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BIBTEX RIS

Enhancing surgical recovery in Central-West Brazil: The ACERTO protocol results

2008; Elsevier BV; Volume: 3; Issue: 2 Linguagem: Inglês

10.1016/j.eclnm.2008.01.003

ISSN

1751-4991

Autores

José Eduardo de Aguilar‐Nascimento, Alberto Bicudo Salomão, Cervantes Caporossi, Raquel M. Silva, Eduardo Antonio Cardoso, Tiago Pádua Santos,

Tópico(s)

Hemodynamic Monitoring and Therapy

Resumo

Multimodal strategies enhance postoperative recovery. The aim of this study was to evaluate the results of an ERAS-based protocol named ACERTO project in elective patients in a University Hospital in Central-West Brazil. A total of 308 patients (M/F = 160/148; median age = 47 (18–85) years old) entered the study. Patients received either traditional (n = 78) or a multidisciplinary protocol of peri-operative care (ACERTO project; n = 230). The implantation of the ACERTO protocol was followed by a decrease in both pre- (16 [8–27] vs. 4 [2–20] h, p < 0.001) and postoperative fasting time (0 [0–20] vs. 1 [0–14] day; p < 0.01), and in the volume of intravenous fluids (8 [1–101] vs. 2.0 [0–100] L, p < 0.001). The changing of protocols reduced hospital stay by 2 days (5 [2–104] vs. 3 [1–64] days, p = 0.002) and surgical site infection rate by 66% (11.5%; 9/78 vs. 3.9%; 9/230, p = 0.01; odds ratio = 3.2, 95%CI: 1.2–8.4). Per-protocol analysis showed that both postoperative stay and morbidity diminished, and in the subset of major operations both infectious and non-infectious complications decreased only in patients who completed the protocol (p < 0.01). The implantation of multidisciplinary routines such as the ACERTO protocol diminishes both hospitalization and morbidity in general surgery.

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