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Surgery
Research
Impact of weekday surgery on application of enhanced recovery pathway: a retrospective cohort study
  1. Benoît Romain,
  2. Fabian Grass,
  3. Valérie Addor,
  4. Nicolas Demartines,
  5. Martin Hübner
  1. Department of Visceral Surgery, University Hospital CHUV, Lausanne, Switzerland
  1. Correspondence to Professor Nicolas Demartines; nicolas.demartines{at}chuv.ch

Abstract

Objective To compare the enhanced recovery after surgery (ERAS) protocol compliance and clinical outcomes depending on the weekday of surgery.

Settings Cohort of consecutive non-selected patients undergoing elective colorectal surgery from January 2012 to March 2015. This retrospective analysis of our prospective database compared patients operated early in the week (Monday and Tuesday) with patients operated in the second half (late: Thursday, Friday).

Primary outcome measures Compliance with the ERAS protocol, functional recovery, complications and length of stay.

Results Demographic and surgical details were similar between the early (n=352) and late groups (n=204). Overall compliance with the ERAS protocol was 78% vs 76% for the early and late groups, respectively (p=0.009). Significant differences were notably prolonged urinary drainage and intravenous fluid infusion in the late group. Complication rates and length of stay, however, were not different between surgery on Monday or Tuesday and surgery on Thursday or Friday.

Conclusions Application of the ERAS protocol showed only minor differences for patients operated on early or late during the week, and clinical outcomes were similar. A fully implemented ERAS programme appears to work also over the weekend.

  • ERAS
  • enhanced recovery
  • weekdays
  • complications

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2016-011067

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    Footnotes

    • Contributors BR and MH contributed to the conception and design of the study. BR, FG and VA participated in the data acquisition. BR, MH, FG and ND contributed to the drafting or revising of the manuscript. All the authors gave their approval for the final version of the manuscript.

    • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval Commission Cantonale d'Ethique.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Data from this project can be made available by a request to the corresponding author.