Bel Diaz J, Barbero Mielgo M, Pérez Garnelo A, Guzmán Carranza R, García Fernández J
Anesthesiology Service, Puerta de Hierro Majadahonda University Hospital, Madrid, Spain.
Anesthesiology Service, Puerta de Hierro Majadahonda University Hospital, Madrid, Spain.
J Healthc Qual Res. 2025 May-Jun;40(3):101111. doi: 10.1016/j.jhqr.2024.12.010. Epub 2025 Feb 1.
Enhanced recovery program (ERAS program) have revolutionized the world of surgery by reducing postoperative complications and hospital stays. Greater adherence to the protocol results in better outcomes; however, adherence often declines over time. The main objective of this study is to analyze the adherence rate to ERAS strategies and the outcomes of an ERAS colorectal (CRC) program five years after its implementation.
This is a descriptive observational study comparing two groups of patients undergoing scheduled CRC surgery under an ERAS program at University Hospital. The first group (ERAS) includes patients operated on during the period immediately following the implementation of the protocol (January 2017-June 2018), while the second group (ERAS 5) includes patients operated on five years after the implementation (January 2022-June 2022).
An increase in the adherence rate to ERAS strategies was observed (88.2% in ERAS vs. 84.2% in ERAS 5, p 0.003), as well as a reduction in healthcare-associated infections (HAIs) (9% in ERAS vs. 25.2% in ERAS 5, p 0.001) and surgical site infections (6% in ERAS vs. 18.2% in ERAS 5, p 0.002). No differences were found in other postoperative complications, functional recovery, average length of stay, and readmission rates.
After five years of implementing an ERAS protocol for CRC in our hospital, we have managed to maintain a high adherence rate to ERAS strategies. There has been a significant reduction in HAIs and surgical site infections.
加速康复计划（ERAS计划）通过减少术后并发症和缩短住院时间，彻底改变了外科手术领域。更严格地遵循该方案会带来更好的结果；然而，随着时间的推移，依从性往往会下降。本研究的主要目的是分析ERAS策略的依从率以及ERAS结直肠癌（CRC）计划实施五年后的结果。
这是一项描述性观察性研究，比较了在大学医院接受ERAS计划下 scheduled CRC手术的两组患者。第一组（ERAS）包括在方案实施后立即进行手术的患者（2017年1月至2018年6月），而第二组（ERAS 5）包括在实施五年后进行手术的患者（2022年1月至2022年6月）。
观察到ERAS策略的依从率有所提高（ERAS组为88.2%，ERAS 5组为84.2%，p = 0.003），医疗相关感染（HAIs）有所减少（ERAS组为9%，ERAS 5组为25.2%，p = 0.001）以及手术部位感染有所减少（ERAS组为6%，ERAS 5组为18.2%，p = 0.002）。在其他术后并发症、功能恢复、平均住院时间和再入院率方面未发现差异。
在我院对CRC实施ERAS方案五年后，我们成功维持了对ERAS策略的高依从率。HAIs和手术部位感染显著减少。
