Evidence map›Paper›PMID 35568508›Full record

Observational studyBritish journal of anaesthesia2022

Delivery of drinking, eating and mobilising (DrEaMing) and its association with length of hospital stay after major noncardiac surgery: observational cohort study.

Charles M Oliver, Samantha Warnakulasuriya, Dermot McGuckin, Georgina Singleton, Peter Martin, Cristel Santos, James Bedford, Duncan Wagstaff, Arun Sahni, David Gilhooly and 18 more

2 registry-linked trialsOpen access · hybridAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in British journal of anaesthesia, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 17 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 2 pooled it
7.6field-weighted citation impact, top 2% 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.

NCT06239831 recruitingnot on this map

Postoperative Respiratory and Activity Monitoring

TypeobservationalSponsorUniversity of Colorado, DenverRan2022 to 2026Enrolled30ConditionsHypoventilation, Hypoxemia, Postoperative Pulmonary ComplicationsArmsExSpiron and ActivPAL Monitors
NCT07728214 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

Reminder-enhanced Incentive Spirometry Evaluation (RISE)

TypeinterventionalSponsorUniversity of Colorado, DenverRan2026 to 2029Enrolled88ConditionsHypoxemiaArmsAlarms ON
3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 38 citations in OpenAlex.

  1. Pooled it
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  12. Transforming in-clinic post-operative and intermediate care with cosinuss°.Computational and structural biotechnology journal · 2024
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

28 authors at 12 institutions in 1 country.

Charles M OliverCentre for Perioperative Medicine, Research Department for Targeted Intervention, Division of Surgery and Interventional Science, University College London, London, UK; Department of Anaesthesia and Perioperative Medicine, University College London Hospitals, London, UK.
Samantha WarnakulasuriyaCentre for Perioperative Medicine, Research Department for Targeted Intervention, Division of Surgery and Interventional Science, University College London, London, UK; Department of Anaesthesia and Perioperative Medicine, University College London Hospitals, London, UK; Health Services Research Centre, National Institute for Academic Anaesthesia, Royal College of Anaesthetists, London, UK.
Dermot McGuckinCentre for Perioperative Medicine, Research Department for Targeted Intervention, Division of Surgery and Interventional Science, University College London, London, UK; Department of Anaesthesia and Perioperative Medicine, University College London Hospitals, London, UK; Health Services Research Centre, National Institute for Academic Anaesthesia, Royal College of Anaesthetists, London, UK.
Georgina SingletonCentre for Perioperative Medicine, Research Department for Targeted Intervention, Division of Surgery and Interventional Science, University College London, London, UK; Department of Anaesthesia and Perioperative Medicine, University College London Hospitals, London, UK; Health Services Research Centre, National Institute for Academic Anaesthesia, Royal College of Anaesthetists, London, UK.
Peter MartinDepartment for Applied Health Research, University College London, London, UK.
Cristel SantosHealth Services Research Centre, National Institute for Academic Anaesthesia, Royal College of Anaesthetists, London, UK.
James BedfordHealth Services Research Centre, National Institute for Academic Anaesthesia, Royal College of Anaesthetists, London, UK.
Duncan WagstaffCentre for Perioperative Medicine, Research Department for Targeted Intervention, Division of Surgery and Interventional Science, University College London, London, UK; Health Services Research Centre, National Institute for Academic Anaesthesia, Royal College of Anaesthetists, London, UK.
Arun SahniHealth Services Research Centre, National Institute for Academic Anaesthesia, Royal College of Anaesthetists, London, UK.
David GilhoolyCentre for Perioperative Medicine, Research Department for Targeted Intervention, Division of Surgery and Interventional Science, University College London, London, UK; Department of Anaesthesia and Perioperative Medicine, University College London Hospitals, London, UK; Health Services Research Centre, National Institute for Academic Anaesthesia, Royal College of Anaesthetists, London, UK.
Jonathan WilsonYork University Hospitals, York, UK.
Kylie EdwardsCentre for Perioperative Medicine, Research Department for Targeted Intervention, Division of Surgery and Interventional Science, University College London, London, UK; Health Services Research Centre, National Institute for Academic Anaesthesia, Royal College of Anaesthetists, London, UK.
Rachel BaumberCentre for Perioperative Medicine, Research Department for Targeted Intervention, Division of Surgery and Interventional Science, University College London, London, UK; Health Services Research Centre, National Institute for Academic Anaesthesia, Royal College of Anaesthetists, London, UK; Royal National Orthopaedic Hospital, Stanmore, UK.
Cecilia Vindrola-PadrosCentre for Perioperative Medicine, Research Department for Targeted Intervention, Division of Surgery and Interventional Science, University College London, London, UK; Health Services Research Centre, National Institute for Academic Anaesthesia, Royal College of Anaesthetists, London, UK.
Jenny DoreyRoyal College of Anaesthetists, London, UK.
Irene LeemanRoyal College of Anaesthetists, London, UK.
Hannah Boyd-CarsonEast Midlands Surgical Academic Network, Queen's Medical Centre, Nottingham, UK; Department of General Surgery, Derby Teaching Hospitals NHS Foundation Trust, Royal Derby Hospital, Derby, UK.
Ravi VohraEast Midlands Surgical Academic Network, Queen's Medical Centre, Nottingham, UK; Trent Oesophago-Gastric Unit, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Pritam SinghRegional Oesophago-Gastric Unit, Royal Surrey County Hospital, Guildford, Surrey, UK.
Matthew BedfordDivision of Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Abigail VallanceBristol Medical School, University of Bristol, Bristol, UK.
Giuseppe AresuDepartment of Thoracic Surgery, Royal Papworth NHS Foundation Trust, Cambridge, UK.
Olga TuckerDivision of Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Michael SwartDepartment of Anaesthesia and Perioperative Medicine, Torbay Hospital, Torquay, UK.
Monty G MythenUniversity College London Hospitals National Institute of Health Research Biomedical Research Centre, London, UK.
PQIP project delivery team
Suneetha R MoonesingheCentre for Perioperative Medicine, Research Department for Targeted Intervention, Division of Surgery and Interventional Science, University College London, London, UK; Department of Anaesthesia and Perioperative Medicine, University College London Hospitals, London, UK; Health Services Research Centre, National Institute for Academic Anaesthesia, Royal College of Anaesthetists, London, UK; University College London Hospitals National Institute of Health Research Biomedical Research Centre, London, UK. Electronic address: ramani.moonesinghe@nhs.net.
PQIP collaborative
Royal College of Anaesthetists · GBUniversity Hospitals Birmingham NHS Foundation Trust · GBNational Institute for Health Research · GBNottingham University Hospitals NHS Trust · GBPapworth Hospital NHS Foundation Trust · GBRoyal Derby Hospital · GBRoyal London Hospital · GBRoyal Surrey County Hospital · GBTorbay Hospital · GBUniversity College London · GBUniversity of Bristol · GBYork Hospital · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEnhanced recovery pathways are associated with improved postoperative outcomes. However, as enhanced recovery pathways have become more complex and varied, compliance has reduced. The 'DrEaMing' bundle re-prioritises early postoperative delivery of drinking, eating, and mobilising. We investigated relationships between DrEaMing compliance, postoperative hospital length of stay (LOS), and complications in a prospective multicentre major surgical cohort.

methodsWe interrogated the UK Perioperative Quality Improvement Programme dataset. Analyses were conducted in four stages. In an exploratory cohort, we identified independent predictors of DrEaMing. We quantified the association between delivery of DrEaMing (and its component variables) and prolonged LOS in a homogenous colorectal subgroup and assessed generalisability in multispecialty patients. Finally, LOS and complications were compared across hospitals, stratified by DrEaMing compliance.

resultsThe exploratory cohort comprised 22 218 records, the colorectal subgroup 7230, and the multispecialty subgroup 5713. DrEaMing compliance was 59% (13 112 patients), 60% (4341 patients), and 60% (3421), respectively, but varied substantially between hospitals. Delivery of DrEaMing predicted reduced odds of prolonged LOS in colorectal (odds ratio 0.51 [0.43-0.59], P<0.001) and multispecialty cohorts (odds ratio 0.47 [0.41-0.53], P<0.001). At the hospital level, complications were not the primary determinant of LOS after colorectal surgery, but consistent delivery of DrEaMing was associated with significantly shorter LOS.

conclusionsDelivery of bundled and unbundled DrEaMing was associated with substantial reductions in postoperative LOS, independent of the effects of confounder variables. Consistency of process delivery, and not complications, predicted shorter hospital-level length of stay. DrEaMing may be adopted by perioperative health systems as a quality metric to support improved patient outcomes and reduced hospital length of stay.

Indexed as

Colorectal NeoplasmsPostoperative ComplicationsCohort StudiesHumansLength of StayProspective Studiesenhanced recoverypatient-centred outcomesperioperativequality improvementquality metricshared decision-makingsurgical outcomes

Identifiers

PMID35568508
PMCPMC9284668
OpenAlexW4280531933

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

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.