Research Day
30-DAY ED VISITS AND READMISSIONS PRE AND POST ERAS IMPLEMENTATION IN HYSTERECTOMY PATIENTS IN A COMMUNITY HOSPITAL
Document Type
Abstract
Date
2021
Abstract
ERAS (enhanced recovery after surgery) protocols have improved post-operative outcomes by refining pre-, peri- and postoperative patient care. In 2018, our institution implemented an ERAS protocol to evaluate and improve postoperative (POP) outcomes of hysterectomy patients. Chart reviewed patients who underwent hysterectomies (abdominal, laparoscopic, robotic, vaginal) with or without Bilateral-Salpingo-Oophorectomy, who visited the Emergency Department (ED) within a 30-day window after surgery. We compared the POP causes of admission, length of stay, and use of narcotic analgesia before and after the ERAS protocol. Data was collected from June 2017 to June 2018 for pe-ERAS and January 2019 to January 2020 for post-ERAS. 295 pre-ERAS hysterectomies were compared to 210 post-ERAS hysterectomies. Of the pre-ERAS hysterectomies, 28 ED visits and 11 readmissions (8 related to complications) occurred. Of the post-ERAS hysterectomies, 26 ED visits and 12 readmissions (11 related to complications) occurred. Pain was the most common cause of POP ED visits (2% pre and 3.8 % post ERAS). Surgical site infections (pelvic abscess and cellulitis) are the most common cause of readmission (1.7% pre- and 2.9% post-ERAS). Narcotic prescriptions were written in 10% of POP ED visits in pre- and 12% of post-ERAS. Chi-square tests demonstrated no statistically significant difference in ED visits, pain, narcotic prescription, readmission rates, or related complications between pre and post-ERAS protocol. In the US, surgical site infections are the most common cause of readmissions. The ERAS protocol implementation in our community hospital has not reduced the readmission frequency for surgical site infections, nor narcotic prescriptions.