Clinical Impact of an Enhanced Recovery Program for Lower-extremity Bypass

Area of Science:

• Vascular Surgery
• Perioperative Medicine
• Surgical Outcomes

Background:

• Enhanced Recovery Programs (ERPs) are known to improve patient outcomes and reduce hospital length of stay (LOS).
• The impact of ERPs on patients undergoing vascular surgery, specifically lower-extremity bypass (LEB), remains under-investigated.
• This study addresses the gap in knowledge regarding ERP effectiveness in the context of LEB procedures.

Purpose of the Study:

• To evaluate the association between the implementation of an Enhanced Recovery Program (ERP) and changes in length of stay (LOS).
• To assess the impact of ERP on various perioperative outcomes for patients undergoing lower-extremity bypass (LEB) surgery.
• To provide evidence for the utility of ERPs in vascular surgery patient management.

Main Methods:

• A retrospective cohort study comparing patients who underwent LEB before and after ERP implementation.
• Data collected included clinicopathologic characteristics and perioperative outcomes for 393 LEB patients.
• Statistical analysis was performed to compare outcomes between the pre-ERP and ERP groups.

Main Results:

• ERP implementation was associated with a significant reduction in both total LOS and postoperative LOS for LEB patients.
• Specific subgroups, including those with claudication, rest pain, and tissue loss, demonstrated shorter postoperative LOS with ERP.
• ERP patients experienced decreased opioid use and an increased rate of direct discharge to home.

Conclusions:

• Enhanced Recovery Program (ERP) implementation is demonstrably effective in reducing length of stay (LOS) for lower-extremity bypass (LEB) patients.
• ERPs are associated with improved perioperative outcomes, including reduced readmissions and increased home discharge rates.
• This study supports the broader adoption of ERPs in vascular surgery to enhance patient recovery and optimize resource utilization.