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



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.



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).



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.
Department of Surgery, Saint Barnabas Medical Center, 94 Old Short Hills Rd., Livingston, NJ, 07039, USA.|Saint George's University School of Medicine, St. George's, Grenada.
Christine S M
CS
Lau
Department of Surgery, Saint Barnabas Medical Center, 94 Old Short Hills Rd., Livingston, NJ, 07039, USA. ronald.chamberlain@bannerhealth.com.|Saint George's University School of Medicine, St. George's, Grenada. ronald.chamberlain@bannerhealth.com.|Banner MD Anderson Cancer Center, 2940 E. Banner Gateway Dr., Gilbert, AZ, 85234, USA. ronald.chamberlain@bannerhealth.com.|Department of Surgery, New Jersey Medical School, Rutgers University, Newark, NJ, USA. ronald.chamberlain@bannerhealth.com.
Ronald S
RS
Chamberlain
D006801:Humans; D007902:Length of Stay; D010359:Patient Readmission; D011182:Postoperative Care; D011183:Postoperative Complications / Q000517:prevention & control; D016032:Randomized Controlled Trials as Topic; D020127:Recovery of Function