Enhanced Recovery After Surgery Protocol in Bariatric Surgery Leads to Decreased Complications and Shorter Length of Stay
Purpose Enhanced recovery after surgery (ERAS) programs have been shown in some specialties to improve short-term outcomes following surgical procedures. There is no consensus regarding the optimal perioperative care for bariatric surgical patients. The purpose of this study was to develop a bariatr...
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| Veröffentlicht in: | Obesity surgery 2023-03, Vol.33 (3), p.743-749 |
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| creator | Fair, Lucas C. Leeds, Steven G. Whitfield, Edward P. Bokhari, Syed Harris Rasmussen, Madeline L. Hasan, Salman S. Davis, Daniel G. Arnold, David T. Ogola, Gerald O. Ward, Marc A. |
| description | Purpose
Enhanced recovery after surgery (ERAS) programs have been shown in some specialties to improve short-term outcomes following surgical procedures. There is no consensus regarding the optimal perioperative care for bariatric surgical patients. The purpose of this study was to develop a bariatric ERAS protocol and determine whether it improved outcomes following surgery.
Materials and Methods
An IRB-approved prospectively maintained database was retrospectively reviewed for all patients undergoing bariatric surgery from October 2018 to January 2020. Propensity matching was used to compare post-ERAS implementation patients to pre-ERAS implementation.
Results
There were 319 patients (87 ERAS, 232 pre-ERAS) who underwent bariatric operations between October 2018 and January 2020. Seventy-nine patients were kept on the ERAS protocol whereas 8 deviated. Patients who deviated from the ERAS protocol had a longer length of stay when compared to patients who completed the protocol. The use of any ERAS protocol (completed or deviated) reduced the odds of complications by 54% and decreased length of stay by 15%. Furthermore, patients who completed the ERAS protocol had an 83% reduction in odds of complications and 31% decrease in length of stay. Similar trends were observed in the matched cohort with 74% reduction in odds of complications and 26% reduction in length of stay when ERAS was used.
Conclusions
ERAS protocol decreases complications and reduces length of stay in bariatric patients.
Graphical abstract |
| doi_str_mv | 10.1007/s11695-023-06474-w |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2769997011</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2783533149</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-71f72207ef7f1d6032ec0dcd01e979d57473dbd19d81073986ee959968f0de893</originalsourceid><addsrcrecordid>eNp9kU1vEzEQhi1ERUPhD3BAlrhwWTq2d-31sYTyIUUCEThbrj3bbLWxg-2lyr_HIaWVeuA0suaZZ6x5CXnF4B0DUOeZMam7BrhoQLaqbW6fkAVT0DfQ8v4pWYCW0PSai1PyPOcbAM4k58_IqZAKGDC2IPvLsLHBoaff0cXfmPb0YiiY6HpO14fXtxRLdHGiY6DvbRptSaO7767Q-kxLpB_QJbS5epZxu5tGZ8sYQ6Y2eLrexHRQrjBclw2NA10Xu39BTgY7ZXx5V8_Iz4-XP5afm9XXT1-WF6vGCdWVRrFBcQ4KBzUwL0FwdOCdB4Zaad-pVgl_5Zn2PQMldC8Rdae17Afw2GtxRt4evbsUf82Yi9mO2eE02YBxzoYrqbWu92AVffMIvYlzCvV3lepFJwRrD0J-pFyKOScczC6NW5v2hoE5BGOOwZgajPkbjLmtQ6_v1PPVFv39yL8kKiCOQK6tUI_7sPs_2j8U2ZlI</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2783533149</pqid></control><display><type>article</type><title>Enhanced Recovery After Surgery Protocol in Bariatric Surgery Leads to Decreased Complications and Shorter Length of Stay</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Fair, Lucas C. ; Leeds, Steven G. ; Whitfield, Edward P. ; Bokhari, Syed Harris ; Rasmussen, Madeline L. ; Hasan, Salman S. ; Davis, Daniel G. ; Arnold, David T. ; Ogola, Gerald O. ; Ward, Marc A.</creator><creatorcontrib>Fair, Lucas C. ; Leeds, Steven G. ; Whitfield, Edward P. ; Bokhari, Syed Harris ; Rasmussen, Madeline L. ; Hasan, Salman S. ; Davis, Daniel G. ; Arnold, David T. ; Ogola, Gerald O. ; Ward, Marc A.</creatorcontrib><description>Purpose
Enhanced recovery after surgery (ERAS) programs have been shown in some specialties to improve short-term outcomes following surgical procedures. There is no consensus regarding the optimal perioperative care for bariatric surgical patients. The purpose of this study was to develop a bariatric ERAS protocol and determine whether it improved outcomes following surgery.
Materials and Methods
An IRB-approved prospectively maintained database was retrospectively reviewed for all patients undergoing bariatric surgery from October 2018 to January 2020. Propensity matching was used to compare post-ERAS implementation patients to pre-ERAS implementation.
Results
There were 319 patients (87 ERAS, 232 pre-ERAS) who underwent bariatric operations between October 2018 and January 2020. Seventy-nine patients were kept on the ERAS protocol whereas 8 deviated. Patients who deviated from the ERAS protocol had a longer length of stay when compared to patients who completed the protocol. The use of any ERAS protocol (completed or deviated) reduced the odds of complications by 54% and decreased length of stay by 15%. Furthermore, patients who completed the ERAS protocol had an 83% reduction in odds of complications and 31% decrease in length of stay. Similar trends were observed in the matched cohort with 74% reduction in odds of complications and 26% reduction in length of stay when ERAS was used.
Conclusions
ERAS protocol decreases complications and reduces length of stay in bariatric patients.
Graphical abstract</description><identifier>ISSN: 0960-8923</identifier><identifier>EISSN: 1708-0428</identifier><identifier>DOI: 10.1007/s11695-023-06474-w</identifier><identifier>PMID: 36701011</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Bariatric Surgery - methods ; Enhanced Recovery After Surgery ; Gastrointestinal surgery ; Humans ; Length of Stay ; Medicine ; Medicine & Public Health ; Obesity, Morbid - surgery ; Original Contributions ; Postoperative Complications - etiology ; Recovery (Medical) ; Retrospective Studies ; Surgery</subject><ispartof>Obesity surgery, 2023-03, Vol.33 (3), p.743-749</ispartof><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-71f72207ef7f1d6032ec0dcd01e979d57473dbd19d81073986ee959968f0de893</citedby><cites>FETCH-LOGICAL-c375t-71f72207ef7f1d6032ec0dcd01e979d57473dbd19d81073986ee959968f0de893</cites><orcidid>0000-0002-7147-3994</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/s11695-023-06474-w$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11695-023-06474-w$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51298</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36701011$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fair, Lucas C.</creatorcontrib><creatorcontrib>Leeds, Steven G.</creatorcontrib><creatorcontrib>Whitfield, Edward P.</creatorcontrib><creatorcontrib>Bokhari, Syed Harris</creatorcontrib><creatorcontrib>Rasmussen, Madeline L.</creatorcontrib><creatorcontrib>Hasan, Salman S.</creatorcontrib><creatorcontrib>Davis, Daniel G.</creatorcontrib><creatorcontrib>Arnold, David T.</creatorcontrib><creatorcontrib>Ogola, Gerald O.</creatorcontrib><creatorcontrib>Ward, Marc A.</creatorcontrib><title>Enhanced Recovery After Surgery Protocol in Bariatric Surgery Leads to Decreased Complications and Shorter Length of Stay</title><title>Obesity surgery</title><addtitle>OBES SURG</addtitle><addtitle>Obes Surg</addtitle><description>Purpose
Enhanced recovery after surgery (ERAS) programs have been shown in some specialties to improve short-term outcomes following surgical procedures. There is no consensus regarding the optimal perioperative care for bariatric surgical patients. The purpose of this study was to develop a bariatric ERAS protocol and determine whether it improved outcomes following surgery.
Materials and Methods
An IRB-approved prospectively maintained database was retrospectively reviewed for all patients undergoing bariatric surgery from October 2018 to January 2020. Propensity matching was used to compare post-ERAS implementation patients to pre-ERAS implementation.
Results
There were 319 patients (87 ERAS, 232 pre-ERAS) who underwent bariatric operations between October 2018 and January 2020. Seventy-nine patients were kept on the ERAS protocol whereas 8 deviated. Patients who deviated from the ERAS protocol had a longer length of stay when compared to patients who completed the protocol. The use of any ERAS protocol (completed or deviated) reduced the odds of complications by 54% and decreased length of stay by 15%. Furthermore, patients who completed the ERAS protocol had an 83% reduction in odds of complications and 31% decrease in length of stay. Similar trends were observed in the matched cohort with 74% reduction in odds of complications and 26% reduction in length of stay when ERAS was used.
Conclusions
ERAS protocol decreases complications and reduces length of stay in bariatric patients.
Graphical abstract</description><subject>Bariatric Surgery - methods</subject><subject>Enhanced Recovery After Surgery</subject><subject>Gastrointestinal surgery</subject><subject>Humans</subject><subject>Length of Stay</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Obesity, Morbid - surgery</subject><subject>Original Contributions</subject><subject>Postoperative Complications - etiology</subject><subject>Recovery (Medical)</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><issn>0960-8923</issn><issn>1708-0428</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kU1vEzEQhi1ERUPhD3BAlrhwWTq2d-31sYTyIUUCEThbrj3bbLWxg-2lyr_HIaWVeuA0suaZZ6x5CXnF4B0DUOeZMam7BrhoQLaqbW6fkAVT0DfQ8v4pWYCW0PSai1PyPOcbAM4k58_IqZAKGDC2IPvLsLHBoaff0cXfmPb0YiiY6HpO14fXtxRLdHGiY6DvbRptSaO7767Q-kxLpB_QJbS5epZxu5tGZ8sYQ6Y2eLrexHRQrjBclw2NA10Xu39BTgY7ZXx5V8_Iz4-XP5afm9XXT1-WF6vGCdWVRrFBcQ4KBzUwL0FwdOCdB4Zaad-pVgl_5Zn2PQMldC8Rdae17Afw2GtxRt4evbsUf82Yi9mO2eE02YBxzoYrqbWu92AVffMIvYlzCvV3lepFJwRrD0J-pFyKOScczC6NW5v2hoE5BGOOwZgajPkbjLmtQ6_v1PPVFv39yL8kKiCOQK6tUI_7sPs_2j8U2ZlI</recordid><startdate>20230301</startdate><enddate>20230301</enddate><creator>Fair, Lucas C.</creator><creator>Leeds, Steven G.</creator><creator>Whitfield, Edward P.</creator><creator>Bokhari, Syed Harris</creator><creator>Rasmussen, Madeline L.</creator><creator>Hasan, Salman S.</creator><creator>Davis, Daniel G.</creator><creator>Arnold, David T.</creator><creator>Ogola, Gerald O.</creator><creator>Ward, Marc A.</creator><general>Springer US</general><general>Springer Nature B.V</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>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</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>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7147-3994</orcidid></search><sort><creationdate>20230301</creationdate><title>Enhanced Recovery After Surgery Protocol in Bariatric Surgery Leads to Decreased Complications and Shorter Length of Stay</title><author>Fair, Lucas C. ; Leeds, Steven G. ; Whitfield, Edward P. ; Bokhari, Syed Harris ; Rasmussen, Madeline L. ; Hasan, Salman S. ; Davis, Daniel G. ; Arnold, David T. ; Ogola, Gerald O. ; Ward, Marc A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-71f72207ef7f1d6032ec0dcd01e979d57473dbd19d81073986ee959968f0de893</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Bariatric Surgery - methods</topic><topic>Enhanced Recovery After Surgery</topic><topic>Gastrointestinal surgery</topic><topic>Humans</topic><topic>Length of Stay</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Obesity, Morbid - surgery</topic><topic>Original Contributions</topic><topic>Postoperative Complications - etiology</topic><topic>Recovery (Medical)</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fair, Lucas C.</creatorcontrib><creatorcontrib>Leeds, Steven G.</creatorcontrib><creatorcontrib>Whitfield, Edward P.</creatorcontrib><creatorcontrib>Bokhari, Syed Harris</creatorcontrib><creatorcontrib>Rasmussen, Madeline L.</creatorcontrib><creatorcontrib>Hasan, Salman S.</creatorcontrib><creatorcontrib>Davis, Daniel G.</creatorcontrib><creatorcontrib>Arnold, David T.</creatorcontrib><creatorcontrib>Ogola, Gerald O.</creatorcontrib><creatorcontrib>Ward, Marc A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</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 Edition)</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>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</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>Obesity surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fair, Lucas C.</au><au>Leeds, Steven G.</au><au>Whitfield, Edward P.</au><au>Bokhari, Syed Harris</au><au>Rasmussen, Madeline L.</au><au>Hasan, Salman S.</au><au>Davis, Daniel G.</au><au>Arnold, David T.</au><au>Ogola, Gerald O.</au><au>Ward, Marc A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Enhanced Recovery After Surgery Protocol in Bariatric Surgery Leads to Decreased Complications and Shorter Length of Stay</atitle><jtitle>Obesity surgery</jtitle><stitle>OBES SURG</stitle><addtitle>Obes Surg</addtitle><date>2023-03-01</date><risdate>2023</risdate><volume>33</volume><issue>3</issue><spage>743</spage><epage>749</epage><pages>743-749</pages><issn>0960-8923</issn><eissn>1708-0428</eissn><abstract>Purpose
Enhanced recovery after surgery (ERAS) programs have been shown in some specialties to improve short-term outcomes following surgical procedures. There is no consensus regarding the optimal perioperative care for bariatric surgical patients. The purpose of this study was to develop a bariatric ERAS protocol and determine whether it improved outcomes following surgery.
Materials and Methods
An IRB-approved prospectively maintained database was retrospectively reviewed for all patients undergoing bariatric surgery from October 2018 to January 2020. Propensity matching was used to compare post-ERAS implementation patients to pre-ERAS implementation.
Results
There were 319 patients (87 ERAS, 232 pre-ERAS) who underwent bariatric operations between October 2018 and January 2020. Seventy-nine patients were kept on the ERAS protocol whereas 8 deviated. Patients who deviated from the ERAS protocol had a longer length of stay when compared to patients who completed the protocol. The use of any ERAS protocol (completed or deviated) reduced the odds of complications by 54% and decreased length of stay by 15%. Furthermore, patients who completed the ERAS protocol had an 83% reduction in odds of complications and 31% decrease in length of stay. Similar trends were observed in the matched cohort with 74% reduction in odds of complications and 26% reduction in length of stay when ERAS was used.
Conclusions
ERAS protocol decreases complications and reduces length of stay in bariatric patients.
Graphical abstract</abstract><cop>New York</cop><pub>Springer US</pub><pmid>36701011</pmid><doi>10.1007/s11695-023-06474-w</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-7147-3994</orcidid></addata></record> |
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| ispartof | Obesity surgery, 2023-03, Vol.33 (3), p.743-749 |
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| language | eng |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Bariatric Surgery - methods Enhanced Recovery After Surgery Gastrointestinal surgery Humans Length of Stay Medicine Medicine & Public Health Obesity, Morbid - surgery Original Contributions Postoperative Complications - etiology Recovery (Medical) Retrospective Studies Surgery |
| title | Enhanced Recovery After Surgery Protocol in Bariatric Surgery Leads to Decreased Complications and Shorter Length of Stay |
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