title: Enhanced recovery care after colorectal surgery in elderly patients. Compliance and outcomes of a multicenter study from the Spanish working group on ERAS.
abstract: OBJECTIVE
  ERAS (enhanced recovery after surgery) programs have proven to reduce morbidity and hospital stay in colorectal surgery. However, the feasibility of these programs in elderly patients has been questioned. The aim of this study is to assess the implementation and outcomes of an ERAS program for colorectal cancer in elderly patients.
  
  
  METHODS
  This is a multicenter observational study of a cohort of elderly patients undergoing colorectal surgery within an ERAS program. A total of 188 consecutive patients over 70 years who underwent elective colorectal surgery within an ERAS program at three institutions during a 2-year period were included. The compliance with the ERAS protocol interventions was measure. Complications were evaluated according to Clavien-Dindo classification. Data on length of stay and readmission rates were analyzed.
  
  
  RESULTS
  Early intake and early mobilization were the most successfully carried out interventions. There was a global compliance rate of 56 % of patients for whom compliance was achieved with all measured interventions. The median hospital length of stay was 6 days. Almost 60 % of patients had no complications, 24 % had minor complications while 13 % had major complications; of them, 8 % patients were reoperated. The readmission rate was 6.4 %.
  
  
  CONCLUSIONS
  ERAS after colorectal surgery in elderly patients presents as safe and feasible based on good reported outcomes of compliance rates, complications, readmissions, and needs for reoperation.
authors.affiliation: Department of General Surgery, Division of Colorectal Surgery, Fundacion Jimenez-Diaz, Reyes Catolicos Ave #2, 28040, Madrid, Spain. sgayora@fjd.es.
authors.forename: Santiago
authors.initials: S
authors.lastname: Gonzalez-Ayora
authors.affiliation: Department of General Surgery, Division of Colorectal Surgery, Fundacion Jimenez-Diaz, Reyes Catolicos Ave #2, 28040, Madrid, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Pastor
authors.affiliation: Department of General Surgery, Division of Colorectal Surgery, Fundacion Jimenez-Diaz, Reyes Catolicos Ave #2, 28040, Madrid, Spain.
authors.forename: Hector
authors.initials: H
authors.lastname: Guadalajara
authors.affiliation: Department of General Surgery, Division of Colorectal Surgery, Hospital Clinico Universitario, Zaragoza, Spain.
authors.forename: Jose Manuel
authors.initials: JM
authors.lastname: Ramirez
authors.affiliation: Department of General Surgery, Division of Colorectal Surgery, Hospital Clinico Universitario, Zaragoza, Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Royo
authors.affiliation: Department of General Surgery, Division of Colorectal Surgery, Hospital Clinico Universitario, Zaragoza, Spain.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Redondo
authors.affiliation: Department of General Surgery, Division of Colorectal Surgery, Hospital General Universitario, Elche, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Arroyo
authors.affiliation: Department of General Surgery, Division of Colorectal Surgery, Hospital General Universitario, Elche, Spain.
authors.forename: Pedro
authors.initials: P
authors.lastname: Moya
authors.affiliation: Department of General Surgery, Division of Colorectal Surgery, Fundacion Jimenez-Diaz, Reyes Catolicos Ave #2, 28040, Madrid, Spain.
authors.forename: Damian
authors.initials: D
authors.lastname: Garcia-Olmo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003107:Colorectal Surgery; D005260:Female; D006801:Humans; D008297:Male; D010349:Patient Compliance; D011182:Postoperative Care; D020127:Recovery of Function; D013030:Spain; D016896:Treatment Outcome
keywords: Colorectal cancer; ERAS; Elderly; Enhanced