What outcomes are important in the assessment of Enhanced Recovery After Surgery (ERAS) pathways?

Feldman, Liane S.; Lee, Lawrence; Fiore, Julio F.

doi:10.1007/s12630-014-0263-1

Cited by 104 publications

(75 citation statements)

References 63 publications

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“…20 Delayed physical recovery is present in up to 60% and 50% of patients at three and six months, respectively. 21,22 Cognitive recovery can be delayed at postoperative day 3 in 14% of the general population 23 and can persist, especially in the elderly population. 24 Cognitive and non-cognitive recovery are also intertwined, with failure of recovery in one being predictive of suboptimal recovery in the other.…”

Section: Implications Of Poor Recoverymentioning

confidence: 99%

“…36,40,42 While initial reporting of surgical recovery was comprehensive, it was principally focused on the provider and limited to in-hospital and 30-day performance indicators. 22 Enhanced Recovery After Surgery (ERAS) pathways now extend recovery to include three phases (up to discharge from the postanesthesia care unit, hospital discharge, and restitution of normal function), but they are still primarily focused on performance indicators in the immediate postoperative period. In comparison, the development of recovery assessment tools that address early (over days), 38,46 intermediate (over weeks), 39,41 and late (over months) 37,54 recovery allow for a broader and contextual assessment of persistent adverse symptoms, functional impairment, and cognitive decline beyond the traditional postoperative period.…”

Section: Measurement Of Recoverymentioning

confidence: 99%

“…10,12,22 Thus, an important advantage of a recovery assessment tool is its ability to aid in the assessment of recovery at multiple clinically relevant time points. By using validated repeat measures, 36,37,41 it can model the trajectory of recovery over time, from discharge (early recovery), to resumption of basic social activities (intermediate recovery), to resolution of full cognitive function (late recovery).…”

Section: Measurement Of Recoverymentioning

confidence: 99%

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The importance of postoperative quality of recovery: influences, assessment, and clinical and prognostic implications

Bowyer

Royse

2015

Can J Anesth/J Can Anesth

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Quality of recovery is a complex construct whose definition is influenced heavily by the opinions and biases of the individual patient, clinician, or institution. As a result, recovery assessment tools differ in their fundamental definitions of recovery, breadth, and assessment time frame. Accurate assessment of recovery is essential as suboptimal recovery has both economic and prognostic implications. Quality of care is often substituted as a surrogate at the institutional level for quality of recovery, but it is ideologically distinct from patients' perceived quality of care, recovery, and satisfaction. Recovery tools also differ in their assessment of recovery as a continuous vs dichotomous variable and in their focus at the group vs individual level. Ideally, recovery measures should assess outcomes in a simple dichotomous fashion and maintain relevancy by assessing in multiple domains at various time points. Assessment of recovery in a dichotomous fashion also has both clinical and research applications. It allows identification of suboptimal recovery at both individual and group levels, respectively, and when performed in real time, it allows the opportunity for timely targeted intervention specific to individual patients as well as for resource rationalization.Résumé La qualité de récupération est un construit complexe dont la définition est fortement influencée par les opinions et les biais du patient, du clinicien, voire de l'établissement. Dès lors, les outils d'évaluation de la récupération diffèrent de par la définition-même de la récupération, leur envergure, et le cadre temporel de l'évaluation. Une évaluation précise de la récupération est essentielle; en effet, une récupération sous-optimale a des implications tant économiques que pronostiques. Au niveau institutionnel, on utilise souvent la qualité des soins comme substitut de la qualité de récupération mais, d'un point de vue idéologique, ce concept se distingue de la qualité des soins, de la récupération et de la satisfaction telles que perçues par les patients. Les outils de récupération diffèrent également dans leur évaluation de la récupération en tant que variable continue ou dichotomique et dans leur emphase sur le groupe ou l'individu. Dans l'idéal, les mesures de la récupération devraient évaluer les pronostics de manière dichotomique simple et maintenir leur pertinence en évaluant plusieurs domaines à différents moments dans le temps. L'évaluation dichotomique de la récupération a également des applications cliniques et en recherche. Elle permet d'identifier une récupération sous-optimale tant au niveau du groupe que de l'individu. D'autre part, lorsque ce type d'évaluation est réalisé en temps réel, elle nous donne la possibilité d'intervenir d'une manière ciblée et opportune spécifique à chaque patient tout en rationnalisant les ressources.Author contributions Andrea Bowyer and Colin Royse contributed substantially to the conception and design of the manuscript and drafted the version to be published.

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Section: Implications Of Poor Recoverymentioning

confidence: 99%

Section: Measurement Of Recoverymentioning

confidence: 99%

Section: Measurement Of Recoverymentioning

confidence: 99%

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The importance of postoperative quality of recovery: influences, assessment, and clinical and prognostic implications

Bowyer

Royse

2015

Can J Anesth/J Can Anesth

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“…Recovery may be defined as early, intermediate (PACU to discharge), or late (return to normal function, weeks to months). 15 Patients tend to define ''recovery as return to normal functioning''. 15 Certainly, anesthesia could facilitate the early and undoubtedly the intermediate recovery phase.…”

Section: Early Recovery After Surgerymentioning

confidence: 99%

“…La récupération peut être définie comme précoce, intermédiaire (de l'USPA au congé) ou tardive (retour à un fonctionnement normal, semaines ou mois). 15 Les patients tendent à définir la « récupération » par le retour à un fonctionnement normal. 15 L'anesthésie pourrait faciliter de façon certaine la phase de récupération précoce, et sans aucun doute celle de récupération intermédiaire.…”

Section: Changement De Prioritésunclassified

Perioperative medicine: why do we care?

Yang

2015

Can J Anesth/J Can Anesth

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Enhanced recovery protocols in patients undergoing pancreatic surgery: An umbrella review

Lin

et al. 2021

Nursing Open

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What outcomes are important in the assessment of Enhanced Recovery After Surgery (ERAS) pathways?

Cited by 104 publications

References 63 publications

The importance of postoperative quality of recovery: influences, assessment, and clinical and prognostic implications

The importance of postoperative quality of recovery: influences, assessment, and clinical and prognostic implications

Perioperative medicine: why do we care?

Enhanced recovery protocols in patients undergoing pancreatic surgery: An umbrella review

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