Impact of enhanced recovery after surgery protocol compliance on patients’ outcome in benign hysterectomy and establishment of a predictive nomogram model

Abstract Background Enhanced recovery after surgery (ERAS) pathways have been shown to improve clinical outcomes after surgery. Considering the importance of patient experience for patients with benign surgery, this study evaluated whether improved compliance with ERAS protocol modified for gynecolo...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Yiwei Shen, Feng Lv, Su Min, Gangming Wu, Juying Jin, Yao Gong, Jian Yu, Peipei Qin, Ying Zhang
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Enhanced recovery after surgery (ERAS) Hysterectomy Compliance Postoperative complications Patient satisfaction Patient experience Anesthesiology RD78.3-87.3
Acceso en línea:	https://doaj.org/article/f73b4686dbb940268159ec3374a0f7a0
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:f73b4686dbb940268159ec3374a0f7a0
record_format	dspace
spelling	oai:doaj.org-article:f73b4686dbb940268159ec3374a0f7a02021-11-28T12:09:48ZImpact of enhanced recovery after surgery protocol compliance on patients’ outcome in benign hysterectomy and establishment of a predictive nomogram model10.1186/s12871-021-01509-01471-2253https://doaj.org/article/f73b4686dbb940268159ec3374a0f7a02021-11-01T00:00:00Zhttps://doi.org/10.1186/s12871-021-01509-0https://doaj.org/toc/1471-2253Abstract Background Enhanced recovery after surgery (ERAS) pathways have been shown to improve clinical outcomes after surgery. Considering the importance of patient experience for patients with benign surgery, this study evaluated whether improved compliance with ERAS protocol modified for gynecological surgery which recommended by the ERAS Society is associated with better clinical outcomes and patient experience, and to determine the influence of compliance with each ERAS element on patients’ outcome after benign hysterectomy. Methods A prospective observational study was performed on the women who underwent hysterectomy between 2019 and 2020. A total of 475 women greater 18 years old were classified into three groups according to their per cent compliance with ERAS protocols: Group I: < 60% (148 cases); Group II:≥60 and < 80% (160 cases); Group III: ≥80% (167 cases). Primary outcome was the 30-day postoperative complications. Second outcomes included QoR-15 questionnaire scores, patient satisfaction on a scale from 1 to 7, and length of stay after operation. After multivariable binary logistic regression analyse, a nomogram model was established to predict the incidence of having a postoperative complication with individual ERAS element compliance. Results The study enrolled 585 patients, and 475 completed the follow-up assessment. Patients with compliance over 80% had a significant reduction in postoperative complications (20.4% vs 41.2% vs 38.1%, P < 0.001) and length of stay after surgery (4 vs 5 vs 4, P < 0.001). Increased compliance was also associated with higher patient satisfaction and QoR-15 scores (P < 0.001),. Among the five dimensions of the QoR-15, physical comfort (P < 0.05), physical independence (P < 0.05), and pain dimension (P < 0.05) were better in the higher compliance groups. Minimally invasive surgery (MIS) (P < 0.001), postoperative nausea and vomiting (PONV) prophylaxis (P < 0.001), early mobilization (P = 0.031), early oral nutrition (P = 0.012), and early removal of urinary drainage (P < 0.001) were significantly associated with less complications. Having a postoperative complication was better predicted by the proposed nomogram model with high AUC value (0.906) and sensitivity (0.948) in the cohort. Conclusions Improved compliance with the ERAS protocol was associated with improved recovery and better patient experience undergoing hysterectomy. MIS, PONV prophylaxis, early mobilization, early oral intake, and early removal of urinary drainage were of concern in reducing postoperative complications. Trial registration Chinese Clinical Trial Registry, ChiCTR1800019178 . Registered on 30/10/2018.Yiwei ShenFeng LvSu MinGangming WuJuying JinYao GongJian YuPeipei QinYing ZhangBMCarticleEnhanced recovery after surgery (ERAS)HysterectomyCompliancePostoperative complicationsPatient satisfactionPatient experienceAnesthesiologyRD78.3-87.3ENBMC Anesthesiology, Vol 21, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Enhanced recovery after surgery (ERAS) Hysterectomy Compliance Postoperative complications Patient satisfaction Patient experience Anesthesiology RD78.3-87.3
spellingShingle	Enhanced recovery after surgery (ERAS) Hysterectomy Compliance Postoperative complications Patient satisfaction Patient experience Anesthesiology RD78.3-87.3 Yiwei Shen Feng Lv Su Min Gangming Wu Juying Jin Yao Gong Jian Yu Peipei Qin Ying Zhang Impact of enhanced recovery after surgery protocol compliance on patients’ outcome in benign hysterectomy and establishment of a predictive nomogram model
description	Abstract Background Enhanced recovery after surgery (ERAS) pathways have been shown to improve clinical outcomes after surgery. Considering the importance of patient experience for patients with benign surgery, this study evaluated whether improved compliance with ERAS protocol modified for gynecological surgery which recommended by the ERAS Society is associated with better clinical outcomes and patient experience, and to determine the influence of compliance with each ERAS element on patients’ outcome after benign hysterectomy. Methods A prospective observational study was performed on the women who underwent hysterectomy between 2019 and 2020. A total of 475 women greater 18 years old were classified into three groups according to their per cent compliance with ERAS protocols: Group I: < 60% (148 cases); Group II:≥60 and < 80% (160 cases); Group III: ≥80% (167 cases). Primary outcome was the 30-day postoperative complications. Second outcomes included QoR-15 questionnaire scores, patient satisfaction on a scale from 1 to 7, and length of stay after operation. After multivariable binary logistic regression analyse, a nomogram model was established to predict the incidence of having a postoperative complication with individual ERAS element compliance. Results The study enrolled 585 patients, and 475 completed the follow-up assessment. Patients with compliance over 80% had a significant reduction in postoperative complications (20.4% vs 41.2% vs 38.1%, P < 0.001) and length of stay after surgery (4 vs 5 vs 4, P < 0.001). Increased compliance was also associated with higher patient satisfaction and QoR-15 scores (P < 0.001),. Among the five dimensions of the QoR-15, physical comfort (P < 0.05), physical independence (P < 0.05), and pain dimension (P < 0.05) were better in the higher compliance groups. Minimally invasive surgery (MIS) (P < 0.001), postoperative nausea and vomiting (PONV) prophylaxis (P < 0.001), early mobilization (P = 0.031), early oral nutrition (P = 0.012), and early removal of urinary drainage (P < 0.001) were significantly associated with less complications. Having a postoperative complication was better predicted by the proposed nomogram model with high AUC value (0.906) and sensitivity (0.948) in the cohort. Conclusions Improved compliance with the ERAS protocol was associated with improved recovery and better patient experience undergoing hysterectomy. MIS, PONV prophylaxis, early mobilization, early oral intake, and early removal of urinary drainage were of concern in reducing postoperative complications. Trial registration Chinese Clinical Trial Registry, ChiCTR1800019178 . Registered on 30/10/2018.
format	article
author	Yiwei Shen Feng Lv Su Min Gangming Wu Juying Jin Yao Gong Jian Yu Peipei Qin Ying Zhang
author_facet	Yiwei Shen Feng Lv Su Min Gangming Wu Juying Jin Yao Gong Jian Yu Peipei Qin Ying Zhang
author_sort	Yiwei Shen
title	Impact of enhanced recovery after surgery protocol compliance on patients’ outcome in benign hysterectomy and establishment of a predictive nomogram model
title_short	Impact of enhanced recovery after surgery protocol compliance on patients’ outcome in benign hysterectomy and establishment of a predictive nomogram model
title_full	Impact of enhanced recovery after surgery protocol compliance on patients’ outcome in benign hysterectomy and establishment of a predictive nomogram model
title_fullStr	Impact of enhanced recovery after surgery protocol compliance on patients’ outcome in benign hysterectomy and establishment of a predictive nomogram model
title_full_unstemmed	Impact of enhanced recovery after surgery protocol compliance on patients’ outcome in benign hysterectomy and establishment of a predictive nomogram model
title_sort	impact of enhanced recovery after surgery protocol compliance on patients’ outcome in benign hysterectomy and establishment of a predictive nomogram model
publisher	BMC
publishDate	2021
url	https://doaj.org/article/f73b4686dbb940268159ec3374a0f7a0
work_keys_str_mv	AT yiweishen impactofenhancedrecoveryaftersurgeryprotocolcomplianceonpatientsoutcomeinbenignhysterectomyandestablishmentofapredictivenomogrammodel AT fenglv impactofenhancedrecoveryaftersurgeryprotocolcomplianceonpatientsoutcomeinbenignhysterectomyandestablishmentofapredictivenomogrammodel AT sumin impactofenhancedrecoveryaftersurgeryprotocolcomplianceonpatientsoutcomeinbenignhysterectomyandestablishmentofapredictivenomogrammodel AT gangmingwu impactofenhancedrecoveryaftersurgeryprotocolcomplianceonpatientsoutcomeinbenignhysterectomyandestablishmentofapredictivenomogrammodel AT juyingjin impactofenhancedrecoveryaftersurgeryprotocolcomplianceonpatientsoutcomeinbenignhysterectomyandestablishmentofapredictivenomogrammodel AT yaogong impactofenhancedrecoveryaftersurgeryprotocolcomplianceonpatientsoutcomeinbenignhysterectomyandestablishmentofapredictivenomogrammodel AT jianyu impactofenhancedrecoveryaftersurgeryprotocolcomplianceonpatientsoutcomeinbenignhysterectomyandestablishmentofapredictivenomogrammodel AT peipeiqin impactofenhancedrecoveryaftersurgeryprotocolcomplianceonpatientsoutcomeinbenignhysterectomyandestablishmentofapredictivenomogrammodel AT yingzhang impactofenhancedrecoveryaftersurgeryprotocolcomplianceonpatientsoutcomeinbenignhysterectomyandestablishmentofapredictivenomogrammodel
_version_	1718408175990865920

Impact of enhanced recovery after surgery protocol compliance on patients’ outcome in benign hysterectomy and establishment of a predictive nomogram model

Ejemplares similares