jsHzofQASUlJVQeT0s9nceSEUZK0pSkbdbQNm3qpiAVb9fzX4umkA2tttBOjFNCBKei2kRbnLU1y-A2urgYIeLLx8kT1jCA8wm_-dc3CPjs_hbPu-RhSPEUT3D0w2sP2A8x-bRIfhy6Hgf48PC5hzZc10fY_7m76OXq8vn8prh7uL49n9wVhlcyFW1tpeOuq6ghoGtiK8etttYZVjtpKqd1yyRzjAFn2nWsE5ZKWXPSVFpIwnfR0ap3Hsb3BcSkZj4a6PtugHERFRNCSsm4EBllK9SEMcYATs2Dn3XhS1GilvbUVC3tqaU9RRqV7eXQ4U__Qs_A_kV-dWXgZAVAXpmXBxVNFmTA-gAmKTv6__q_Af3agEg</recordid><startdate>202103</startdate><enddate>202103</enddate><creator>Shin, Hope D.</creator><creator>Rodriguez, Abigail M.</creator><creator>Abraham, Jasson T.</creator><creator>Cargile, John C.</creator><creator>Brown, Candace N.</creator><creator>Altman, Andrew M.</creator><creator>Saint-Cyr, Michel H.</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202103</creationdate><title>Does ERAS benefit higher BMI patients? A single institutional review</title><author>Shin, Hope D. ; Rodriguez, Abigail M. ; Abraham, Jasson T. ; Cargile, John C. ; Brown, Candace N. ; Altman, Andrew M. ; Saint-Cyr, Michel H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-97d6f3fa51c0eb70d5f3dbddfc27f6c5fbb9262f22e32bfa2a4d16673085b4603</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Autologous breast reconstruction</topic><topic>Body Mass Index</topic><topic>Breast reconstruction</topic><topic>Clinical Protocols</topic><topic>Diep</topic><topic>Enhanced Recovery After Surgery - standards</topic><topic>ERAS</topic><topic>Female</topic><topic>Free flap</topic><topic>Free Tissue Flaps - adverse effects</topic><topic>Free Tissue Flaps - statistics & numerical data</topic><topic>Humans</topic><topic>Length of stay</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Mammaplasty - adverse effects</topic><topic>Mammaplasty - methods</topic><topic>Mammaplasty - rehabilitation</topic><topic>Microsurgery</topic><topic>Middle Aged</topic><topic>mstram</topic><topic>Obesity - diagnosis</topic><topic>Obesity - surgery</topic><topic>Outcome and Process Assessment, Health Care</topic><topic>Patient Acceptance of Health Care</topic><topic>Postoperative Complications - etiology</topic><topic>Postoperative Complications - surgery</topic><topic>Reoperation - methods</topic><topic>Reoperation - statistics & numerical data</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shin, Hope D.</creatorcontrib><creatorcontrib>Rodriguez, Abigail M.</creatorcontrib><creatorcontrib>Abraham, Jasson T.</creatorcontrib><creatorcontrib>Cargile, John C.</creatorcontrib><creatorcontrib>Brown, Candace N.</creatorcontrib><creatorcontrib>Altman, Andrew M.</creatorcontrib><creatorcontrib>Saint-Cyr, Michel H.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of plastic, reconstructive & aesthetic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shin, Hope D.</au><au>Rodriguez, Abigail M.</au><au>Abraham, Jasson T.</au><au>Cargile, John C.</au><au>Brown, Candace N.</au><au>Altman, Andrew M.</au><au>Saint-Cyr, Michel H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Does ERAS benefit higher BMI patients? A single institutional review</atitle><jtitle>Journal of plastic, reconstructive & aesthetic surgery</jtitle><addtitle>J Plast Reconstr Aesthet Surg</addtitle><date>2021-03</date><risdate>2021</risdate><volume>74</volume><issue>3</issue><spage>475</spage><epage>479</epage><pages>475-479</pages><issn>1748-6815</issn><eissn>1878-0539</eissn><abstract>Enhanced recovery after surgery (ERAS) is increasingly used in plastic surgery to optimize patient care. Mitigating the risk of postoperative complications is particularly important in patients with risk factors, such as obesity. The objective of this study is to evaluate the impact of the ERAS pathway in patients, stratified by BMI, undergoing free flap breast reconstruction on length of stay and complications.
A retrospective review of all patients who underwent abdominally based free flap breast reconstruction from January 2014 to December 2017 was performed. Data collected include participation in the ERAS protocol, patient demographics, length of stay (LOS), complications (minor and major), and 30-day reoperation rates.
A total of 123 patients met the inclusion criteria, with 36 non-ERAS and 87 ERAS patients. ERAS patients had a shorter length of stay than non-ERAS patients (4.14 vs. 4.69, p = 0.049). Higher BMI patients progressively benefited from their involvement in an ERAS pathway: class I obese patients had an LOS decrease of 0.99 days (p = 0.048) and class II+ obese patients had an LOS decrease of 1.35 days (p = 0.093). Minor complications, major complications, and reoperation rates were similar between ERAS and non-ERAS patients (p>0.05).
Utilization of an ERAS protocol for free flap breast reconstruction safely decreases LOS, especially with increasing BMI. Patients benefit from an ERAS protocol without increasing risk of postoperative complications, compared to non-ERAS patients of similar BMIs.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>32972878</pmid><doi>10.1016/j.bjps.2020.08.098</doi><tpages>5</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1748-6815 |
| ispartof | Journal of plastic, reconstructive & aesthetic surgery, 2021-03, Vol.74 (3), p.475-479 |
| issn | 1748-6815 1878-0539 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2446662344 |
| source | MEDLINE; Elsevier ScienceDirect Journals Complete |
| subjects | Adult Autologous breast reconstruction Body Mass Index Breast reconstruction Clinical Protocols Diep Enhanced Recovery After Surgery - standards ERAS Female Free flap Free Tissue Flaps - adverse effects Free Tissue Flaps - statistics & numerical data Humans Length of stay Length of Stay - statistics & numerical data Mammaplasty - adverse effects Mammaplasty - methods Mammaplasty - rehabilitation Microsurgery Middle Aged mstram Obesity - diagnosis Obesity - surgery Outcome and Process Assessment, Health Care Patient Acceptance of Health Care Postoperative Complications - etiology Postoperative Complications - surgery Reoperation - methods Reoperation - statistics & numerical data Retrospective Studies |
| title | Does ERAS benefit higher BMI patients? A single institutional review |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-12T20%3A27%3A32IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Does%20ERAS%20benefit%20higher%20BMI%20patients?%20A%20single%20institutional%20review&rft.jtitle=Journal%20of%20plastic,%20reconstructive%20&%20aesthetic%20surgery&rft.au=Shin,%20Hope%20D.&rft.date=2021-03&rft.volume=74&rft.issue=3&rft.spage=475&rft.epage=479&rft.pages=475-479&rft.issn=1748-6815&rft.eissn=1878-0539&rft_id=info:doi/10.1016/j.bjps.2020.08.098&rft_dat=%3Cproquest_cross%3E2446662344%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2446662344&rft_id=info:pmid/32972878&rft_els_id=S1748681520304812&rfr_iscdi=true |