Adherence to Enhanced Recovery After Surgery (ERAS) With Bellwether Surgical Procedures in Ethiopia: A Retrospective...

Area of Science:

• Perioperative Medicine
• Surgical Outcomes Research
• Global Health Equity

Background:

• Enhanced Recovery After Surgery (ERAS) is a multimodal approach to optimize patient recovery and reduce surgical stress.
• Implementing ERAS in low-resource settings presents unique challenges due to infrastructure and resource limitations.
• This study investigates adherence to key ERAS recommendations in Ethiopian surgical facilities.

Purpose of the Study:

• To assess adherence to five specific ERAS guidelines in Ethiopian surgical facilities.
• To determine the impact of ERAS adherence on postoperative hospital length of stay (LOS).
• To identify high-impact ERAS recommendations for future implementation in resource-limited environments.

Main Methods:

• Retrospective review of the Ethiopian perioperative registry involving 555 patients.
• Data collected included patient demographics, ASA classification, surgical variables, and LOS.
• Primary outcome: adherence to early mobilization, feeding, PONV prophylaxis, catheter removal, and IV fluid discontinuation.

Main Results:

• Overall adherence to the five ERAS recommendations was 65.2% across 555 patients.
• Adherence to all five ERAS recommendations reduced LOS by 128 hours compared to nonadherence.
• Early mobilization, early catheter removal, and early feeding demonstrated consistent LOS reductions.

Conclusions:

• Implementing a subset of ERAS recommendations can decrease LOS by approximately 5 days for Bellwether surgical procedures in low-resource settings.
• Targeting specific ERAS components like early mobilization and feeding offers a feasible strategy to improve surgical outcomes in resource-limited areas.