ArticleDiseases of the colon and rectum2017
Reducing Readmissions While Shortening Length of Stay: The Positive Impact of an Enhanced Recovery Protocol in Colorectal Surgery.
Article in Diseases of the colon and rectum, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 3 of them syntheses that pooled it.
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Who cites it
27 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Enhanced recovery after colorectal surgery in patients with inflammatory bowel disease to reduce hospital length of stay: A systematic review and meta-analysis.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2026Pooled it
- Effectiveness of care transition strategies for colorectal cancer patients: a systematic review and meta-analysis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2022Pooled it
- Overall readmissions and readmissions related to dehydration after creation of an ileostomy: a systematic review and meta-analysis.Techniques in coloproctology · 2022Pooled it
- Rapid rehabilitation technique with integrated traditional Chinese and Western medicine promotes postoperative gastrointestinal function recovery.World journal of gastroenterology · 2020Trial
- Fiftieth Anniversary of the Publication of the World Journal of Surgery Title: Landmark Advances in Colorectal Surgery: A Primer of a Fifty-Year Evolution.World journal of surgery · 2026Review
- Article
- From Emergency Department to Operating Room: The Role of Early Prehabilitation and Perioperative Care in Emergency Laparotomy: A Scoping Review and Practical Proposal.Journal of clinical medicine · 2025Review
- Assessment of pre-, peri-, and post-surgical practices for elective colorectal patients in a model 4 hospital in Ireland.Irish journal of medical science · 2024Article
- National analysis of racial disparities in emergent surgery for colorectal cancer.Surgery open science · 2024Article
- Review
- Wearable technology and the association of perioperative activity level with 30-day readmission among patients undergoing major colorectal surgery.Surgical endoscopy · 2022Observational
- Transition from hospital to home after elective colorectal surgery performed in an enhanced recovery program: An integrative review.Nursing open · 2021Review
- Readmission after rectal resection in the ERAS-era: is a loop ileostomy the Achilles heel?BMC surgery · 2021Article
- Preoperative opioid use is associated with increased risk of postoperative complications within a colorectal-enhanced recovery protocol.Surgical endoscopy · 2021Article
- Volume-outcome relationship in rectal cancer surgery.Discover oncology · 2021Article
- Feasibility assessment of outpatient colorectal resections at a tertiary referral center.International journal of colorectal disease · 2021Article
- ERAS pathway in colorectal surgery: structured implementation program and high adherence for improved outcomes.Updates in surgery · 2021Article
- Predictors of readmission and reoperation in patients with colorectal cancer.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2020Article
- Mortality and Health Care Utilization Among Medicare Patients Undergoing Emergency General Surgery vs Those With Acute Medical Conditions.JAMA surgery · 2020Article
- Results after 10 years of colorectal cancer screenings in Spain: Hospital incidence and in-hospital mortality (2011-2016).PloS one · 2020Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundHospital readmission rates are an increasingly important quality metric since enactment of the 2012 Hospital Readmissions Reduction Program. The proliferation of enhanced recovery protocols and earlier discharge raises concerns for increased readmission rates.
objectiveWe evaluated the effect of enhanced recovery on readmissions and identified risk factors for readmission.
designThis study involved implementation of a multidisciplinary enhanced recovery protocol. SETTINGS: It was conducted at a large academic medical center PATIENTS:: All patients undergoing elective colorectal surgery between 2011 and 2015 at our center were included.
main outcome measuresThis cohort study compared patients before and after enhanced recovery initiation, looking at 30-day readmission as the primary outcome. A multivariable logistic regression model identified predictors of 30-day readmission. Kaplan-Meier analysis identified differences in time to readmission.
resultsA total of 707 patients underwent colorectal procedures between 2011 and 2015, including 383 patients before enhanced recovery protocol was implemented and 324 patients after enhanced protocol was implemented. Length of stay decreased from a median 5 days to a median 4 days before and after enhanced recovery implementation (p < 0.0001). Thirty-day readmission decreased from 19% (72/383) in the pre-enhanced recovery pathway to 12% (38/324) in the enhanced recovery pathway (p = 0.009). Twenty-one percent (21/99) of patients who underwent ileostomy were readmitted before enhanced recovery implementation compared with 19% (18/93) of patients who underwent ileostomy after enhanced recovery implementation (p = 0.16). Multivariable logistic regression identified ileostomy as increasing the risk of readmission (p = 0.04), whereas enhanced recovery protocol decreased the risk of readmission (p = 0.006). LIMITATIONS: The study is limited because it was conducted at a single institution and used a before-and-after study design.
conclusionsThese data suggest that use of a standardized enhanced recovery protocol significantly reduces length of stay and readmission rates in an elective colorectal surgery population. However, the presence of an ileostomy maintains a high association with readmission, serving as a significant burden to patients and providers alike. Ongoing efforts are needed to further improve the management of patients undergoing ileostomy in the outpatient setting after discharge to prevent readmissions.
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