Impact of implementation of the ERAS program in colorectal surgery: a multi-center study based on the “Lazio Network” collective database
Background ERAS implementation improved outcomes in patients undergoing colorectal surgery. The process of incorporating this pathway in clinical practice may be challenging. This observational study investigated the impact of systematic ERAS implementation on surgical outcomes in patients undergoin...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Grieco, Michele [verfasserIn] Lorenzon, Laura [verfasserIn] Pernazza, Graziano [verfasserIn] Carlini, Massimo [verfasserIn] Brescia, Antonio [verfasserIn] Santoro, Roberto [verfasserIn] Crucitti, Antonio [verfasserIn] Palmieri, Raffaele Macarone [verfasserIn] Santoro, Emanuele [verfasserIn] Stipa, Francesco [verfasserIn] Sacchi, Marco [verfasserIn] Persiani, Roberto [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2020 |
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| Übergeordnetes Werk: |
Enthalten in: International journal of colorectal disease - Berlin : Springer, 1986, 35(2020), 3 vom: 02. Jan., Seite 445-453 |
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| Übergeordnetes Werk: |
volume:35 ; year:2020 ; number:3 ; day:02 ; month:01 ; pages:445-453 |
| Links: |
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| DOI / URN: |
10.1007/s00384-019-03496-8 |
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| Katalog-ID: |
SPR00477440X |
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| 245 | 1 | 0 | |a Impact of implementation of the ERAS program in colorectal surgery: a multi-center study based on the “Lazio Network” collective database |
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| 520 | |a Background ERAS implementation improved outcomes in patients undergoing colorectal surgery. The process of incorporating this pathway in clinical practice may be challenging. This observational study investigated the impact of systematic ERAS implementation on surgical outcomes in patients undergoing colorectal resections in a regional network of 10 institutions. Methods Implementation of ERAS pathway was designed using regular audits and a common protocol. All patients undergoing elective colorectal surgery between 2016 and 2017 were considered eligible. A collective database including 18 ERAS items, clinical and surgical data, and outcomes was designed. Univariate and multivariate analyses were performed for the following outcomes: morbidity, anastomotic leak, reinterventions, hospital stay, and readmissions. Results A total of 827 patients were included, and a mean of 11.3 ERAS items applied/patient was reported. Logistic regression indicated that an increased number of ERAS items applied reduced overall and severe morbidity (OR 0.86 and 0.87, respectively 95%CI 0.8197–0.9202 and 95%CI 0.7821–0.9603), hospitalization (OR 0.53 95%CI 0.4917–0.5845) and reinterventions (OR 0.84 95%CI 0.7536–0.9518) in the entire series. The same results were obtained for a prolonged hospitalization differentiating right-sided (OR 0.48 95%CI 0.4036–0.5801), left-sided (OR 0.48 95%CI 0.3984–0.5815), and rectal resections (OR 0.46 95%CI 0.3753–0.5851). An inverse correlation was found between the application of ERAS items and morbidity in right-sided and rectal procedures (OR 0.89 and 0.84, respectively 95%CI 0.7976–0.9773 and 95%CI 0.7418–0.9634). Conclusions Systematic implementation of the ERAS pathway using multi-institutional audits can increase protocol adherence and improve surgical outcomes in patients undergoing colorectal surgery. | ||
| 650 | 4 | |a ERAS guidelines |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Colorectal surgery |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Fast track |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Outcomes |7 (dpeaa)DE-He213 | |
| 700 | 1 | |a Lorenzon, Laura |e verfasserin |4 aut | |
| 700 | 1 | |a Pernazza, Graziano |e verfasserin |4 aut | |
| 700 | 1 | |a Carlini, Massimo |e verfasserin |4 aut | |
| 700 | 1 | |a Brescia, Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a Santoro, Roberto |e verfasserin |4 aut | |
| 700 | 1 | |a Crucitti, Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a Palmieri, Raffaele Macarone |e verfasserin |4 aut | |
| 700 | 1 | |a Santoro, Emanuele |e verfasserin |4 aut | |
| 700 | 1 | |a Stipa, Francesco |e verfasserin |4 aut | |
| 700 | 1 | |a Sacchi, Marco |e verfasserin |4 aut | |
| 700 | 1 | |a Persiani, Roberto |e verfasserin |4 aut | |
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10.1007/s00384-019-03496-8 doi (DE-627)SPR00477440X (SPR)s00384-019-03496-8-e DE-627 ger DE-627 rakwb eng 610 ASE 44.87 bkl Grieco, Michele verfasserin aut Impact of implementation of the ERAS program in colorectal surgery: a multi-center study based on the “Lazio Network” collective database 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background ERAS implementation improved outcomes in patients undergoing colorectal surgery. The process of incorporating this pathway in clinical practice may be challenging. This observational study investigated the impact of systematic ERAS implementation on surgical outcomes in patients undergoing colorectal resections in a regional network of 10 institutions. Methods Implementation of ERAS pathway was designed using regular audits and a common protocol. All patients undergoing elective colorectal surgery between 2016 and 2017 were considered eligible. A collective database including 18 ERAS items, clinical and surgical data, and outcomes was designed. Univariate and multivariate analyses were performed for the following outcomes: morbidity, anastomotic leak, reinterventions, hospital stay, and readmissions. Results A total of 827 patients were included, and a mean of 11.3 ERAS items applied/patient was reported. Logistic regression indicated that an increased number of ERAS items applied reduced overall and severe morbidity (OR 0.86 and 0.87, respectively 95%CI 0.8197–0.9202 and 95%CI 0.7821–0.9603), hospitalization (OR 0.53 95%CI 0.4917–0.5845) and reinterventions (OR 0.84 95%CI 0.7536–0.9518) in the entire series. The same results were obtained for a prolonged hospitalization differentiating right-sided (OR 0.48 95%CI 0.4036–0.5801), left-sided (OR 0.48 95%CI 0.3984–0.5815), and rectal resections (OR 0.46 95%CI 0.3753–0.5851). An inverse correlation was found between the application of ERAS items and morbidity in right-sided and rectal procedures (OR 0.89 and 0.84, respectively 95%CI 0.7976–0.9773 and 95%CI 0.7418–0.9634). Conclusions Systematic implementation of the ERAS pathway using multi-institutional audits can increase protocol adherence and improve surgical outcomes in patients undergoing colorectal surgery. ERAS guidelines (dpeaa)DE-He213 Colorectal surgery (dpeaa)DE-He213 Fast track (dpeaa)DE-He213 Outcomes (dpeaa)DE-He213 Lorenzon, Laura verfasserin aut Pernazza, Graziano verfasserin aut Carlini, Massimo verfasserin aut Brescia, Antonio verfasserin aut Santoro, Roberto verfasserin aut Crucitti, Antonio verfasserin aut Palmieri, Raffaele Macarone verfasserin aut Santoro, Emanuele verfasserin aut Stipa, Francesco verfasserin aut Sacchi, Marco verfasserin aut Persiani, Roberto verfasserin aut Enthalten in International journal of colorectal disease Berlin : Springer, 1986 35(2020), 3 vom: 02. Jan., Seite 445-453 (DE-627)253724244 (DE-600)1459217-4 1432-1262 nnns volume:35 year:2020 number:3 day:02 month:01 pages:445-453 https://dx.doi.org/10.1007/s00384-019-03496-8 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2018 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.87 ASE AR 35 2020 3 02 01 445-453 |
| spelling |
10.1007/s00384-019-03496-8 doi (DE-627)SPR00477440X (SPR)s00384-019-03496-8-e DE-627 ger DE-627 rakwb eng 610 ASE 44.87 bkl Grieco, Michele verfasserin aut Impact of implementation of the ERAS program in colorectal surgery: a multi-center study based on the “Lazio Network” collective database 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background ERAS implementation improved outcomes in patients undergoing colorectal surgery. The process of incorporating this pathway in clinical practice may be challenging. This observational study investigated the impact of systematic ERAS implementation on surgical outcomes in patients undergoing colorectal resections in a regional network of 10 institutions. Methods Implementation of ERAS pathway was designed using regular audits and a common protocol. All patients undergoing elective colorectal surgery between 2016 and 2017 were considered eligible. A collective database including 18 ERAS items, clinical and surgical data, and outcomes was designed. Univariate and multivariate analyses were performed for the following outcomes: morbidity, anastomotic leak, reinterventions, hospital stay, and readmissions. Results A total of 827 patients were included, and a mean of 11.3 ERAS items applied/patient was reported. Logistic regression indicated that an increased number of ERAS items applied reduced overall and severe morbidity (OR 0.86 and 0.87, respectively 95%CI 0.8197–0.9202 and 95%CI 0.7821–0.9603), hospitalization (OR 0.53 95%CI 0.4917–0.5845) and reinterventions (OR 0.84 95%CI 0.7536–0.9518) in the entire series. The same results were obtained for a prolonged hospitalization differentiating right-sided (OR 0.48 95%CI 0.4036–0.5801), left-sided (OR 0.48 95%CI 0.3984–0.5815), and rectal resections (OR 0.46 95%CI 0.3753–0.5851). An inverse correlation was found between the application of ERAS items and morbidity in right-sided and rectal procedures (OR 0.89 and 0.84, respectively 95%CI 0.7976–0.9773 and 95%CI 0.7418–0.9634). Conclusions Systematic implementation of the ERAS pathway using multi-institutional audits can increase protocol adherence and improve surgical outcomes in patients undergoing colorectal surgery. ERAS guidelines (dpeaa)DE-He213 Colorectal surgery (dpeaa)DE-He213 Fast track (dpeaa)DE-He213 Outcomes (dpeaa)DE-He213 Lorenzon, Laura verfasserin aut Pernazza, Graziano verfasserin aut Carlini, Massimo verfasserin aut Brescia, Antonio verfasserin aut Santoro, Roberto verfasserin aut Crucitti, Antonio verfasserin aut Palmieri, Raffaele Macarone verfasserin aut Santoro, Emanuele verfasserin aut Stipa, Francesco verfasserin aut Sacchi, Marco verfasserin aut Persiani, Roberto verfasserin aut Enthalten in International journal of colorectal disease Berlin : Springer, 1986 35(2020), 3 vom: 02. Jan., Seite 445-453 (DE-627)253724244 (DE-600)1459217-4 1432-1262 nnns volume:35 year:2020 number:3 day:02 month:01 pages:445-453 https://dx.doi.org/10.1007/s00384-019-03496-8 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2018 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.87 ASE AR 35 2020 3 02 01 445-453 |
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10.1007/s00384-019-03496-8 doi (DE-627)SPR00477440X (SPR)s00384-019-03496-8-e DE-627 ger DE-627 rakwb eng 610 ASE 44.87 bkl Grieco, Michele verfasserin aut Impact of implementation of the ERAS program in colorectal surgery: a multi-center study based on the “Lazio Network” collective database 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background ERAS implementation improved outcomes in patients undergoing colorectal surgery. The process of incorporating this pathway in clinical practice may be challenging. This observational study investigated the impact of systematic ERAS implementation on surgical outcomes in patients undergoing colorectal resections in a regional network of 10 institutions. Methods Implementation of ERAS pathway was designed using regular audits and a common protocol. All patients undergoing elective colorectal surgery between 2016 and 2017 were considered eligible. A collective database including 18 ERAS items, clinical and surgical data, and outcomes was designed. Univariate and multivariate analyses were performed for the following outcomes: morbidity, anastomotic leak, reinterventions, hospital stay, and readmissions. Results A total of 827 patients were included, and a mean of 11.3 ERAS items applied/patient was reported. Logistic regression indicated that an increased number of ERAS items applied reduced overall and severe morbidity (OR 0.86 and 0.87, respectively 95%CI 0.8197–0.9202 and 95%CI 0.7821–0.9603), hospitalization (OR 0.53 95%CI 0.4917–0.5845) and reinterventions (OR 0.84 95%CI 0.7536–0.9518) in the entire series. The same results were obtained for a prolonged hospitalization differentiating right-sided (OR 0.48 95%CI 0.4036–0.5801), left-sided (OR 0.48 95%CI 0.3984–0.5815), and rectal resections (OR 0.46 95%CI 0.3753–0.5851). An inverse correlation was found between the application of ERAS items and morbidity in right-sided and rectal procedures (OR 0.89 and 0.84, respectively 95%CI 0.7976–0.9773 and 95%CI 0.7418–0.9634). Conclusions Systematic implementation of the ERAS pathway using multi-institutional audits can increase protocol adherence and improve surgical outcomes in patients undergoing colorectal surgery. ERAS guidelines (dpeaa)DE-He213 Colorectal surgery (dpeaa)DE-He213 Fast track (dpeaa)DE-He213 Outcomes (dpeaa)DE-He213 Lorenzon, Laura verfasserin aut Pernazza, Graziano verfasserin aut Carlini, Massimo verfasserin aut Brescia, Antonio verfasserin aut Santoro, Roberto verfasserin aut Crucitti, Antonio verfasserin aut Palmieri, Raffaele Macarone verfasserin aut Santoro, Emanuele verfasserin aut Stipa, Francesco verfasserin aut Sacchi, Marco verfasserin aut Persiani, Roberto verfasserin aut Enthalten in International journal of colorectal disease Berlin : Springer, 1986 35(2020), 3 vom: 02. Jan., Seite 445-453 (DE-627)253724244 (DE-600)1459217-4 1432-1262 nnns volume:35 year:2020 number:3 day:02 month:01 pages:445-453 https://dx.doi.org/10.1007/s00384-019-03496-8 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2018 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.87 ASE AR 35 2020 3 02 01 445-453 |
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10.1007/s00384-019-03496-8 doi (DE-627)SPR00477440X (SPR)s00384-019-03496-8-e DE-627 ger DE-627 rakwb eng 610 ASE 44.87 bkl Grieco, Michele verfasserin aut Impact of implementation of the ERAS program in colorectal surgery: a multi-center study based on the “Lazio Network” collective database 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background ERAS implementation improved outcomes in patients undergoing colorectal surgery. The process of incorporating this pathway in clinical practice may be challenging. This observational study investigated the impact of systematic ERAS implementation on surgical outcomes in patients undergoing colorectal resections in a regional network of 10 institutions. Methods Implementation of ERAS pathway was designed using regular audits and a common protocol. All patients undergoing elective colorectal surgery between 2016 and 2017 were considered eligible. A collective database including 18 ERAS items, clinical and surgical data, and outcomes was designed. Univariate and multivariate analyses were performed for the following outcomes: morbidity, anastomotic leak, reinterventions, hospital stay, and readmissions. Results A total of 827 patients were included, and a mean of 11.3 ERAS items applied/patient was reported. Logistic regression indicated that an increased number of ERAS items applied reduced overall and severe morbidity (OR 0.86 and 0.87, respectively 95%CI 0.8197–0.9202 and 95%CI 0.7821–0.9603), hospitalization (OR 0.53 95%CI 0.4917–0.5845) and reinterventions (OR 0.84 95%CI 0.7536–0.9518) in the entire series. The same results were obtained for a prolonged hospitalization differentiating right-sided (OR 0.48 95%CI 0.4036–0.5801), left-sided (OR 0.48 95%CI 0.3984–0.5815), and rectal resections (OR 0.46 95%CI 0.3753–0.5851). An inverse correlation was found between the application of ERAS items and morbidity in right-sided and rectal procedures (OR 0.89 and 0.84, respectively 95%CI 0.7976–0.9773 and 95%CI 0.7418–0.9634). Conclusions Systematic implementation of the ERAS pathway using multi-institutional audits can increase protocol adherence and improve surgical outcomes in patients undergoing colorectal surgery. ERAS guidelines (dpeaa)DE-He213 Colorectal surgery (dpeaa)DE-He213 Fast track (dpeaa)DE-He213 Outcomes (dpeaa)DE-He213 Lorenzon, Laura verfasserin aut Pernazza, Graziano verfasserin aut Carlini, Massimo verfasserin aut Brescia, Antonio verfasserin aut Santoro, Roberto verfasserin aut Crucitti, Antonio verfasserin aut Palmieri, Raffaele Macarone verfasserin aut Santoro, Emanuele verfasserin aut Stipa, Francesco verfasserin aut Sacchi, Marco verfasserin aut Persiani, Roberto verfasserin aut Enthalten in International journal of colorectal disease Berlin : Springer, 1986 35(2020), 3 vom: 02. Jan., Seite 445-453 (DE-627)253724244 (DE-600)1459217-4 1432-1262 nnns volume:35 year:2020 number:3 day:02 month:01 pages:445-453 https://dx.doi.org/10.1007/s00384-019-03496-8 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2018 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.87 ASE AR 35 2020 3 02 01 445-453 |
| allfieldsSound |
10.1007/s00384-019-03496-8 doi (DE-627)SPR00477440X (SPR)s00384-019-03496-8-e DE-627 ger DE-627 rakwb eng 610 ASE 44.87 bkl Grieco, Michele verfasserin aut Impact of implementation of the ERAS program in colorectal surgery: a multi-center study based on the “Lazio Network” collective database 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background ERAS implementation improved outcomes in patients undergoing colorectal surgery. The process of incorporating this pathway in clinical practice may be challenging. This observational study investigated the impact of systematic ERAS implementation on surgical outcomes in patients undergoing colorectal resections in a regional network of 10 institutions. Methods Implementation of ERAS pathway was designed using regular audits and a common protocol. All patients undergoing elective colorectal surgery between 2016 and 2017 were considered eligible. A collective database including 18 ERAS items, clinical and surgical data, and outcomes was designed. Univariate and multivariate analyses were performed for the following outcomes: morbidity, anastomotic leak, reinterventions, hospital stay, and readmissions. Results A total of 827 patients were included, and a mean of 11.3 ERAS items applied/patient was reported. Logistic regression indicated that an increased number of ERAS items applied reduced overall and severe morbidity (OR 0.86 and 0.87, respectively 95%CI 0.8197–0.9202 and 95%CI 0.7821–0.9603), hospitalization (OR 0.53 95%CI 0.4917–0.5845) and reinterventions (OR 0.84 95%CI 0.7536–0.9518) in the entire series. The same results were obtained for a prolonged hospitalization differentiating right-sided (OR 0.48 95%CI 0.4036–0.5801), left-sided (OR 0.48 95%CI 0.3984–0.5815), and rectal resections (OR 0.46 95%CI 0.3753–0.5851). An inverse correlation was found between the application of ERAS items and morbidity in right-sided and rectal procedures (OR 0.89 and 0.84, respectively 95%CI 0.7976–0.9773 and 95%CI 0.7418–0.9634). Conclusions Systematic implementation of the ERAS pathway using multi-institutional audits can increase protocol adherence and improve surgical outcomes in patients undergoing colorectal surgery. ERAS guidelines (dpeaa)DE-He213 Colorectal surgery (dpeaa)DE-He213 Fast track (dpeaa)DE-He213 Outcomes (dpeaa)DE-He213 Lorenzon, Laura verfasserin aut Pernazza, Graziano verfasserin aut Carlini, Massimo verfasserin aut Brescia, Antonio verfasserin aut Santoro, Roberto verfasserin aut Crucitti, Antonio verfasserin aut Palmieri, Raffaele Macarone verfasserin aut Santoro, Emanuele verfasserin aut Stipa, Francesco verfasserin aut Sacchi, Marco verfasserin aut Persiani, Roberto verfasserin aut Enthalten in International journal of colorectal disease Berlin : Springer, 1986 35(2020), 3 vom: 02. Jan., Seite 445-453 (DE-627)253724244 (DE-600)1459217-4 1432-1262 nnns volume:35 year:2020 number:3 day:02 month:01 pages:445-453 https://dx.doi.org/10.1007/s00384-019-03496-8 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2018 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.87 ASE AR 35 2020 3 02 01 445-453 |
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Enthalten in International journal of colorectal disease 35(2020), 3 vom: 02. Jan., Seite 445-453 volume:35 year:2020 number:3 day:02 month:01 pages:445-453 |
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Enthalten in International journal of colorectal disease 35(2020), 3 vom: 02. Jan., Seite 445-453 volume:35 year:2020 number:3 day:02 month:01 pages:445-453 |
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ERAS guidelines Colorectal surgery Fast track Outcomes |
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Grieco, Michele @@aut@@ Lorenzon, Laura @@aut@@ Pernazza, Graziano @@aut@@ Carlini, Massimo @@aut@@ Brescia, Antonio @@aut@@ Santoro, Roberto @@aut@@ Crucitti, Antonio @@aut@@ Palmieri, Raffaele Macarone @@aut@@ Santoro, Emanuele @@aut@@ Stipa, Francesco @@aut@@ Sacchi, Marco @@aut@@ Persiani, Roberto @@aut@@ |
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The process of incorporating this pathway in clinical practice may be challenging. This observational study investigated the impact of systematic ERAS implementation on surgical outcomes in patients undergoing colorectal resections in a regional network of 10 institutions. Methods Implementation of ERAS pathway was designed using regular audits and a common protocol. All patients undergoing elective colorectal surgery between 2016 and 2017 were considered eligible. A collective database including 18 ERAS items, clinical and surgical data, and outcomes was designed. Univariate and multivariate analyses were performed for the following outcomes: morbidity, anastomotic leak, reinterventions, hospital stay, and readmissions. Results A total of 827 patients were included, and a mean of 11.3 ERAS items applied/patient was reported. Logistic regression indicated that an increased number of ERAS items applied reduced overall and severe morbidity (OR 0.86 and 0.87, respectively 95%CI 0.8197–0.9202 and 95%CI 0.7821–0.9603), hospitalization (OR 0.53 95%CI 0.4917–0.5845) and reinterventions (OR 0.84 95%CI 0.7536–0.9518) in the entire series. The same results were obtained for a prolonged hospitalization differentiating right-sided (OR 0.48 95%CI 0.4036–0.5801), left-sided (OR 0.48 95%CI 0.3984–0.5815), and rectal resections (OR 0.46 95%CI 0.3753–0.5851). An inverse correlation was found between the application of ERAS items and morbidity in right-sided and rectal procedures (OR 0.89 and 0.84, respectively 95%CI 0.7976–0.9773 and 95%CI 0.7418–0.9634). 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Grieco, Michele |
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Grieco, Michele ddc 610 bkl 44.87 misc ERAS guidelines misc Colorectal surgery misc Fast track misc Outcomes Impact of implementation of the ERAS program in colorectal surgery: a multi-center study based on the “Lazio Network” collective database |
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610 ASE 44.87 bkl Impact of implementation of the ERAS program in colorectal surgery: a multi-center study based on the “Lazio Network” collective database ERAS guidelines (dpeaa)DE-He213 Colorectal surgery (dpeaa)DE-He213 Fast track (dpeaa)DE-He213 Outcomes (dpeaa)DE-He213 |
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ddc 610 bkl 44.87 misc ERAS guidelines misc Colorectal surgery misc Fast track misc Outcomes |
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ddc 610 bkl 44.87 misc ERAS guidelines misc Colorectal surgery misc Fast track misc Outcomes |
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International journal of colorectal disease |
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International journal of colorectal disease |
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Impact of implementation of the ERAS program in colorectal surgery: a multi-center study based on the “Lazio Network” collective database |
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Impact of implementation of the ERAS program in colorectal surgery: a multi-center study based on the “Lazio Network” collective database |
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Grieco, Michele |
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International journal of colorectal disease |
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International journal of colorectal disease |
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Grieco, Michele Lorenzon, Laura Pernazza, Graziano Carlini, Massimo Brescia, Antonio Santoro, Roberto Crucitti, Antonio Palmieri, Raffaele Macarone Santoro, Emanuele Stipa, Francesco Sacchi, Marco Persiani, Roberto |
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Grieco, Michele |
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impact of implementation of the eras program in colorectal surgery: a multi-center study based on the “lazio network” collective database |
| title_auth |
Impact of implementation of the ERAS program in colorectal surgery: a multi-center study based on the “Lazio Network” collective database |
| abstract |
Background ERAS implementation improved outcomes in patients undergoing colorectal surgery. The process of incorporating this pathway in clinical practice may be challenging. This observational study investigated the impact of systematic ERAS implementation on surgical outcomes in patients undergoing colorectal resections in a regional network of 10 institutions. Methods Implementation of ERAS pathway was designed using regular audits and a common protocol. All patients undergoing elective colorectal surgery between 2016 and 2017 were considered eligible. A collective database including 18 ERAS items, clinical and surgical data, and outcomes was designed. Univariate and multivariate analyses were performed for the following outcomes: morbidity, anastomotic leak, reinterventions, hospital stay, and readmissions. Results A total of 827 patients were included, and a mean of 11.3 ERAS items applied/patient was reported. Logistic regression indicated that an increased number of ERAS items applied reduced overall and severe morbidity (OR 0.86 and 0.87, respectively 95%CI 0.8197–0.9202 and 95%CI 0.7821–0.9603), hospitalization (OR 0.53 95%CI 0.4917–0.5845) and reinterventions (OR 0.84 95%CI 0.7536–0.9518) in the entire series. The same results were obtained for a prolonged hospitalization differentiating right-sided (OR 0.48 95%CI 0.4036–0.5801), left-sided (OR 0.48 95%CI 0.3984–0.5815), and rectal resections (OR 0.46 95%CI 0.3753–0.5851). An inverse correlation was found between the application of ERAS items and morbidity in right-sided and rectal procedures (OR 0.89 and 0.84, respectively 95%CI 0.7976–0.9773 and 95%CI 0.7418–0.9634). Conclusions Systematic implementation of the ERAS pathway using multi-institutional audits can increase protocol adherence and improve surgical outcomes in patients undergoing colorectal surgery. |
| abstractGer |
Background ERAS implementation improved outcomes in patients undergoing colorectal surgery. The process of incorporating this pathway in clinical practice may be challenging. This observational study investigated the impact of systematic ERAS implementation on surgical outcomes in patients undergoing colorectal resections in a regional network of 10 institutions. Methods Implementation of ERAS pathway was designed using regular audits and a common protocol. All patients undergoing elective colorectal surgery between 2016 and 2017 were considered eligible. A collective database including 18 ERAS items, clinical and surgical data, and outcomes was designed. Univariate and multivariate analyses were performed for the following outcomes: morbidity, anastomotic leak, reinterventions, hospital stay, and readmissions. Results A total of 827 patients were included, and a mean of 11.3 ERAS items applied/patient was reported. Logistic regression indicated that an increased number of ERAS items applied reduced overall and severe morbidity (OR 0.86 and 0.87, respectively 95%CI 0.8197–0.9202 and 95%CI 0.7821–0.9603), hospitalization (OR 0.53 95%CI 0.4917–0.5845) and reinterventions (OR 0.84 95%CI 0.7536–0.9518) in the entire series. The same results were obtained for a prolonged hospitalization differentiating right-sided (OR 0.48 95%CI 0.4036–0.5801), left-sided (OR 0.48 95%CI 0.3984–0.5815), and rectal resections (OR 0.46 95%CI 0.3753–0.5851). An inverse correlation was found between the application of ERAS items and morbidity in right-sided and rectal procedures (OR 0.89 and 0.84, respectively 95%CI 0.7976–0.9773 and 95%CI 0.7418–0.9634). Conclusions Systematic implementation of the ERAS pathway using multi-institutional audits can increase protocol adherence and improve surgical outcomes in patients undergoing colorectal surgery. |
| abstract_unstemmed |
Background ERAS implementation improved outcomes in patients undergoing colorectal surgery. The process of incorporating this pathway in clinical practice may be challenging. This observational study investigated the impact of systematic ERAS implementation on surgical outcomes in patients undergoing colorectal resections in a regional network of 10 institutions. Methods Implementation of ERAS pathway was designed using regular audits and a common protocol. All patients undergoing elective colorectal surgery between 2016 and 2017 were considered eligible. A collective database including 18 ERAS items, clinical and surgical data, and outcomes was designed. Univariate and multivariate analyses were performed for the following outcomes: morbidity, anastomotic leak, reinterventions, hospital stay, and readmissions. Results A total of 827 patients were included, and a mean of 11.3 ERAS items applied/patient was reported. Logistic regression indicated that an increased number of ERAS items applied reduced overall and severe morbidity (OR 0.86 and 0.87, respectively 95%CI 0.8197–0.9202 and 95%CI 0.7821–0.9603), hospitalization (OR 0.53 95%CI 0.4917–0.5845) and reinterventions (OR 0.84 95%CI 0.7536–0.9518) in the entire series. The same results were obtained for a prolonged hospitalization differentiating right-sided (OR 0.48 95%CI 0.4036–0.5801), left-sided (OR 0.48 95%CI 0.3984–0.5815), and rectal resections (OR 0.46 95%CI 0.3753–0.5851). An inverse correlation was found between the application of ERAS items and morbidity in right-sided and rectal procedures (OR 0.89 and 0.84, respectively 95%CI 0.7976–0.9773 and 95%CI 0.7418–0.9634). Conclusions Systematic implementation of the ERAS pathway using multi-institutional audits can increase protocol adherence and improve surgical outcomes in patients undergoing colorectal surgery. |
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Impact of implementation of the ERAS program in colorectal surgery: a multi-center study based on the “Lazio Network” collective database |
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Lorenzon, Laura Pernazza, Graziano Carlini, Massimo Brescia, Antonio Santoro, Roberto Crucitti, Antonio Palmieri, Raffaele Macarone Santoro, Emanuele Stipa, Francesco Sacchi, Marco Persiani, Roberto |
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Lorenzon, Laura Pernazza, Graziano Carlini, Massimo Brescia, Antonio Santoro, Roberto Crucitti, Antonio Palmieri, Raffaele Macarone Santoro, Emanuele Stipa, Francesco Sacchi, Marco Persiani, Roberto |
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| score |
7.400613 |