Effect of Enhanced Recovery After Surgery program on hospital stay and 90-day readmission after pancreaticoduodenectomy: a single, tertiary center experience in Korea

Doo-Hun Kim; Yoo-Seok Yoon; Ho-Seong Han; Jai-Young Cho; Jun-Seo Lee; Boram Lee

Effect of Enhanced Recovery After Surgery program on hospital stay and 90-day readmission after pancreaticoduodenectomy: a single, tertiary center experience in Korea

Recommendations

Search

Questions

Type: Academic journal

Author: Doo-Hun Kim (Seoul National University College of Medicine) Yoo-Seok Yoon (Seoul National University College of Medicine) Ho-Seong Han (Seoul National University College of Medicine) Jai-Young Cho (Seoul National University College of Medicine) Jun-Seo Lee (Seoul National University College of Medicine)

Journal: The Korean Surgical Society Annals of Surgical Treatment and Research Vol.100 No.2 KCI Accredited Journals SCIE

Published: 2021.2

Pages: 76 - 85 (10page)

Usage

📌

Topic

📖

Background

🔬

Method

🏆

Result

Effect of Enhanced Recovery After Surgery program on hospital stay and 90-day readmission after pancreaticoduodenectomy: a single, tertiary center experience in Korea

Abstract· Keywords

Report Errors

Purpose: Despite increasing number of reports on Enhanced Recovery After Surgery program (ERAS) and readmission after pancreaticoduodenectomy (PD) from Western countries, there are very few reports on this topic from Asian countries. This study aimed to evaluate the effects of ERAS on hospital stay and readmission and to identify reasons and risk factors for readmission after PD.
Methods: This retrospective cohort study included 670 patients who underwent open PD from January 2003 to December 2017. The patients were classified into ERAS (n = 352) and non-ERAS (n = 318) groups. Patients’ characteristics, perioperative outcomes, and readmission rates were compared.
Results: There were no significant differences in the postoperative complication rates between the groups. The mean postoperative hospital stay was significantly shorter in the ERAS group (24.5 vs. 18.0 days, P < 0.001), but the 90-day readmission rate was similar in the 2 groups (9.1% vs. 8.5%, P = 0.785). Complications associated with pancreatic fistula (42.4%) were the most common cause for readmission. In the multivariate analysis, diabetes mellitus (odds ratio [OR], 1.84; 95% confidence interval [CI], 1.05–3.24; P = 0.034), preoperative non-jaundice (OR, 0.45; 95% CI, 0.25–0.82; P = 0.009) and severe postoperative complications (OR, 4.12; 95% CI, 2.34–7.26; P < 0.001) were identified as risk factors for readmission.
Conclusion: The results confirmed that the ERAS program for PD was beneficial in reducing postoperative stay without increasing readmission risks. To decrease readmission rates, prudent discharge planning and medical support should be considered in patients who experience severe complications.

#Enhanced Recovery After Surgery #Length of stay #Korea #Pancreaticoduodenectomy #Patient readmission

INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES

References (25)

Add References

Grobmyer SR / 2007 / Defining morbidity after pancreaticoduodenectomy:use of a prospective complication grading system / J Am Coll Surg 204:356~364

Gouma DJ / 2000 / Rates of complications and death after pancreaticoduodenectomy: risk factors and the impact of hospital volume / Ann Surg 232:786~795

Varadhan KK / 2010 / The enhanced recovery after surgery (ERAS) pathway for patients undergoing major elective open colorectal surgery: a meta-analysis of randomized controlled trials / Clin Nutr 29:434~440

Teeuwen PH / 2010 / Enhanced recovery after surgery (ERAS) versus conventional postoperative care in colorectal surgery / J Gastrointest Surg 14:88~95

Lassen K / 2012 / Guidelines for perioperative care for pancreaticoduodenectomy: Enhanced Recovery After Surgery (ERAS®) Society recommendations / Clin Nutr 31:817~830

Recommendations

It is an article recommended by DBpia according to the article similarity. Check out the related articles!