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World Journal of Surgery

, Volume 41, Issue 4, pp 899–913 | Cite as

Enhanced Recovery After Surgery Programs Improve Patient Outcomes and Recovery: A Meta-analysis

  • Christine S. M. Lau
  • Ronald S. ChamberlainEmail author
Original Scientific Report

Abstract

Introduction

Enhanced recovery after surgery (ERAS) programs have been developed to improve patient outcomes, accelerate recovery after surgery, and reduce healthcare costs. ERAS programs are a multimodal approach, with interventions during all stages of care. This meta-analysis examines the impact of ERAS programs on patient outcomes and recovery.

Methods

A comprehensive search of all published randomized control trials (RCTs) assessing the use of ERAS programs in surgical patients was conducted. Outcomes analyzed were length of stay (LOS), overall mortality, 30-day readmission rates, total costs, total complications, time to first flatus, and time to first bowel movement.

Results

Forty-two RCTs involving 5241 patients were analyzed. ERAS programs significantly reduced LOS, total complications, and total costs across all types of surgeries (p < 0.001). Return of gastrointestinal (GI) function was also significantly improved, as measured by earlier time to first flatus and time to first bowel movement, p < 0.001. There was no overall difference in mortality or 30-day readmission rates; however, 30-day readmission rates after upper GI surgeries nearly doubled with the use of ERAS programs (RR = 1.922; p = 0.019).

Conclusions

ERAS programs are associated with a significant reduction in LOS, total complications, total costs, as well as earlier return of GI function. Overall mortality and readmission rates remained similar, but there was a significant increase in 30-day readmission rates after upper GI surgeries. ERAS programs are effective and a valuable part in improving patient outcomes and accelerating recovery after surgery.

Keywords

Readmission Rate Total Hospital Cost Total Complication Compromise Patient Safety Early Oral Nutrition 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

268_2016_3807_MOESM1_ESM.docx (14 kb)
Supplementary material 1 (DOCX 13 kb)

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Copyright information

© Société Internationale de Chirurgie 2016

Authors and Affiliations

  • Christine S. M. Lau
    • 1
    • 2
  • Ronald S. Chamberlain
    • 1
    • 2
    • 3
    • 4
    Email author
  1. 1.Department of SurgerySaint Barnabas Medical CenterLivingstonUSA
  2. 2.Saint George’s University School of MedicineSt. George’sGrenada
  3. 3.Banner MD Anderson Cancer CenterGilbertUSA
  4. 4.Department of Surgery, New Jersey Medical SchoolRutgers UniversityNewarkUSA

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