Enhanced REVENUE After Surgery? A Cost‐Standardized Enhanced Recovery Pathway for Mastectomy Decreases Length of Stay

Abstract

Background Enhanced recovery after surgery (ERAS) attempts to decrease the surgical stress response to minimize postoperative complications and improve functional rehabilitation after major surgery, but it have not been widely utilized in spinal surgery. This study is to evaluate the implementation of an ERAS pathway for patients undergoing oblique lumbar interbody fusion (OLIF) surgery. Methods This was a retrospective cohort study of patient who underwent OLIF in 2018 prior to ERAS ("pre-ERAS" ,n=23) and in 2019 after ERAS was instituted ("ERAS", n=24). Major outcomes were collected included demographics, length of hospital stay, nancial cost, postoperative complications, off-bed time and perioperative factors. Visual Analogue Scale (VAS) was used to evaluate the pain. The ERAS pathway and compliance with pathway elements were also recorded. Results After ERAS implementation, we found no signi cant differences in the baseline characteristics between the two groups. In our study, the mean stay in the hospital was signi cantly lower (p= 0.033) in the ERAS group (15.3±3.9 days) compared to the standard pathway group (13.0±3.1 days). In comparison to the standard group, we also found a variation between the nancial costs of surgery and hospitalization [(16446.5±4353.3)vs(14237.7±2784.9) USD, P < 0.05]. The ERAS group manifested a lower blood loss compared with the pre-ERAS group with statistical signi cance [(68.3±57.1)vs(119.3±104.8) ml, P < 0.05]. There was no signi cant difference in operative time, complications, and 30-d readmission rates (P > 0.05). Pain scores between the two groups showed a signi cant difference during the 3th hour and 6th hour (P < 0.05). Conclusion Institution of an ERAS protocol appears to accelerate functional recovery and reduce length of stay, nancial costs and decreased pain.

The Effect of Coronavirus (COVID-19) on Breast Cancer Teamwork: A Multicentric Survey

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Misalignment of Stakeholder Incentives in the Opioid Crisis

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Enhanced recovery after surgery (ERAS) protocol in Oblique lumbar interbody fusion(OLIF): a case-controlled study

“…Early mobilization that likely contribute to shorter recovery without increased readmission and complications (Table 4). Other institutions have shown LOS in ERAS spine surgery was decreased by 1.5 to 2 days with no change in complication or readmission rate (15,16). So n (17) described an ERAS protocol for lumbar surgery.…”