Anatomic Lung Resection Outcomes After Implementation of a Universal Thoracic ERAS Protocol Across a Diverse Healthcare System
Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved..
OBJECTIVE: We sought to evaluate how implementing a thoracic Enhanced Recovery After Surgery (ERAS) protocol impacted surgical outcomes after elective anatomic lung resection.
SUMMARY BACKGROUND DATA: The effect of implementing the ERAS Society/European Society of Thoracic Surgery (ESTS) thoracic ERAS protocol on postoperative outcomes throughout an entire healthcare system has not yet been reported.
METHODS: This was a prospective cohort study within one healthcare system (1/2019-3/2023). A thoracic ERAS protocol was implemented on 5/1/2021 for elective anatomic lung resections, and postoperative outcomes were tracked using the electronic health record and Vizient data. The primary outcome was overall morbidity; secondary outcomes included individual complications, length of stay (LOS), opioid use, chest tube duration, and total cost. Patients were grouped into pre- and post-ERAS cohorts. Bivariable comparisons were performed using independent t-test, chi-square, or Fisher's exact tests, and multivariable logistic regression was performed to control for confounders.
RESULTS: There were 1,007 patients in the cohort; 450 (44.7%) were in the post-ERAS group. Mean age was 66.2 years; most patients were female (65.1%), white (83.8%), had a BMI between 18.5-29.9 (69.7%), and were ASA class 3 (80.6%). Patients in the post-implementation group had lower risk-adjusted rates of any morbidity, any respiratory complication, pneumonia, surgical site infection, arrhythmias, infections, opioid usage, ICU use, and shorter postoperative LOS (all P<0.05).
CONCLUSIONS: Postoperative outcomes were improved after implementation of an evidence-based thoracic ERAS protocol throughout the healthcare system. This study validates the ERAS Society/ESTS guidelines and demonstrates that simultaneous multihospital implementation can be feasible and effective.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
|---|---|
| Enthalten in: |
Annals of surgery - (2024) vom: 22. Feb. |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Dyas, Adam R [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
|---|
| Anmerkungen: |
Date Revised 22.02.2024 published: Print-Electronic Citation Status Publisher |
|---|
| doi: |
10.1097/SLA.0000000000006243 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM368752933 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM368752933 | ||
| 003 | DE-627 | ||
| 005 | 20240222233255.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240222s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1097/SLA.0000000000006243 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1302.xml |
| 035 | |a (DE-627)NLM368752933 | ||
| 035 | |a (NLM)38385282 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Dyas, Adam R |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Anatomic Lung Resection Outcomes After Implementation of a Universal Thoracic ERAS Protocol Across a Diverse Healthcare System |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 22.02.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved. | ||
| 520 | |a OBJECTIVE: We sought to evaluate how implementing a thoracic Enhanced Recovery After Surgery (ERAS) protocol impacted surgical outcomes after elective anatomic lung resection | ||
| 520 | |a SUMMARY BACKGROUND DATA: The effect of implementing the ERAS Society/European Society of Thoracic Surgery (ESTS) thoracic ERAS protocol on postoperative outcomes throughout an entire healthcare system has not yet been reported | ||
| 520 | |a METHODS: This was a prospective cohort study within one healthcare system (1/2019-3/2023). A thoracic ERAS protocol was implemented on 5/1/2021 for elective anatomic lung resections, and postoperative outcomes were tracked using the electronic health record and Vizient data. The primary outcome was overall morbidity; secondary outcomes included individual complications, length of stay (LOS), opioid use, chest tube duration, and total cost. Patients were grouped into pre- and post-ERAS cohorts. Bivariable comparisons were performed using independent t-test, chi-square, or Fisher's exact tests, and multivariable logistic regression was performed to control for confounders | ||
| 520 | |a RESULTS: There were 1,007 patients in the cohort; 450 (44.7%) were in the post-ERAS group. Mean age was 66.2 years; most patients were female (65.1%), white (83.8%), had a BMI between 18.5-29.9 (69.7%), and were ASA class 3 (80.6%). Patients in the post-implementation group had lower risk-adjusted rates of any morbidity, any respiratory complication, pneumonia, surgical site infection, arrhythmias, infections, opioid usage, ICU use, and shorter postoperative LOS (all P<0.05) | ||
| 520 | |a CONCLUSIONS: Postoperative outcomes were improved after implementation of an evidence-based thoracic ERAS protocol throughout the healthcare system. This study validates the ERAS Society/ESTS guidelines and demonstrates that simultaneous multihospital implementation can be feasible and effective | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Stuart, Christina M |e verfasserin |4 aut | |
| 700 | 1 | |a Bronsert, Michael R |e verfasserin |4 aut | |
| 700 | 1 | |a Kelleher, Alyson D |e verfasserin |4 aut | |
| 700 | 1 | |a Bata, Kyle E |e verfasserin |4 aut | |
| 700 | 1 | |a Cumbler, Ethan U |e verfasserin |4 aut | |
| 700 | 1 | |a Erickson, Crystal J |e verfasserin |4 aut | |
| 700 | 1 | |a Blum, Matthew G |e verfasserin |4 aut | |
| 700 | 1 | |a Vizena, Annette S |e verfasserin |4 aut | |
| 700 | 1 | |a Barker, Alison R |e verfasserin |4 aut | |
| 700 | 1 | |a Funk, Lauren |e verfasserin |4 aut | |
| 700 | 1 | |a Sack, Karishma |e verfasserin |4 aut | |
| 700 | 1 | |a Abrams, Benjamin A |e verfasserin |4 aut | |
| 700 | 1 | |a Randhawa, Simran K |e verfasserin |4 aut | |
| 700 | 1 | |a David, Elizabeth A |e verfasserin |4 aut | |
| 700 | 1 | |a Mitchell, John D |e verfasserin |4 aut | |
| 700 | 1 | |a Weyant, Michael J |e verfasserin |4 aut | |
| 700 | 1 | |a Scott, Christopher D |e verfasserin |4 aut | |
| 700 | 1 | |a Meguid, Robert A |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Annals of surgery |d 1885 |g (2024) vom: 22. Feb. |w (DE-627)NLM000026654 |x 1528-1140 |7 nnns |
| 773 | 1 | 8 | |g year:2024 |g day:22 |g month:02 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1097/SLA.0000000000006243 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |j 2024 |b 22 |c 02 | ||