Evidence map›Paper›PMID 35135904›Full record

ArticleJournal of chest surgery2022

Evolution of Process and Outcome Measures during an Enhanced Recovery after Thoracic Surgery Program.

Alex Lee, Nazgol Seyednejad, Yaseen Al Lawati, Amanda Mattice, Caitlin Anstee, Mark Legacy, Sebastien Gilbert, Donna E Maziak, Ramanadhan S Sundaresan, Patrick J Villeneuve and 2 more

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of chest surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.3field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 2 institutions in 1 country.

Alex LeeOttawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada.ORCID https://orcid.org/0000-0003-3842-1225
Nazgol SeyednejadDivision of Thoracic Surgery, Department of Surgery, University of Ottawa, Ottawa, ON, Canada.
Yaseen Al LawatiDivision of Thoracic Surgery, Department of Surgery, University of Ottawa, Ottawa, ON, Canada.
Amanda MatticeOttawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada.
Caitlin AnsteeOttawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada.ORCID https://orcid.org/0000-0001-6543-5214
Mark LegacyOttawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada.ORCID https://orcid.org/0000-0003-4417-1656
Sebastien GilbertDivision of Thoracic Surgery, Department of Surgery, University of Ottawa, Ottawa, ON, Canada.ORCID https://orcid.org/0000-0003-4357-9553
Donna E MaziakDivision of Thoracic Surgery, Department of Surgery, University of Ottawa, Ottawa, ON, Canada.ORCID https://orcid.org/0000-0002-2216-9056
Ramanadhan S SundaresanDivision of Thoracic Surgery, Department of Surgery, University of Ottawa, Ottawa, ON, Canada.ORCID https://orcid.org/0000-0001-6970-1233
Patrick J VilleneuveDivision of Thoracic Surgery, Department of Surgery, University of Ottawa, Ottawa, ON, Canada.ORCID https://orcid.org/0000-0001-6620-6413
Calvin ThompsonDepartment of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, ON, Canada.ORCID https://orcid.org/0000-0001-7220-0990
Andrew J E SeelyOttawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada.ORCID https://orcid.org/0000-0002-6459-8801
University of Ottawa · CAOttawa Hospital · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA time course analysis was undertaken to evaluate how perioperative process-of-care and outcome measures evolved after implementation of an enhanced recovery after thoracic surgery (ERATS) program.

methodsOutcome and process-of-care measures were compared between patients undergoing major elective thoracic surgery during a 9-month pre-ERATS implementation period to those at 1-3, 4-6, and 7-9 months post-ERATS implementation. Outcome measures included length of stay, the 30-day readmission rate, 30-day emergency department visits, and minor and major adverse events. Process measures included first time to activity, out-of-bed, ambulation, fluid diet, diet as tolerated, as well as removal of the first and last chest tube, epidural, patient-controlled analgesia, and Foley and intravenous catheters.

resultsIn total, 704 patients (352 pre-ERATS, 352 post-ERATS) were included. Mobilization-related process measures, including time to first activity (16.5 vs. 6.8 hours, p<0.001), out-of-bed (17.6 vs. 8.9 hours, p<0.001), and ambulation (32.4 vs. 25.4 hours, p=0.04) saw statistically significant improvements by 1-3 months post-ERATS implementation compared to pre-ERATS. Time to Foley removal improved by 4-6 months post-ERATS (19.5 vs. 18.2 hours, p=0.003). Outcome measures, including the 30-day readmission rate and emergency department visits, steadily decreased post-ERATS. By 7-9 months post-ERATS, both minor (18.2% vs. 7.9%, p=0.009) and major (13.6% vs. 4.4%, p=0.007) adverse events demonstrated statistically significant improvements. Length of stay trended towards improvement from 6.2 days pre-ERATS to 4.8 days by 7-9 months post-ERATS (p=0.06).

conclusionThe adoption of ERATS led to improvements in multiple process-of-care measures, which may collectively and gradually achieve optimization of clinical outcomes.

Indexed as

Enhanced recovery after surgeryInterrupted time series analysisOutcome and process assessmentPostoperative careThoracic surgery

Identifiers

PMID35135904
PMCPMC9005934
OpenAlexW4210920747

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.