title: Observational cross-sectional study of compliance with the fast track protocol in elective surgery for colon cancer in Spain.
abstract: OBJECTIVE
  The purpose of this study was to establish the degree of compliance with the fast track (enhanced recovery) protocol in habitual clinical practice and to determine which measures are fundamental for achieving the results obtained by applying the entire protocol.
  
  
  METHODS
  Observational, cross-sectional, multicenter trial was conducted. Participating hospitals prospectively recorded data from at least ten consecutive patients undergoing surgery for colon cancer who were applied some or all of the items comprising the enhanced recovery protocol. The data were analyzed both globally and dividing the sample into the two groups of patients.
  
  
  RESULTS
  Data on 363 patients from 25 hospitals were recorded, one hundred seventy-three in the "non-fast track" group and 190 in the "fast track" group. The non-fast track group complied with a mean of 5.4 (±1.8) items and the fast track group with a mean of 8.4 (±1.8) items. The mean functional hospital stay was 7.3 (±5.1) days in the non-fast track group and 6.2 (±5.1) days in the fast track group (p < 0.05). Morbidity was 31.1 % in the fast track group and 24.3 % in the non-fast track group, though the differences were not statistically significant. The only prognostic factors that have an impact on improving the results are measures against hypothermia and mobilization before 24 h.
  
  
  CONCLUSIONS
  Compliance with the enhanced recovery protocol is not exhaustive in habitual clinical practice. However, greater compliance was associated with shorter hospital stay without any increase in morbidity. The only items clearly associated with reduced functional hospital stay were measures against hypothermia and mobilization before 24 h.
authors.affiliation: General and Digestive Surgery Service, Hospital Universitario Parc Tauli, Parc Tauli s/n, 08208, Sabadell, Barcelona, Spain, malcantara@tauli.cat.
authors.forename: Manuel
authors.initials: M
authors.lastname: Alcántara-Moral
authors.forename: X
authors.initials: X
authors.lastname: Serra-Aracil
authors.forename: M J
authors.initials: MJ
authors.lastname: Gil-Egea
authors.forename: M
authors.initials: M
authors.lastname: Frasson
authors.forename: B
authors.initials: B
authors.lastname: Flor-Lorente
authors.forename: E
authors.initials: E
authors.lastname: Garcia-Granero
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002985:Clinical Protocols; D003110:Colonic Neoplasms / Q000601:surgery*; D003430:Cross-Sectional Studies; D017558:Elective Surgical Procedures / Q000009:adverse effects; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D013030:Spain; D016896:Treatment Outcome; D055815:Young Adult