Table 2.
Patient characteristics, oncologic factors, procedural details, and postoperative outcomes before and after implementation of an enhanced recovery protocol
| Pre-ERP n = 174 |
ERP n = 189 |
p value | |
|---|---|---|---|
| Patient characteristics | |||
| Age (years) | 61.1 (53.1-68.7) | 62.4 (53.6-72.2) | 0.262 |
| BMI (kg/m2) | 28.3 (24.3-32.0) | 28.3 (24.1-32.4) | 0.922 |
| Male | 93 (53.5%) | 110 (58.2%) | 0.362 |
| Race | 0.659 | ||
| White | 148 (85.1%) | 163 (86.2%) | |
| Black | 23 (13.2%) | 20 (10.6%) | |
| Asian | 1 (0.6%) | 1 (0.5%) | |
| Not reported | 2 (1.2%) | 5 (2.7%) | |
| Hypertension | 96 (55.2%) | 96 (50.8%) | 0.404 |
| Diabetes mellitus | 38 (21.8%) | 32 (16.9%) | 0.236 |
| ESRD | 1 (0.6%) | 1 (0.5%) | 0.953 |
| COPD | 8 (4.6%) | 10 (5.3%) | 0.761 |
| Dyspnea | 33 (19.0%) | 12 (6.4%) | <0.001 |
| Ascites | 3 (1.7%) | 2 (1.1%) | 0.587 |
| Bleeding disorder | 3 (1.7%) | 3 (1.6%) | 0.919 |
| Current smoker | 37 (21.3%) | 31 (16.4%) | 0.236 |
| 10% body weight loss | 23 (13.2%) | 11 (5.8%) | 0.016 |
| Preoperative transfusion | 1 (0.6%) | 2 (1.1%) | 0.611 |
| Chronic steroid use | 4 (2.3%) | 6 (3.2%) | 0.611 |
| Functional health status | 0.172 | ||
| Independent | 167 (96.0%) | 187 (98.9%) | |
| Partially dependent | 6 (3.5%) | 2 (1.1%) | |
| Totally dependent | 1 (0.6%) | 0 (0.0%) | |
| ASA classification | 0.755 | ||
| ASA 1 | 0 (0.0%) | 1 (0.5%) | |
| ASA 2 | 75 (43.1%) | 76 (40.2%) | |
| ASA 3 | 93 (53.5%) | 105 (55.6%) | |
| ASA 4 | 6 (3.5%) | 7 (3.7%) | |
| Oncologic factors | |||
| Site | 0.399 | ||
| Colon | 67 (38.5%) | 81 (42.9%) | |
| Rectum | 107 (61.5%) | 108 (57.1%) | |
| Neoadjuvant chemoradiation | 97 (55.8%) | 102 (54.0%) | 0.734 |
| Neoadjuvant chemotherapy | 7 (4.0%) | 19 (10.1%) | 0.026 |
| High grade | 58 (33.3%) | 58 (30.7%) | 0.589 |
| Final stage | 0.890 | ||
| 2 | 55 (31.6%) | 58 (30.7%) | |
| 3 | 91 (52.3%) | 97 (51.3%) | |
| 4 | 28 (16.1%) | 34 (18.0%) | |
| Adjuvant chemotherapy | 0.022 | ||
| On-time | 55 (31.6%) | 86 (45.5%) | |
| Delayed | 63 (36.2%) | 51 (27.0%) | |
| Omitted | 56 (32.2%) | 52 (27.5%) | |
| Procedural details | |||
| Laparoscopic/Robotic | 16 (9.2%) | 73 (38.6%) | <0.001 |
| Wound classification | 0.790 | ||
| Clean | 2 (1.2%) | 2 (1.1%) | |
| Clean/contaminated | 160 (92.0%) | 170 (90.0%) | |
| Contaminated | 11 (6.3%) | 14 (7.4%) | |
| Dirty/infected | 1 (0.6%) | 3 (1.6%) | |
| Ileostomy | 77 (53.1%) | 68 (46.9%) | 0.108 |
| Procedure duration (minutes) | 221.5 (164.0-284.0) | 260.0 (205.0-336.0) | <0.001 |
| Postoperative Complications | |||
| Unplanned intubation | 4 (2.3%) | 4 (2.1%) | 0.906 |
| Superficial incisional SSI | 22 (12.6%) | 5 (2.7%) | <0.001 |
| Deep incisional SSI | 2 (1.2%) | 3 (1.6%) | 0.721 |
| Organ space SSI | 12 (6.9%) | 12 (6.4%) | 0.834 |
| Composite SSI | 33 (19.0%) | 20 (10.6%) | 0.024 |
| Wound disruption | 4 (2.3%) | 0 (0.0%) | 0.036 |
| UTI | 5 (2.9%) | 4 (2.1%) | 0.643 |
| Sepsis | 4 (2.3%) | 5 (2.7%) | 0.832 |
| Intraoperative/postoperative transfusion | 26 (14.9%) | 20 (10.6%) | 0.212 |
| Progressive renal insufficiency | 2 (1.2%) | 8 (4.2%) | 0.073 |
| Acute renal failure | 3 (1.7%) | 1 (0.5%) | 0.276 |
| Myocardial infarction | 3 (1.7%) | 2 (1.1%) | 0.587 |
| Cerebrovascular accident | 2 (1.2%) | 1 (0.5%) | 0.514 |
| Vein thrombosis requiring therapy | 4 (2.3%) | 2 (1.1%) | 0.354 |
| Pulmonary embolism | 2 (1.2%) | 0 (0.0%) | 0.139 |
| Total Complication(s) | 61 (35.1%) | 52 (27.5%) | 0.121 |
| Return to OR | 9 (5.2%) | 10 (5.3%) | 0.960 |
| Length of stay (days) | 7.0 (5.0-10.0) | 4.0 (3.0-7.0) | <0.001 |
| 30-day readmissions | 30 (17.2%) | 29 (15.3%) | 0.625 |
Categorical variables listed as N (%) and continuous variables listed as median (interquartile range)
ERP=Enhanced recovery protocol; BMI=Body mass index; ESRD=End stage renal disease; COPD=Chronic obstructive pulmonary disease; ASA Classification=American Society of Anesthesiologists physical status classification, SSI=Surgical site infection; UTI=Urinary tract infection; OR=Operating room