Impact of the COVID-19 Pandemic on Enhanced Recovery After Surgery (ERAS) Application and Outcomes: Analysis in the "Lazio Network" Database.
Journal
World journal of surgery
ISSN: 1432-2323
Titre abrégé: World J Surg
Pays: United States
ID NLM: 7704052
Informations de publication
Date de publication:
10 2022
10 2022
Historique:
accepted:
28
07
2022
pubmed:
17
8
2022
medline:
9
9
2022
entrez:
16
8
2022
Statut:
ppublish
Résumé
The aim of this study was to investigate how the COVID-19 pandemic influenced ERAS program application in colorectal surgery across hospitals in the Lazio region (central district in Italy) participating in the "Lazio Network" project. A multi-institutional database was constructed. All patients included in this study underwent elective colorectal surgery for both malignant and benign disease between January 2019 and December 2020. Emergency procedures were excluded. The population was divided into 2 groups: a pre-COVID-19 group (PG) of patients operated on between February and December 2019 and a COVID-19 group (CG) of patients operated on between February and December 2020, during the first 2 waves of the pandemic in Italy. The groups included 622 patients in the PG and 615 in the CG treated in 8 hospitals of the network. The mean number of items applied was higher in the PG (65.6% vs. 56.6%, p < 0.001) in terms of preoperative items (64.2% vs. 50.7%, p < 0.001), intraoperative items (65.0% vs. 53.3%, p < 0.001), and postoperative items (68.8% vs. 63.2%, p < 0.001). Postoperative recovery was faster in the PG, with a shorter time to first flatus, first stool, autonomous mobilization and discharge (6.82 days vs. 7.43 days, p = 0.021). Postoperative complications, mortality and reoperations were similar among the groups. The COVID-19 pandemic had a negative impact on the application of ERAS in the centers of the "Lazio Network" study group, with a reduction in adherence to the ERAS protocol in terms of preoperative, intraoperative and postoperative items. In addition, in the CG, the patients had worse postoperative outcomes with respect to recovery and discharge.
Sections du résumé
BACKGROUND
The aim of this study was to investigate how the COVID-19 pandemic influenced ERAS program application in colorectal surgery across hospitals in the Lazio region (central district in Italy) participating in the "Lazio Network" project.
METHODS
A multi-institutional database was constructed. All patients included in this study underwent elective colorectal surgery for both malignant and benign disease between January 2019 and December 2020. Emergency procedures were excluded. The population was divided into 2 groups: a pre-COVID-19 group (PG) of patients operated on between February and December 2019 and a COVID-19 group (CG) of patients operated on between February and December 2020, during the first 2 waves of the pandemic in Italy.
RESULTS
The groups included 622 patients in the PG and 615 in the CG treated in 8 hospitals of the network. The mean number of items applied was higher in the PG (65.6% vs. 56.6%, p < 0.001) in terms of preoperative items (64.2% vs. 50.7%, p < 0.001), intraoperative items (65.0% vs. 53.3%, p < 0.001), and postoperative items (68.8% vs. 63.2%, p < 0.001). Postoperative recovery was faster in the PG, with a shorter time to first flatus, first stool, autonomous mobilization and discharge (6.82 days vs. 7.43 days, p = 0.021). Postoperative complications, mortality and reoperations were similar among the groups.
CONCLUSIONS
The COVID-19 pandemic had a negative impact on the application of ERAS in the centers of the "Lazio Network" study group, with a reduction in adherence to the ERAS protocol in terms of preoperative, intraoperative and postoperative items. In addition, in the CG, the patients had worse postoperative outcomes with respect to recovery and discharge.
Identifiants
pubmed: 35972532
doi: 10.1007/s00268-022-06694-8
pii: 10.1007/s00268-022-06694-8
pmc: PMC9380676
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2288-2296Investigateurs
Domenico Spoletini
(D)
Giulia Russo
(G)
Rosa Menditto
(R)
Filippo Palla
(F)
Gian Marco Giorgetti
(GM)
Graziano Pernazza
(G)
Paola Marino
(P)
Laura De Luca
(L)
Raffaello Mancini
(R)
Vito Pende
(V)
Marco Lirici
(M)
Francesco Falbo
(F)
Domenico D'Ugo
(D)
Liliana Sollazzi
(L)
Maria Cristina Mele
(MC)
Laura Lorenzon
(L)
Antonio Gasbarrini
(A)
Roberto Pezzuto
(R)
Emanuele Rinninella
(E)
Marco Cintoni
(M)
Enrica Adducci
(E)
Augusto Belardi
(A)
Elena Bonasera
(E)
Daniela Cappelloni
(D)
Riccardo Angeloni
(R)
Luciana Minieri
(L)
Andrea Sagnotta
(A)
Gloria Folliero
(G)
Luigi Solinas
(L)
Alessandro Arturi
(A)
Corrado Ferraris
(C)
Giorgio Capuano
(G)
Gherardo Romeo
(G)
Pietro Maria Amodio
(PM)
Sara Carnevale
(S)
Andrea Sansonetti
(A)
Simone Maria Tierno
(SM)
Andrea Mazzari
(A)
Paolo Diamanti
(P)
Lucilla Muccichini
(L)
Damiano Menghetti
(D)
Informations de copyright
© 2022. The Author(s) under exclusive licence to Société Internationale de Chirurgie.
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