Surgical Recovery Program Reduced Hospital Stay, Complication Rates: Study

Researchers indicate that a new post-surgery recovery program, which deviates from standard practices in place at hospitals nationwide, appears to help reduce the rate of deaths and serious complications among patients. 

In a study published last week in the medical journal JAMA Surgery, researchers with Kaiser Permanente report that a new surgical recovery program also helped to reduce the need for narcotic painkillers, and helped get patients home sooner, with fewer complications.

Researchers implemented the Enhanced Recovery After Surgery Program (ERAS) in 20 Northern California Kaiser Permanente hospitals. This impacted nearly 16,000 patients from February 2014 to the end of that year.

Nearly 4,000 patients undergoing colorectal resection and 5,000 emergency hip fracture repair surgery patients were offered the ERAS program. They were compared to more than 5,500 patients undergoing elective gastrointestinal surgery and 1,500 emergency orthopedic surgery patients.

The recovery program focused on improving pain control, nutrition, fluid management, and mobility. They offered alternative methods for pain control, avoided prolonged fasting before surgery, and encouraged early walking after surgery, which is shown to reduce complications like blood clots, muscle atrophy, nausea, confusion, delirium and infections.

Doctors set a goal for patients of walking 21 feet within the first three days after surgery. Instead of restricting food intake after midnight the night before surgery, they offered a high carb drink two to four hours before surgery and focused on post-operative nutrition within 12 hours after surgery.

The recovery program was associated with a one-third reduction in postoperative complication rates. Patients also reduced their opioid painkiller use by 21%. The total dose of painkillers decreased significantly in both groups.

“Rapid, large-scale implementation of a multidisciplinary ERAS program is feasible and effective in improving surgical outcomes,” the researchers concluded.

Overall, colorectal resection patients had decreased hospital mortality rates. Patients who had hip fracture surgery increased their home discharge rates. Both groups had a decrease in hospital length of stay.

Colorectal surgery patients saw a 34% increased rate of walking early after surgery. Among hip fracture patients, an increased 18% were able to walk earlier than normal.

The findings of the study could have significant impact, the study’s authors indicate, considering more than 50 million inpatient procedures are performed annually in the U.S. They said the program could help patients get back on their feet quicker, reduce deaths, reduce complications and help prevent opioid dependency following surgery.