A newly implemented ERP on a dedicated colorectal surgery service in an academic non-university hospital setting resulted in shorter hospital LOS, but increased readmissions, for patients undergoing elective open and minimally invasive colon and rectal surgery. Future multi-institutional studies are needed to understand the impact of ERP on postoperative complications and readmissions.
330 patients were discharged with narcotics (average 12 oxycodone 5mg pills) and 63 patients were discharged without narcotics. Patients discharged without opioids were older (63 vs. 48 years, p<0.0001), had a non-elective procedure (63% vs. 37%, p<0.0001), higher Anesthesiologists Physical Status (ASA) score (3 vs. 2, p¼0.004) and longer LOS (1 vs. 0 days, p<0.0001) compared to non-opioid patients. There were no differences in gender, race, smoking, substance use, or depression. Average pain score prior to discharge and average daily postoperative morphine equivalent (MEQ) use were higher in the opioid population, 5 vs. 3.7 (p<0.0001) and 152 vs. 30mg (p<0.0001). Multivariate analysis identified age (OR 1.023, p<0.0286), non-elective procedure (OR 0.353, p<0.0022), and postoperative average daily MEQ (OR 0.998, p<0.0377) as predictors of opioid-free discharge. With every 5-year increase in age, the odds of opioid-free discharge rose by 12%, whereas each postoperative Oxycodone tablet taken after surgery reduced those odds by 2%.CONCLUSION: Non-elective procedures, older age, and lower postoperative average daily MEQ are predictors of opioid-free discharge after laparoscopic cholecystectomy.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.