For a study, researchers sought to assess in retrospect the effectiveness of the enhanced recovery after surgery (ERAS) protocol in patients who underwent cystectomy and/or urinary diversion for benign or malignant reasons, as well as the duration of hospital stays, 30-day readmission rates, and complication rates.

Retrospective data extraction was done for cystectomies and/or urinary diversion procedures carried out at our facility between June 2016 and May 2019. To analyze the data, R 4.0.4 (R Foundation), R Package “Tidverse” V1.3.0.9, and RStudio V1.44.1106 (RStudio, PBC) were used. In addition, descriptive statistics, Chi-squared, Wilcoxon rank-sum, binary logistic regression, and linear regression functions were also employed.

With 36 and 66 individuals in each cohort for benign and malignant reasons, 102 patients satisfied the selection criteria. BMI, age, opioid exposure, and spinal abnormalities differed significantly. Preoperative and intraoperative ERAS completion rates for the malignant cohort were higher (41% and 53% vs. 14% and 19%). Patients with benign and malignant indications had substantially different mean ERAS item administrations (2.9 vs. 4.2, P<0.01). According to the logistic regression analysis results, ERAS failure was substantially correlated with a benign indication (OR 4.25, 95% CI 1.18 – 21.03, P=0.043). Shorter hospital stays and reduced complication rates (P=<0.01, P=0.019) were related to higher ERAS item administration sums. There was no correlation seen with 30-day readmission.

In the study, fewer ERAS protocol items were given to the benign urinary diversion/cystectomy population because they more commonly had features that prevented them from completing the program. Higher surgical complication rates & more extended hospital stays were linked to it. Morbidity might be decreased by population-specific ERAS procedures aimed at enhancing ERAS completion.

Reference: goldjournal.net/article/S0090-4295(21)00818-9/fulltext