Predictors of Patient-Reported Receipt of Preoperative Education in an Enhanced Recovery Program

Preoperative education is a critical component of enhanced recovery programs. Factors associated with receipt of preoperative education are unknown.

We performed a retrospective cohort study of patients undergoing elective colorectal surgery (2019-2023) using data from our institution's enhanced recovery program dashboard and American College of Surgeons National Surgical Quality Improvement Program database. The primary outcome of patient-reported receipt of preoperative education was analyzed using multivariable linear regression and machine learning classification trees.

Of 1175 patients, 87.7% reported receiving preoperative education. On multivariable analysis, patients undergoing extended colectomy and other procedures had marginal increases in receipt of education by 5.8% (P = 0.01) and 9.6% (P < 0.01), respectively, compared to partial colectomy. Compared to open surgery, patients undergoing minimally invasive surgery had a marginal increase of 4.9% (P = 0.04). Patients who reported education had a body mass index (BMI) 0.003 higher than those who did not (P = 0.03). Receipt of education varied significantly between surgeons (P < 0.05). Machine learning analysis identified surgeon, BMI, and procedure type as predictors of education for open procedures.

Surgeon, procedure type, operative approach, and BMI were associated with patient-reported receipt of preoperative education.