Implementation of an enhanced recovery program for bariatric surgery

Area of Science:

• Bariatric Surgery
• Surgical Outcomes
• Healthcare Management

Background:

• Enhanced Recovery After Surgery (ERAS) programs show varied success in bariatric surgery.
• A standardized ERAS program with pre-, intra-, and post-operative protocols was implemented at an institution.
• The study aimed to evaluate the effectiveness of this ERAS program in bariatric surgery.

Purpose of the Study:

• To assess the impact of a newly implemented Enhanced Recovery After Surgery (ERAS) program on bariatric surgery outcomes.
• To determine if ERAS protocols influence length of stay, cost, and 30-day complication rates in bariatric procedures.
• To quantify the overall effectiveness and value of ERAS in a bariatric surgery setting.

Main Methods:

• Comparative analysis of bariatric surgery patients from 2015 (pre-ERAS) and 2017 (post-ERAS).
• Utilized the Premier Hospital Database for data extraction.
• Employed Poisson and quantile regressions for length of stay and cost analysis, and logistic regression for readmission rates.

Main Results:

• A total of 625 procedures were analyzed (277 pre-ERAS, 348 post-ERAS).
• Post-ERAS implementation saw a significant decrease in average length of stay (2.77 to 1.77 days) and median cost ($11,739.03 to $9482.18).
• The 30-day readmission rate decreased from 7.94% to 2.86%, with ERAS associated with reduced LOS, cost, and readmission risk.

Conclusions:

• The standardized ERAS program significantly reduced length of stay, cost, and 30-day readmissions in bariatric surgery.
• The program resulted in substantial cost savings, exceeding $800,000 annually.
• ERAS programs offer significant benefits for both bariatric surgery patients and healthcare systems.