ERAS, hospital stay and private insurance

Abstract

(>80 years), obesity (BMI>30 kg/m 2) and elevated ASA-PS scores (III and IV). Outcomes were length of stay (LOS), global postoperative complications, anastomotic leaks, readmission and reoperation rates within 30 postoperative days, and mortality. Results: 6,446 patients from 11 clinical trials were selected and divided into three groups, clustered by advanced age, BMI>30 and ASA III-IV. Highrisk patients responded differently to the application of ERAS protocol in colorectal surgery: age and ASA III-IV had a medium effect on LOS (SMD respectively of 0.464 e p<0.001-and 0.581), obesity had a small effect (SMD: 0.027). Old patients and patients with ASA III-IV showed lower levels of readmission. Old people showed a risk of a new operation greater than younger patients (OR: 1.25). There were no differences between old (OR 0.405) and obese patients (OR 1.031) and controls in anastomotic leaks, these factors show no influence on the integrity of the intestinal anastomoses. Regarding global postoperative complications: old patients had 63% more risk than younger people (OR¼1.636, p<0.001), obese subjects had a major risk of 26% (OR¼1.262), and patients with ASA score of III-IV had an OR of 0.753 of developing postoperative complications. Finally, mortality was influenced by age >80 years (OR: 3.603, p<0.001). Conclusion: High-risk patients treated according to ERAS programmes developed similar complications according to data reported by recent papers analyzing the same outcomes in high-risk patients undergoing colorectal surgery with conventional care. Older age and ASA III-IV did not influence the readmission rate. Disclosure of interest: None declared.