Implementing a structured Enhanced Recovery After Surgery (ERAS) protocol reduces length of stay after abdominal hysterectomy. (13th June 2014)

• Record Type: Journal Article
• Authors: Wijk, Lena; Franzen, Karin; Ljungqvist, Olle; Nilsson, Kerstin
• Is Part Of: Acta obstetricia et gynecologica Scandinavica. Volume 93:Number 8(2014)
• Page Start: 749
• Page End: 756
• Publication Date: 2014-06-13
• Subjects: Gynecology -- Periodicals; Pregnancy -- Periodicals; Obstetrics -- Periodicals; 618.05
• DOI: 10.1111/aogs.12423
• Languages: English
• ISSNs: 0001-6349

Abstract

<abstract abstract-type="main" id="aogs12423-abs-0001"> <title>Abstract</title> <sec id="aogs12423-sec-0001" sec-type="section"> <title>Objective</title> <p>To study the effects of introducing an Enhanced Recovery After Surgery (ERAS) protocol, modified for gynecological surgery, on length of stay and complications following abdominal hysterectomy.</p> </sec> <sec id="aogs12423-sec-0002" sec-type="section"> <title>Design</title> <p>Observational study.</p> </sec> <sec id="aogs12423-sec-0003" sec-type="section"> <title>Setting</title> <p>Department of Obstetrics and Gynecology, Örebro University Hospital, Sweden.</p> </sec> <sec id="aogs12423-sec-0004" sec-type="section"> <title>Population</title> <p>Eighty‐five patients undergoing abdominal hysterectomy for benign or malignant indications between January and December 2012, with or without salpingo‐oophorectomy. Outcomes were compared with all consecutive patients who had undergone the same surgery from January to December 2011, immediately before establishing the ERAS protocol (<italic>n </italic>= 120).</p> </sec> <sec id="aogs12423-sec-0005" sec-type="section"> <title>Methods</title> <p>The ERAS protocol was initiated in January 2012 as part of a targeted implementation program. Data were extracted from patient records and from a specific database.</p> </sec> <sec id="aogs12423-sec-0006" sec-type="section"> <title>Main outcome measures</title> <p>Length of stay and the proportion of patients achieving target length of stay (2 days).</p> </sec> <sec id="aogs12423-sec-0007" sec-type="section"> <title>Results</title> <p>Length of stay was significantly reduced in the study population after introducing the ERAS protocol from a mean of 2.6 (SD 1.1) days to a mean of 2.3 (SD 1.2) days (<italic>p </italic>= 0.011). The proportion of patients discharged at 2 days was significantly increased from 56% pre‐ERAS to 73% after ERAS (<italic>p </italic>= 0.012). No differences were found in complications (5% vs. 3.5% in primary stay, 12% vs. 15% within 30 days after discharge), reoperations (2% vs. 1%) or readmission (4% vs. 4%).</p> </sec> <sec id="aogs12423-sec-0008" sec-type="section"> <title>Conclusions</title> <p>Introducing the ERAS protocol for abdominal hysterectomy reduced length of stay without increasing complications or readmissions.</p> </sec> </abstract>