Abstract:
OBJECTIVE:To examine the results of a quality-improvement study that implemented an enhanced recovery after surgery (ERAS) program for cesarean delivery. METHODS:A pre-post design was used to assess changes in opioid use, length of stay, and costs among all patients undergoing cesarean delivery before and after implementation of an evidence-based ERAS pathway for the preoperative, intraoperative, and postoperative management of patients beginning December 2018. RESULTS:A total of 3,679 cesarean deliveries (scheduled and emergent) were included from January 1, 2018, through August 31, 2019, of which 2,171 occurred before implementation on December 17, 2018, and 1,508 occurred postimplementation. Eighty-four percent of patients received opioids as inpatients after cesarean delivery during the preimplementation period, as compared with 24% in the postimplementation period (odds ratio [OR] 16.8, 95% CI 14.3-19.9). Among patients who required any opioids, the total morphine milligram equivalents also significantly decreased (median 56.5 vs 15.0, mean relative change 0.32, 95% CI 0.28-0.35). Compared with the preimplementation period, those in the postimplementation period had a shorter postcesarean length of stay (3.2 vs 2.7 days, mean relative change 0.82, 95% CI 0.80-0.83, median 3 days in both periods), lower median direct costs by $349 (mean relative change 0.93, 95% CI 0.91-0.95), and no change in the 30-day readmission rate (1.4% vs 1.7%, OR 0.83, 95% CI 0.49-1.41). CONCLUSION:An ERAS approach for the cesarean delivery population is associated with improved outcomes including decreases in opioid use, length of stay, and costs.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Mullman L,Hilden P,Goral J,Gwacham N,Tauro C,Spinola K,Rosales K,Collier S,Holmes L,Maccione J,Pitera R,Miller R,Yodice Pdoi
10.1097/AOG.0000000000004023subject
Has Abstractpub_date
2020-10-01 00:00:00pages
685-691issue
4eissn
0029-7844issn
1873-233Xpii
00006250-202010000-00008journal_volume
136pub_type
杂志文章abstract:OBJECTIVE:To characterize long-term national trends in surgical approach for hysterectomy after the U.S. Food and Drug Administration (FDA) warning against power morcellation for laparoscopic specimen removal. METHODS:This was a descriptive study using data from the American College of Surgeons National Surgical Quali...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000003181
更新日期:2019-04-01 00:00:00
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journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000269047.46078.28
更新日期:2007-07-01 00:00:00
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journal_title:Obstetrics and gynecology
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doi:10.1016/s0029-7844(99)00477-9
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journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3181c2ce96
更新日期:2009-12-01 00:00:00
abstract:OBJECTIVE:To estimate the prevalence of corpus uteri, cervix uteri, and ovarian malignancy in women undergoing hysterectomy or myomectomy for presumed benign indications. METHODS:We conducted a secondary analysis of data from the 2014-2015 American College of Surgeons National Surgical Quality Improvement Program. Adu...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,多中心研究
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更新日期:2018-04-01 00:00:00
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journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(96)00119-6
更新日期:1996-07-01 00:00:00
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journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
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更新日期:2011-11-01 00:00:00
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journal_title:Obstetrics and gynecology
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更新日期:2003-02-01 00:00:00
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doi:10.1097/AOG.0000000000002591
更新日期:2018-05-01 00:00:00
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journal_title:Obstetrics and gynecology
pub_type: 杂志文章,实务指引
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journal_title:Obstetrics and gynecology
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更新日期:1999-10-01 00:00:00
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更新日期:2012-09-01 00:00:00
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更新日期:2002-11-01 00:00:00
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更新日期:2004-07-01 00:00:00
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journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章,多中心研究
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更新日期:2020-11-01 00:00:00
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更新日期:2005-11-01 00:00:00
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journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1993-05-01 00:00:00
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更新日期:1999-08-01 00:00:00