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Table 5 Outcomes

From: Impact of an enhanced recovery pathway on length of stay and complications in elective radical cystectomy: a before and after cohort study

 

Historical controls (N = 100)

ERAS patients (N = 100)

p value

Length of stay

 Median length of stay (days)

10 (8,18)

7 (6,11)

< 0.00011

 Mean length of stay (days)

14.86 (11.05)

10.00 (7.03)

< 0.0011

Recovery milestones

 Postoperative days to end IV

6.73 (7.67)

4.53 (4.40)

0.2531

 Days to end IV ≥ 1

63 (63.00%)

77 (77.00%)

0.0312

 Postoperative days to first stool

5.83 (3.83)

3.99 (1.93)

< 0.0011

 Postoperative days to first liquid

5.05 (6.71)

1.09 (1.34)

< 0.0011

 Postoperative days to first solid food

9.68 (8.79)

3.20 (2.52)

< 0.0011

 Postoperative days to self-stoma management

10.11 (7.52)

8.88 (20.45)

< 0.0011

 Postoperative TPN

32 (32.00%)

21 (21.00%)

0.0782

 Postoperative days to end TPN

16.56 (7.72)

11.19 (6.93)

0.0091

 Postoperative days to first on feet

1.98 (1.15)

1.25 (0.79)

< 0.0011

Opioids use and pain scores

 Intravenous opioids (total morphine equivalents)

  DOS

10.76 (30.72)

0.91 (6.05)

< 0.0011

  POD1

36.09 (84.40)

8.66 (44.27)

< 0.0011

  POD2

51.06 (122.05)

10.30 (55.44)

< 0.0011

  POD3

50.17 (118.82)

7.51 (40.32)

< 0.0011

  POD4

48.14 (116.83)

5.55 (34.69)

< 0.0011

  POD5

38.21 (95.86)

1.94 (17.63)

< 0.0011

  Total

234.45 (458.07)

34.87 (159.47)

< 0.0011

 Maximum pain score

  DOS

3.49 (3.60)

3.27 (3.44)

0.7111

  POD1

5.16 (3.23)

3.91 (3.13)

0.0061

  POD2

4.40 (2.97)

3.60 (3.16)

0.0491

  POD3

3.85 (2.98)

3.39 (2.84)

0.3061

  POD4

4.01 (2.92)

3.79 (3.05)

0.6421

  POD5

4.33 (3.08)

3.80 (3.23)

0.2391

  Total

6.95 (2.67)

6.60 (2.76)

0.3361

Adverse events

 Readmission within 30 days

38 (38.00%)

19 (20.00%)

0.0062

 Re-operation within 30 days

15 (15.31%)

9 (9.00%)

0.1742

 Adverse event(s) at all during primary stay

87 (87.88%)

76 (76.00%)

0.0302

 Complications during admission

  Respiratory

20 (20.00%)

17 (17.00%)

0.5852

  Infectious

34 (34.00%)

20 (20.20%)

0.0292

  Cardiovascular

25 (25.00%)

21 (21.00%)

0.5022

  Postoperative ileus

65 (65.00%)

36 (36.73%)

< 0.0012

  Surgical complication(s)

23 (23.23%)

15 (15.00%)

0.1402

  Delirium

12 (12.37%)

2 (2.06%)

0.0062

  PONV

72 (72.00%)

67 (67.68%)

0.5062

 Requiring intensive care

10 (10.00%)

5 (5.00%)

0.1792

 30 day mortality

2 (2.00%)

2 (2.00%)

0.9992

  1. Length of stay reported as both median (IQR) and mean (SD). Median may be more representative due to outliers and non-parametric nature of outcome. Other continuous variables reported as mean (SD); categorical variables reported as frequency (percentage)
  2. Respiratory complications include atelectasis, pneumonia, pleural fluid, respiratory failure, pneumothorax, and other unspecified
  3. Infectious complications include wound infection, urinary tract infection, intraperitoneal or retroperitoneal abscess, sepsis, septic shock, and other unspecified
  4. Cardiovascular complications include heart failure, acute myocardial infarction, deep venous thrombosis, pulmonary embolus, cardiac arrhythmia, cardiac arrest, and other unspecified
  5. Surgical complications include anastomotic leak, urinary leakage, urinary tract injury, mechanical bowl obstruction, deep wound dehiscence, peritoneal soiling, and other unspecified
  6. TPN total parenteral nutrition; postoperative days to end TPN measured among those who received postoperative TPN. PONV postoperative nausea or vomiting
  7. 1Wilcoxon
  8. 2Chi-Square
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Perioperative Medicine

ISSN: 2047-0525