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Master Thesis

Évaluation de l’impact de la mise en place des recommandations sur les résultats de la réhabilitation améliorée après chirurgie bariatrique au CHU de caen : analyse chez 464 patients avec un score de propension

Abstract : Background: the aim of this study was to investigate whether the implementation of enhanced recovery after surgery (ERAS) guidelines according to Thorell and co.’ in our tertiary referral bariatric center might improve post-operative outcomes. Methods: ERAS program was introduced in our center since January 1st 2017. Retrospective review of a prospectively collected database identified patients who underwent laparoscopic primary and revisional bariatric surgeries from October 2005 to January 2018. Patients exposed to ERAS program (“ERAS group”) were matched in a 1:1 ratio with patients exposed to conventional care (Control Group) using a propensity score based on age, gender, preoperative body mass index (BMI), diabetes mellitus and the type of procedures. The primary outcome was total hospital length of stay (LOS) and the secondary outcomes included the post-operative complications and readmission rates. Results: during the study period, 464 patients were included, 232 in each group. Implementation of the ERAS protocol was significantly associated with a reduction of LOS (2.47 ± 1.7 vs 5.39 ± 1.9 days, p<0.00001). One third of patients was discharged (77/232, 33%) on the first postoperative day (POD) and more than three quarters of patients on POD2 (182/232, 77%). At the opposite, no patients of the Control Group were discharged on POD2. Overall 30-days and 90-days morbidity and readmission rates were the same in both groups. There were no death in each group. Conclusions: this large case-matched study using a propensity score analysis suggests that implementation of ERAS program reduced significantly the length of stay with no significant consequences on the overall morbidity, and readmission rates.
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https://dumas.ccsd.cnrs.fr/dumas-02328783
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Submitted on : Wednesday, October 23, 2019 - 12:33:18 PM
Last modification on : Tuesday, April 14, 2020 - 12:24:09 PM
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  • HAL Id : dumas-02328783, version 1

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Hugo Meunier. Évaluation de l’impact de la mise en place des recommandations sur les résultats de la réhabilitation améliorée après chirurgie bariatrique au CHU de caen : analyse chez 464 patients avec un score de propension. Médecine humaine et pathologie. 2019. ⟨dumas-02328783⟩

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