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The longitudinal impact of division-wide implementation of an enhanced recovery after thoracic surgery programme.
Thompson, Calvin; Mattice, Amanda M S; Al Lawati, Yaseen; Seyednejad, Nazgol; Lee, Alex; Maziak, Donna E; Gilbert, Sebastian; Sundaresan, Sudhir; Villeneuve, James; Shamji, Farid; Brehaut, Jamie; Ramsay, Tim; Seely, Andrew J E.
Afiliación
  • Thompson C; Dept. of Anesthesiology and Pain Medicine, The Ottawa Hospital, Ottawa, ON, Canada.
  • Mattice AMS; Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.
  • Al Lawati Y; Division of Thoracic Surgery, The Ottawa Hospital, Ottawa, ON, Canada.
  • Seyednejad N; Division of Thoracic Surgery, The Ottawa Hospital, Ottawa, ON, Canada.
  • Lee A; Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.
  • Maziak DE; Division of Thoracic Surgery, The Ottawa Hospital, Ottawa, ON, Canada.
  • Gilbert S; Division of Thoracic Surgery, The Ottawa Hospital, Ottawa, ON, Canada.
  • Sundaresan S; Division of Thoracic Surgery, The Ottawa Hospital, Ottawa, ON, Canada.
  • Villeneuve J; Division of Thoracic Surgery, The Ottawa Hospital, Ottawa, ON, Canada.
  • Shamji F; Division of Thoracic Surgery, The Ottawa Hospital, Ottawa, ON, Canada.
  • Brehaut J; Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.
  • Ramsay T; School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
  • Seely AJE; Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.
Eur J Cardiothorac Surg ; 61(6): 1223-1229, 2022 05 27.
Article en En | MEDLINE | ID: mdl-34849684
OBJECTIVES: Data regarding enhanced recovery after thoracic surgery (ERATS) are sparse and inconsistent. This study aims to evaluate the effects of implementing an enhanced ERATS programme on postoperative outcomes, patient experience and quality of life (QOL). METHODS: We conducted a prospective, longitudinal study evaluating 9 months before (pre-ERATS) and 9 months after (post-ERATS) a 3-month implementation of an ERATS programme in a single academic tertiary care centre. All patients undergoing major thoracic surgeries were included. The primary outcomes included length of stay (LOS), adverse events (AEs), 6-min walk test scores at 4 weeks, 30-day emergency room visits (without admission) and 30-day readmissions. The process-of-care outcomes included time to 'out-of-bed', independent ambulation, successful fluid intake, last chest tube removal and removal of urinary catheter. Perioperative anaesthesia-related outcomes were examined as well as patient experience and QOL scores. RESULTS: The pre-ERATS group (n = 352 patients) and post-ERATS group (n = 352) demonstrated no differences in demographics. Post-ERATS patients had improved LOS (4.7 vs 6.2 days, P < 0.02), 6-min walk test scores (402 vs 371 m, P < 0.05) and 30-day emergency room visits (13.7% vs 21.6%, P = 0.03) with no differences in AEs and 30-day readmissions. Patients experienced shorter mean time to 'out-of-bed', independent ambulation, successful fluid intake, last chest tube removal and urinary catheter removal. There were no differences in postoperative analgesia administration, patient satisfaction and QOL scores. CONCLUSIONS: ERATS implementation was associated with improved LOS, expedited feeding, ambulation and chest tube removal, without increasing AEs or readmissions, while maintaining a high level of patient satisfaction and QOL.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cirugía Torácica / Recuperación Mejorada Después de la Cirugía Tipo de estudio: Observational_studies / Risk_factors_studies / Sysrev_observational_studies Aspecto: Implementation_research / Patient_preference Límite: Humans Idioma: En Revista: Eur J Cardiothorac Surg Asunto de la revista: CARDIOLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Alemania
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cirugía Torácica / Recuperación Mejorada Después de la Cirugía Tipo de estudio: Observational_studies / Risk_factors_studies / Sysrev_observational_studies Aspecto: Implementation_research / Patient_preference Límite: Humans Idioma: En Revista: Eur J Cardiothorac Surg Asunto de la revista: CARDIOLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Alemania