title: Fast-track surgery in real life: how patient factors influence outcomes and compliance with an enhanced recovery clinical pathway after colorectal surgery.
abstract: The aim of this prospective cohort study was to identify the patient factors that predict postoperative deviation from each item of a fast-track colorectal surgery protocol (FT) and these factors' influences on postoperative outcomes. A total of 606 patients with colorectal pathology from 2005 to 2011 were analyzed to assess the relationships between patient factors, the outcome variables, and the items of the FT program. The median length of stay was 5 days, and readmission rate was 2.3%. The morbidity rate was 26.7%. Independent predictors of prolonged length of stay were older than 75 years of age, ASA grade 3 and 4, and the presence of an ileostomy. Independent predictors of morbidity were age above 75 years old and ASA grade, whereas age was confirmed as an independent predictor of mortality. Male sex, age above 75 years old, and ASA 3 and 4 were identified as independent predictors of negative compliance to most of the postoperative FT items.
authors.affiliation: Department of General Surgery, Misericordia and Dolce Hospital, Prato, Italy. fferoci@yahoo.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Feroci
authors.forename: Elisa
authors.initials: E
authors.lastname: Lenzi
authors.forename: Maddalena
authors.initials: M
authors.lastname: Baraghini
authors.forename: Alessia
authors.initials: A
authors.lastname: Garzi
authors.forename: Andrea
authors.initials: A
authors.lastname: Vannucchi
authors.forename: Stefano
authors.initials: S
authors.lastname: Cantafio
authors.forename: Marco
authors.initials: M
authors.lastname: Scatizzi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000601:surgery*; D003107:Colorectal Surgery / Q000379:methods*; D019091:Critical Pathways; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome