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优化手术效果:术后加速康复(ERAS)方案在改善巴基斯坦患者康复情况及缩短住院时间方面的作用

Optimizing Surgical Outcomes: The Role of Enhanced Recovery After Surgery (ERAS) Protocols in Improving Recovery and Reducing Hospital Stays in Pakistan.

作者信息

Amjad Talha, Malana Muhammad Ali, Khan Muhammad Shah Nawaz, Hasan Syed Asad, Fahad Shah, Haider Maithem

机构信息

Anatomy, Hazrat Bari Imam Sarkar (HBS) Medical and Dental College, Islamabad, PAK.

General Surgery, Pakistan Institute of Medical Sciences (PIMS), Islamabad, PAK.

出版信息

Cureus. 2025 Jan 1;17(1):e76713. doi: 10.7759/cureus.76713. eCollection 2025 Jan.

Abstract

Background Enhanced recovery after surgery (ERAS) procedures are increasingly recognized for their ability to improve surgical outcomes and shorten hospital stays, particularly in resource-constrained environments like Pakistan. This study underscores the transformative potential of ERAS protocols in not only enhancing patient recovery but also optimizing healthcare resource utilization in such settings. The research aimed to evaluate the effectiveness of ERAS protocols in reducing postoperative complications and hospital stays among surgical patients in Pakistan, with a focus on their impact on overall recovery and healthcare efficiency. Methodology A prospective cohort design was employed, recruiting 400 adult patients aged 18 years and older undergoing elective surgical procedures from January to December 2023. Data on demographics, adherence to ERAS procedures, postoperative complications, duration of hospital stay, and recovery metrics were gathered before, during, and after surgery for participants who were split into ERAS and standard care groups. To compare results between groups, statistical procedures such as t-tests and chi-square tests were used. Results The ERAS group exhibited a significantly shorter mean length of hospital stay (3.52 ± 1.27 days) compared to the standard care group (6.29 ± 2.15 days, p < 0.001). Full recovery rates at 30 days, three months, and six months were significantly higher in the ERAS group, with 160 patients (80.0%), 178 patients (89.0%), and 191 patients (95.5%), respectively. In contrast, the standard care group showed recovery rates of 122 patients (61.0%), 147 patients (73.5%), and 164 patients (82.0%) at the same intervals. The ERAS group also had lower rates of postoperative complications, with 176 patients (88.0%) experiencing no complications compared to 152 patients (76.0%) in the standard care group, and lower readmission rates, with nine patients (4.5%) compared to 19 patients (9.5%) in the standard care group. Conclusion The successful implementation of ERAS procedures in Pakistan highlights their potential to improve healthcare efficiency by increasing surgical recovery and lowering hospital stays.

摘要

背景

手术加速康复(ERAS)程序因其改善手术效果和缩短住院时间的能力而日益受到认可,尤其是在像巴基斯坦这样资源有限的环境中。本研究强调了ERAS方案不仅在促进患者康复方面,而且在优化此类环境中的医疗资源利用方面的变革潜力。该研究旨在评估ERAS方案在降低巴基斯坦外科手术患者术后并发症和缩短住院时间方面的有效性,重点关注其对整体康复和医疗效率的影响。

方法

采用前瞻性队列设计,招募了400名年龄在18岁及以上的成年患者,他们在2023年1月至12月期间接受择期手术。收集了参与者在手术前、手术期间和手术后的人口统计学数据、对ERAS程序的依从性、术后并发症、住院时间和康复指标数据,这些参与者被分为ERAS组和标准护理组。为了比较两组之间的结果,使用了t检验和卡方检验等统计方法。

结果

与标准护理组(6.29±2.15天,p<0.001)相比,ERAS组的平均住院时间显著缩短(3.52±1.27天)。ERAS组在30天、三个月和六个月时的完全康复率显著更高,分别为160例患者(80.0%)、178例患者(89.0%)和191例患者(95.5%)。相比之下,标准护理组在相同时间间隔的康复率分别为122例患者(61.0%)、147例患者(73.5%)和164例患者(82.0%)。ERAS组的术后并发症发生率也较低,176例患者(88.0%)无并发症,而标准护理组为152例患者(76.0%);再入院率也较低,ERAS组为9例患者(4.5%),而标准护理组为19例患者(9.5%)。

结论

ERAS程序在巴基斯坦的成功实施凸显了其通过提高手术康复率和缩短住院时间来提高医疗效率的潜力。

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