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一项回顾性比较试验,调查2015年至2022年间实施七种术后加速康复(ERAS)方案后的总住院时长。

A Retrospective Comparison Trial Investigating Aggregate Length of Stay Post Implementation of Seven Enhanced Recovery After Surgery (ERAS) Protocols between 2015 and 2022.

作者信息

Blumenthal Rebecca N, Locke Andrew R, Ben-Isvy Noah, Hasan Muneeb S, Wang Chi, Belanger Matthew J, Minhaj Mohammed, Greenberg Steven B

机构信息

Department of Anesthesiology, Critical Care, and Pain Medicine, Endeavor Health, Evanston, IL 60201, USA.

Department of Anesthesiology and Critical Care, Pritzker School of Medicine, University of Chicago, Chicago, IL 60637, USA.

出版信息

J Clin Med. 2024 Sep 30;13(19):5847. doi: 10.3390/jcm13195847.

Abstract

(1) : Enhanced Recovery After Surgery (ERAS) protocols can create a cultural shift that will benefit patients by significantly reducing patient length of stay when compared to an equivalent group of surgical patients not following an ERAS protocol. (2) : In this retrospective study of 2236 patients in a multi-center, community-based healthcare system, matching was performed based on a multitude of variables related to demographics, comorbidities, and surgical outcomes across seven ERAS protocols. These cohorts were then compared pre and post ERAS protocol implementation. (3) : ERAS protocols significantly reduced hospital length of stay from 3.0 days to 2.1 days ( <0.0001). Additional significant outcomes included reductions in opioid consumption from 40 morphine milligram equivalents (MMEs) to 20 MMEs ( <0.001) and decreased pain scores on postoperative day zero (POD 0), postoperative day one (POD 1), and postoperative day two (POD 2) when stratified into mild, moderate, and severe pain ( <0.001 on all three days). (4) : ERAS protocols aggregately reduce hospital length of stay, pain scores, and opioid consumption.

摘要

(1):与未遵循加速康复外科(ERAS)方案的同等手术患者组相比,加速康复外科(ERAS)方案可带来文化转变,显著缩短患者住院时间,从而使患者受益。(2):在这项针对多中心、社区医疗系统中2236名患者的回顾性研究中,基于与人口统计学、合并症以及七个ERAS方案的手术结果相关的众多变量进行匹配。然后对这些队列在ERAS方案实施前后进行比较。(3):ERAS方案显著缩短了住院时间,从3.0天降至2.1天(<0.0001)。其他显著结果包括阿片类药物消耗量从40毫克吗啡当量(MMEs)降至20 MMEs(<0.001),以及在术后第0天(POD 0)、术后第1天(POD 1)和术后第2天(POD 2),按轻度、中度和重度疼痛分层时疼痛评分降低(所有三天均<0.001)。(4):ERAS方案总体上缩短了住院时间、降低了疼痛评分并减少了阿片类药物消耗量。

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