Lausanne University Hospital e CHUV, Lausanne, Switzerland. * Corresponding author. Department of Visceral Surgery, Lausanne University. Hospital e CHUV ...
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Abstracts / Clinical Nutrition ESPEN 25 (2018) 166e209
independent t test was used for comparison. ERAS-specific costs were integrated into the model. Results: Demographics and preoperative characteristics were similar between the pre-ERAS and ERAS groups. The mean total costs were USD14’128 (95% CI: 11’967-16’477) for the ERAS group and USD18’772 (15’399-22’721) for the pre-ERAS group (p¼0.041). Preoperative and postoperative mean costs for the ERAS group (USD8’226, 7’001-9’715) were lower than for the pre-ERAS group (13’538, 10’367-17’293, p¼0.015). Intraoperative costs were similar between both groups (ERAS: USD5’901, 5’133-6’746 vs. pre-ERAS: 5’234, 4’678-5’870, p¼0.185). Subgroup analysis showed that nursing costs (mean difference: USD1’992, p¼0.031) and intensive care unit costs (1’486, p¼0.018) were significantly lower in the ERAS group. ERAS specific cost per patient where USD512. The final total gain per patient was USD4’132. Conclusion: Implementation of ERAS in gynaecological surgery induced a significant decrease of overall costs. Disclosure of Interest: None declared. P009 ENHANCED RECOVERY AFTER SURGERY PATHWAYS IN GYNAECOLOGICAL SURGERY DECREASES DURATION OF HOSPITAL STAY WITHOUT INCREASING READMISSION RATE €tan-Romain Joliat 1, Martin Hübner 1, Fabian Basile C.-E. Pache 1, 2, *, Gae Nicolas Demartines 1, Patrice Mathevet 2, Chahin Grass 1, Achtari 2. 1 Department of Visceral Surgery, Lausanne University Hospital e ere-Enfant”, CHUV, Lausanne, Switzerland; 2 Department “Femme-M Lausanne University Hospital e CHUV, Lausanne, Switzerland * Corresponding author. Department of Visceral Surgery, Lausanne University Hospital e CHUV, Lausanne, Switzerland.
Objectives: Enhanced recovery after surgery (ERAS) aims to reduce perioperative stressors and provide standardized pathways for clinical practice. ERAS has been shown to reduce length of hospital stay in various fields of surgery (colorectal, hepatobiliary), but evidence in gynaecology remains scarce. The aim of the present study was to assess the effect of ERAS implementation in gynaecological surgery on length of stay and readmission rate. Methods: Retrospective analysis of a prospectively maintained database of women undergoing gynaecological surgery (benign, staging or debulking) within an ERAS protocol from 9 October 2013 to 31 December 2016. Results were compared with a case-matched group before implementation (preERAS) from 3 October 2012 to 30 September 2013 in a Swiss tertiary centre. Perioperative items were prospectively collected on a daily basis into a dedicated database. Complications were graded according to ClavienDindo classification, with major complications defined as grade III-V. Results: 445 women were included, with ERAS (n¼403) and pre-ERAS (n¼42) groups. Preoperative characteristics and demographics were similar in both groups. Overall, complications rate was not different between the two groups (25% (104/403) vs 29% (12/42), p¼0.698). No differences were found for major complications rate (7.1% (3/42) vs 2.5% (10/ 403), p¼0. 088), reoperations rate (2.5% (10/403) vs 2,4% (1/42), p¼0.968), neither for number of patients in Intensive Care Unit postoperatively: 9.4% (38/403) vs 19% (8/42), p¼0.062). Median length of stay was significantly reduced in the ERAS group compared to pre-ERAS with 3 days (IQR 2-4) vs 5 (IQR 3-8), p0.05). The reduction in LOS was not significant for both
