Predictors of Admission After the Implementation of an Enhanced Recovery After Surgery Pathway for Minimally Invasive Gynecologic Surgery

Predictors of Admission After the Implementation of an Enhanced Recovery After Surgery Pathway for Minimally Invasive Gynecologic Surgery

Keil DS et al. Predictors of Admission After the Implementation of an Enhanced Recovery After Surgery Pathway for Minimally Invasive Gynecologic Surgery. Anesth Analg. 2019 Sep;129(3):776-783.

What is already known:
ERAS pathways have dramatically shortened the average length of stay in a vast number of different procedures. For some procedures like laparoscopic hysterectomy [LH] same day discharge is even possible. Same-day discharge has been associated with increased patient satisfaction, as well as decreased total hospital
costs without significant increases in perioperative complications or rates of readmission/reoperation. So if one can establish which factors are predictive of admission then it is possible to focus on these to potentially improve outcomes.

What this paper adds:
165 patients underwent LH within a comprehensive ERAS programme. 56% were discharged on the same-day and the rest were admitted. There were no differences in ER visits, readmissions or re-operations. The most common causes of admission were urinary retention (30%), pain (30%) and PONV (10%). Multivariable logistic regression demonstrated that ASA class, increased length of surgery and ethnicity were all found to be risk factors for being admitted postoperatively.

Chris Jones, Guildford. @chrisnjones