TY - JOUR
T1 - An international assessment of the adoption of enhanced recovery after surgery (ERAS®) principles across colorectal units in 2019–2020
AU - ESCP Enhanced Recovery Collaborating Group
AU - Pinkney, Thomas D.
AU - Taylor, H.
AU - Tong, C.
AU - Schmitz, N. D.
AU - Morton, D. G.
AU - Bhangu, A.
AU - Blackwell, S.
AU - Dardanov, D.
AU - Dulskas, A.
AU - Gallo, G.
AU - Glasbey, J.
AU - Keatley, J.
AU - Knowles, C.
AU - Li, Y. E.
AU - McCourt, V.
AU - Minaya-Bravo, A.
AU - Neary, P.
AU - Nepogodiev, D.
AU - Pata, F.
AU - Pellino, G.
AU - Sivrikoz, E.
AU - van Ramshorst, G.
AU - Zmora, O.
AU - Perry, R.
AU - Magill, E. L.
AU - Abdalkoddus, M.
AU - Abelevich, A.
AU - Ábraham, S.
AU - Abraham-Nordling, M.
AU - Adamina, M.
AU - Agalar, C.
AU - Agresta, F.
AU - Ahallat, M.
AU - Ahmad, N.
AU - Aiupov, R.
AU - Akca, O.
AU - Aleksic, A.
AU - Aleotti, F.
AU - Alías, D.
AU - Alonso, J.
AU - Alonso Gonçalves, S.
AU - Alonso Martín, J.
AU - Alonso Poza, A.
AU - Alonso-Hernández, N.
AU - Alós Company, R.
AU - Al-Saeedi, M.
AU - Avital, S.
AU - Tulchinsky, H.
AU - Wasserberg, N.
AU - White, I.
N1 - Publisher Copyright:
© 2021 Association of Coloproctology of Great Britain and Ireland
PY - 2021/11
Y1 - 2021/11
N2 - Aim: The Enhanced Recovery After Surgery (ERAS®) Society guidelines aim to standardize perioperative care in colorectal surgery via 25 principles. We aimed to assess the variation in uptake of these principles across an international network of colorectal units. Method: An online survey was circulated amongst European Society of Coloproctology members in 2019–2020. For each ERAS principle, respondents were asked to score how frequently the principle was implemented in their hospital, from 1 (‘rarely’) to 4 (‘always’). Respondents were also asked to recall whether practice had changed since 2017. Subgroup analyses based on hospital characteristics were conducted. Results: Of hospitals approached, 58% responded to the survey (195/335), with 296 individual responses (multiple responses were received from some hospitals). The majority were European (163/195, 83.6%). Overall, respondents indicated they ‘most often’ or ‘always’ adhered to most individual ERAS principles (18/25, 72%). Variability in the uptake of principles was reported, with universal uptake of some principles (e.g., prophylactic antibiotics; early mobilization) and inconsistency from ‘rarely’ to ‘always’ in others (e.g., no nasogastric intubation; no preoperative fasting and carbohydrate drinks). In alignment with 2018 ERAS guideline updates, adherence to principles for prehabilitation, managing anaemia and postoperative nutrition appears to have increased since 2017. Conclusions: Uptake of ERAS principles varied across hospitals, and not all 25 principles were equally adhered to. Whilst some principles exhibited a high level of acceptance, others had a wide variability in uptake indicative of controversy or barriers to uptake. Further research into specific principles is required to improve ERAS implementation.
AB - Aim: The Enhanced Recovery After Surgery (ERAS®) Society guidelines aim to standardize perioperative care in colorectal surgery via 25 principles. We aimed to assess the variation in uptake of these principles across an international network of colorectal units. Method: An online survey was circulated amongst European Society of Coloproctology members in 2019–2020. For each ERAS principle, respondents were asked to score how frequently the principle was implemented in their hospital, from 1 (‘rarely’) to 4 (‘always’). Respondents were also asked to recall whether practice had changed since 2017. Subgroup analyses based on hospital characteristics were conducted. Results: Of hospitals approached, 58% responded to the survey (195/335), with 296 individual responses (multiple responses were received from some hospitals). The majority were European (163/195, 83.6%). Overall, respondents indicated they ‘most often’ or ‘always’ adhered to most individual ERAS principles (18/25, 72%). Variability in the uptake of principles was reported, with universal uptake of some principles (e.g., prophylactic antibiotics; early mobilization) and inconsistency from ‘rarely’ to ‘always’ in others (e.g., no nasogastric intubation; no preoperative fasting and carbohydrate drinks). In alignment with 2018 ERAS guideline updates, adherence to principles for prehabilitation, managing anaemia and postoperative nutrition appears to have increased since 2017. Conclusions: Uptake of ERAS principles varied across hospitals, and not all 25 principles were equally adhered to. Whilst some principles exhibited a high level of acceptance, others had a wide variability in uptake indicative of controversy or barriers to uptake. Further research into specific principles is required to improve ERAS implementation.
KW - Enhanced Recovery After Surgery (ERAS)
KW - Perioperative Optimisation
KW - Surgery
UR - http://www.scopus.com/inward/record.url?scp=85116399304&partnerID=8YFLogxK
U2 - 10.1111/codi.15863
DO - 10.1111/codi.15863
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C2 - 34365718
AN - SCOPUS:85116399304
SN - 1462-8910
VL - 23
SP - 2980
EP - 2987
JO - Colorectal Disease
JF - Colorectal Disease
IS - 11
ER -