Impact of enhanced recovery after surgery protocol compliance on patients’ outcome in benign hysterectomy and establishment of a predictive nomogram model

Shen, Yiwei; Lv, Feng; Min, Su; Jin, Juying; Gong, Yingyun; Yu, Jian; Qin, Peipei; Zhang, Ying

doi:10.1186/s12871-021-01509-0

Cited by 13 publications

(8 citation statements)

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“…ERAS programs intended to improve surgical outcomes have been implemented across various hospital procedures across the world with positive outcomes. Low compliance rates with ERAS remain a challenge [ 46–48 ], and many studies have demonstrated that increasing compliance further improves outcomes [ 49 , 50 ]. Particularly for hospitals with a larger share of Medicare patients, where net difference is in many procedures at or near zero even for patients without complications, applying the protocols and technology enablers could have an immense impact on overall profitability.…”

Section: Discussionmentioning

confidence: 99%

Impact of surgical complications on hospital costs and revenues: retrospective database study of Medicare claims

2023

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Aim: To compare the length of stay, hospital costs and hospital revenues for Medicare patients with and without a subset of potentially preventable postoperative complications after major noncardiac surgery. Materials & methods: Retrospective data analysis using the Medicare Standard Analytical Files, Limited Data Set, 5% inpatient claims files for years 2016–2020. Results: In 74,103 claims selected for analysis, 71,467 claims had no complications and 2636 had one or more complications of interest. Claims with complications had significantly longer length of hospital stay (12.41 vs 3.95 days, p < 0.01), increased payments to the provider ($34,664 vs $16,641, p < 0.01) and substantially higher estimates of provider cost ($39,357 vs $16,158, p < 0.01) compared with claims without complications. This results on average in a negative difference between payments and costs for patients with complications compared with a positive difference for claims without complications (-$4693 vs $483, p < 0.01). Results were consistent across three different cost estimation methods used in the study. Conclusion: Compared with patients without postoperative complications, patients developing complications stay longer in the hospital and incur increased costs that outpace the increase in received payments. Complications are therefore costly to providers and payers, may negatively impact hospital profitability, and decrease the quality of life of patients. Quality initiatives aimed at reducing complications can be immensely valuable for both improving patient outcomes and hospital finances.

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Section: Discussionmentioning

confidence: 99%

Impact of surgical complications on hospital costs and revenues: retrospective database study of Medicare claims

2023

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“…Results show that ERAS protocol for colorectal surgery allows faster recovery and also lower days of hospital stay in comparison with traditional protocol (17). There are increasing reports in the gynecological literature to improve outcomes (18,19). In a study (2012) Carter performed laparotomy for gynecological cancer in three hundred and eighty-nine patients and used fasttrack management (18).…”

Section: Discussionmentioning

confidence: 99%

Effect of Fast-Track Surgery under ERAS protocol in Laparoscopic Hysterectomy: A Randomized Controlled Trial

Gharouni

Kashi

Chaichian

et al. 2022

J Obstet Gynecol Cancer Res

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Background and Objective: Fast-track surgery (FTS) consists of different pathways to decrease surgical complications and improve outcomes and patient satisfaction. FTS in an elective gynecologic laparoscopic surgery has not been well assessed. No consensus guidelines have been developed for gynecologic laparoscopic surgeries. The purpose of this study is to evaluate enhanced recovery after surgery (ERAS) for total laparoscopic hysterectomy. Methods: 260 patients underwent for laparoscopic hysterectomy surgery. All patients were divided into two groups as follows: one group received traditional laparoscopic hysterectomy surgery and the intervention group was treated under ERAS protocol. ERAS protocol includes not receiving preoperative mechanical bowel preparation and laxatives as well as fasting 6 h and not drinking liquids 2h before surgery. The patients were allowed to resume the ordinary diet 6h post-operation. Ondansetron 4 mg were prescribed after surgery for nausea and vomiting, pain was controlled with non-narcotic analgesics diclofenac suppository 100 mg/q12 h and paracetamol 1000 mg/q6 h until discharge. Urinary catheter was removed whenever possible and early ambulation occurred 6h after the surgery. Results: A total of 260 patients were studied. Regarding the length of hospitalization, significant differences were shown between the groups (P<0.001). Return to daily functions was occurred earlier in the fast-track surgery group than another group. Complications and VAS pain scores showed no significant differences between the groups. Conclusion: Our results show that ERAS surgery has fewer side effects and better outcomes which make it more suitable for patients undergoing laparoscopic hysterectomy.

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“…The higher of the QoR-15 scores, the better of the quality of recovery after surgery (range is 0 to 150 points). 20 …”

Section: Methodsmentioning

confidence: 99%

“…The higher of the QoR-15 scores, the better of the quality of recovery after surgery (range is 0 to 150 points). 20 NRS pain scores were assessed for all patients at 2, 4, 6, 12 and 24 h after surgery (0 points: painless; 1-3 points: mild pain; 4-6 points: moderate pain; 7-10 points: severe pain). The quality of sleep was evaluated using a 10-point rating scale (0 = terrible sleep, 10 = excellent sleep).…”

Section: Primary and Secondary Outcomesmentioning

confidence: 99%

Effects of the Different Doses of Esketamine on Postoperative Quality of Recovery in Patients Undergoing Modified Radical Mastectomy: A Randomized, Double-Blind, Controlled Trial

Zhu¹,

Xu²,

Ju³

et al. 2022

DDDT

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Purpose This study aims to investigate the effects of the different doses of esketamine on postoperative quality of recovery in patients undergoing modified radical mastectomy. Methods Ninety-nine female patients were randomly allocated to three groups: the low-dose esketamine group (group E 1 ) (0.5 mg/kg loading, 2 µg/kg/h infusion), the high-dose esketamine group (group E 2 ) (0.5 mg/kg loading, 4 µg/kg/h infusion), the control group (group C) (received normal saline). The primary outcome was the quality of recovery-15 (QoR-15) scores on postoperative day 1 (POD1) and days 3 (POD3). The secondary outcomes were the sleep quality scores on POD1, bispectral index (BIS) value at 10, 30, and 60 min after operation, numeric rating scale (NRS) pain scores within 24 h after surgery, nausea, vomiting, drowsiness, nightmare, and intraoperative awareness. Results The total QoR-15 scores were higher in group E 1 and group E 2 than in group C on POD1 and POD3 ( P <0.05). The sleep quality scores on POD1 and BIS value at 10, 30, and 60 min after operation were higher in group E 1 and group E 2 than in group C ( P <0.05). The NRS pain scores at 2, 4 and 6 h after surgery in group E 1 and at 2, 4, 6, 12 and 24 h after surgery in group E 2 were lower than in group C ( P <0.05). The NRS pain scores at 6, 12 and 24 h after surgery in group E 2 were lower than in group E 1 ( P <0.05). The incidence of drowsiness was higher in group E 1 and group E 2 than in group C ( P <0.05). Conclusion Esketamine infusion improved to some extent the quality of recovery on POD1 and POD3 in patients undergoing modified radical mastectomy, especially 4 µg/kg/h esketamine was better, but the BIS value and incidence of drowsiness were significantly increased.

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Impact of enhanced recovery after surgery protocol compliance on patients’ outcome in benign hysterectomy and establishment of a predictive nomogram model

Cited by 13 publications

References 50 publications

Impact of surgical complications on hospital costs and revenues: retrospective database study of Medicare claims

Impact of surgical complications on hospital costs and revenues: retrospective database study of Medicare claims

Effect of Fast-Track Surgery under ERAS protocol in Laparoscopic Hysterectomy: A Randomized Controlled Trial

Effects of the Different Doses of Esketamine on Postoperative Quality of Recovery in Patients Undergoing Modified Radical Mastectomy: A Randomized, Double-Blind, Controlled Trial

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