This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Cost‐effectiveness of the implementation of an enhanced recovery protocol for colorectal surgery. BJS 2013; 100: 1108-1114.
Published: 10th June 2013
Authors: D. Roulin, A. Donadini, S. Gander, A.‐C. Griesser, C. Blanc, M. Hübner et al.
Background
Enhanced recovery protocols may reduce postoperative complications and length of hospital stay. However, the implementation of these protocols requires time and financial investment. This study evaluated the cost‐effectiveness of enhanced recovery implementation.
Method
The first 50 consecutive patients treated during implementation of an enhanced recovery programme were compared with 50 consecutive patients treated in the year before its introduction. The enhanced recovery protocol principally implemented preoperative counselling, reduced preoperative fasting, preoperative carbohydrate loading, avoidance of premedication, optimized fluid balance, standardized postoperative analgesia, use of a no‐drain policy, as well as early nutrition and mobilization. Length of stay, readmissions and complications within 30 days were compared. A cost‐minimization analysis was performed.
Results
Hospital stay was significantly shorter in the enhanced recovery group: median 7 (interquartile range 5–12)
Conclusion
Enhanced recovery is cost‐effective, with savings evident even in the initial implementation period.
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