Background: The association between compliance to an enhanced recovery protocol (ERAS) and outcome after surgery for gastric cancer has been poorly investigated, particularly in Western patients. The aim of the study was to evaluate whether the rate of adherence to the ERAS program was correlated with outcome and time of discharge. Methods: A prospective, observational, multicenter study was designed to be performed at Italian referral centers for gastric surgery. The protocol was discussed and approved by the Italian Research Group on Gastric Cancer. Twenty-three ERAS domains were applied. A multivariate logistic regression was used to assess the association between ERAS compliance and overall and major complication rates. The Poisson regression model (measured as mean ratios) was used to assess the association of ERAS compliance rate and length of stay (LOS). Results: Eight centers participated and 290 subjects with a median age of 73 years were enrolled. The overall rates of adherence to pre-, intra-, and postoperative ERAS items were 69.8%, 60.3%, and 82.5%, respectively. At the multivariate model, there was an association between overall rate of morbidity and an overall ERAS compliance rate greater than 70% (OR 0.413; 95% CI 0.235–0.7240; P 0.002). A similar association was found for major complications (OR 0.328; 95% CI 0.151–0.709; P 0.005). The Poisson regression showed that in patients with ERAS compliance rate >70%, LOS was reduced of approximately 20% (mean ratio 0.812; 95% CI 0.694–0.950; P 0.009). Conclusions: These results suggest a moderate compliance to an ERAS program and a significant association between adherence and outcomes.

Gianotti, L., Fumagalli Romario, U., De Pascale, S., Weindelmayer, J., Mengardo, V., Sandini, M., et al. (2019). Association Between Compliance to an Enhanced Recovery Protocol and Outcome After Elective Surgery for Gastric Cancer. Results from a Western Population-Based Prospective Multicenter Study. WORLD JOURNAL OF SURGERY, 43(10), 2490-2498 [10.1007/s00268-019-05068-x].

Association Between Compliance to an Enhanced Recovery Protocol and Outcome After Elective Surgery for Gastric Cancer. Results from a Western Population-Based Prospective Multicenter Study

Gianotti L.;Sandini M.;Rosati R.;Sansonetti A.;Bernasconi D. P.;
2019

Abstract

Background: The association between compliance to an enhanced recovery protocol (ERAS) and outcome after surgery for gastric cancer has been poorly investigated, particularly in Western patients. The aim of the study was to evaluate whether the rate of adherence to the ERAS program was correlated with outcome and time of discharge. Methods: A prospective, observational, multicenter study was designed to be performed at Italian referral centers for gastric surgery. The protocol was discussed and approved by the Italian Research Group on Gastric Cancer. Twenty-three ERAS domains were applied. A multivariate logistic regression was used to assess the association between ERAS compliance and overall and major complication rates. The Poisson regression model (measured as mean ratios) was used to assess the association of ERAS compliance rate and length of stay (LOS). Results: Eight centers participated and 290 subjects with a median age of 73 years were enrolled. The overall rates of adherence to pre-, intra-, and postoperative ERAS items were 69.8%, 60.3%, and 82.5%, respectively. At the multivariate model, there was an association between overall rate of morbidity and an overall ERAS compliance rate greater than 70% (OR 0.413; 95% CI 0.235–0.7240; P 0.002). A similar association was found for major complications (OR 0.328; 95% CI 0.151–0.709; P 0.005). The Poisson regression showed that in patients with ERAS compliance rate >70%, LOS was reduced of approximately 20% (mean ratio 0.812; 95% CI 0.694–0.950; P 0.009). Conclusions: These results suggest a moderate compliance to an ERAS program and a significant association between adherence and outcomes.
Articolo in rivista - Articolo scientifico
Age Factors; Aged; Comorbidity; Elective Surgical Procedures; Female; Humans; Italy; Male; Middle Aged; Patient Discharge; Poisson Distribution; Postoperative Complications; Postoperative Period; Prospective Studies; Stomach Neoplasms; Gastrectomy; Length of Stay; Patient Compliance
English
2019
43
10
2490
2498
reserved
Gianotti, L., Fumagalli Romario, U., De Pascale, S., Weindelmayer, J., Mengardo, V., Sandini, M., et al. (2019). Association Between Compliance to an Enhanced Recovery Protocol and Outcome After Elective Surgery for Gastric Cancer. Results from a Western Population-Based Prospective Multicenter Study. WORLD JOURNAL OF SURGERY, 43(10), 2490-2498 [10.1007/s00268-019-05068-x].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/276391
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