Table 3.
Process and Outcome Metrics Before (Pre) and After (Post) Enhanced Recovery After Surgery Implementation for the Colorectal Resection and Hip Fracture Repair Cohorts
| Metric | No. of Patients | Patientsa | P Valueb | |
|---|---|---|---|---|
| Pre | Post | |||
| Colorectal Resection Cohort | ||||
| Mobility | ||||
| Early ambulation | 3687 | 415 (22.3) | 1032 (56.5) | <.001 |
| Sustained ambulation | 3685 | 1603 (86.2) | 1735 (95.0) | <.001 |
| Time to first ambulation, median (IQR), h | 3717 | 20.3 (13.5–26.1) | 10.3 (6.7–18.6) | <.001 |
| Nutrition | ||||
| No prolonged fast | 3767 | 69 (3.7) | 247 (13.2) | <.001 |
| Early nutrition | 3767 | 245 (13.0) | 736 (39.2) | <.001 |
| Time to first nutrition, median (IQR), h | 3680 | 27.0 (18.4–54.1) | 16.4 (7.0–23.2) | <.001 |
| Analgesia and sedation | ||||
| Any benzodiazepine use | 3767 | 267 (14.1) | 233 (12.4) | .12 |
| Morphine equivalents, median (IQR), mg | 3604 | 52.4 (23.0–102.0) | 30.6 (13.9–65.5) | <.001 |
| Mean acceptable pain scores, median (IQR), % | 3761 | 75.9 (60.0–88.7) | 73.8 (59.3–88.4) | .14 |
| Outcome metrics | ||||
| Hospital length of stay, median (IQR), d | 3768 | 5.1 (3.4–7.1) | 4.2 (3.1–6.2) | <.001 |
| Hospital mortality | 3768 | 16 (0.9) | 6 (0.3) | .03 |
| Discharge to home | 3768 | 1808 (95.7) | 1816 (96.7) | .10 |
| 30-d Readmission | 3768 | 348 (18.6) | 364 (19.4) | .50 |
| Postoperative complications | 2406 | 184 (18.1) | 204 (14.7) | .02 |
| Major complications | 2406 | 42 (4.1) | 39 (2.8) | .08 |
| Hip Fracture Repair Cohort | ||||
| Process metrics | ||||
| Mobility | ||||
| Early ambulation | 4619 | 66 (2.8) | 481 (21.2) | <.001 |
| Sustained ambulation | 4616 | 356 (15.2) | 719 (31.7) | <.001 |
| Time to first ambulation, median (IQR), h | 3189 | 25.3 (18.1–46.4) | 17.3 (11.6–25.5) | <.001 |
| Nutrition | ||||
| No prolonged fast | 5002 | 32 (1.3) | 122 (4.9) | <.001 |
| Early nutrition | 5002 | 1134 (45.6) | 1436 (57.1) | <.001 |
| Time to first nutrition, median (IQR), h | 4915 | 12.6 (6.5–17.5) | 10.3 (4.9–15.7) | <.001 |
| Analgesia and sedation | ||||
| Any benzodiazepine use | 5002 | 316 (12.7) | 251 (10.0) | .002 |
| Morphine equivalents, median (IQR), mg | 4887 | 38.9 (22.0–66.5) | 27.0 (13.5–48.3) | <.001 |
| Mean acceptable pain scores, median (IQR), % | 4988 | 68.2 (54.3–82.1) | 72.7 (57.1–85.7) | <.001 |
| Outcome metrics | ||||
| Hospital length of stay, median (IQR), d | 5002 | 3.6 (2.8–4.8) | 3.2 (2.6–4.7) | <.001 |
| Hospital mortality | 5002 | 35 (1.4) | 42 (1.7) | .45 |
| Discharge to home | 5002 | 541 (21.7) | 676 (26.9) | <.001 |
| 30-d Readmission | 5002 | 299 (12.2) | 342 (13.8) | .09 |
| Postoperative complications | 2287 | 240 (30.8) | 375 (24.9) | .003 |
| Major complications | 2287 | 25 (3.2) | 56 (3.7) | .53 |
Abbreviation: IQR, interquartile range.
a
Data are presented as number (percentage) of patients unless otherwise indicated. Not all data were available for all patients, so the total denominator differs based on the specific metric.
b
P values are based on χ2 or Wilcoxon rank sum tests.