BACKGROUND & AIMS: This study reviewed the case mix, clinical management, and clinical outcomes of patients undergoing colorectal resection in five European centres performing different forms of conventional or 'fast-track' perioperative care. METHODS: The perioperative care programme and surgical practice in each centre was defined. Patient data were collected by case-note review on an internet-based audit system. Case mix was determined using ASA classification and the P-POSSUM scoring system. RESULTS: A total of 451 consecutive patients from units practicing either conventional (Sweden, n=109; UK, n=87; Netherlands, n=76, Norway, n=61) or fast-track surgery (Denmark, n=118), were studied between 1998 and 2001. Elements of perioperative practice varied widely both between units practicing 'traditional' care and the reference 'fast-track' unit (Denmark). Based on the P-POSSUM scores, the case mix was similar between centres. There were no differences in morbidity or 30-day mortality between the different centres. The median length of stay was 2 days in Denmark and 7-9 days in the other centres (P<0.05). The readmission rate was 22% in Denmark and 2-16% in the other centres (P<0.05). CONCLUSION: Compared with traditional care, fast-track perioperative care results in a reduced length of hospital stay but may be associated with a higher readmission rate. Morbidity and mortality appears to be similar with either approach. Prospective evaluation of the potential benefits of the fast-track approach in different European centres is merited.
BACKGROUND & AIMS: This study reviewed the case mix, clinical management, and clinical outcomes of patients undergoing colorectal resection in five European centres performing different forms of conventional or 'fast-track' perioperative care. METHODS: The perioperative care programme and surgical practice in each centre was defined. Patient data were collected by case-note review on an internet-based audit system. Case mix was determined using ASA classification and the P-POSSUM scoring system. RESULTS: A total of 451 consecutive patients from units practicing either conventional (Sweden, n=109; UK, n=87; Netherlands, n=76, Norway, n=61) or fast-track surgery (Denmark, n=118), were studied between 1998 and 2001. Elements of perioperative practice varied widely both between units practicing 'traditional' care and the reference 'fast-track' unit (Denmark). Based on the P-POSSUM scores, the case mix was similar between centres. There were no differences in morbidity or 30-day mortality between the different centres. The median length of stay was 2 days in Denmark and 7-9 days in the other centres (P<0.05). The readmission rate was 22% in Denmark and 2-16% in the other centres (P<0.05). CONCLUSION: Compared with traditional care, fast-track perioperative care results in a reduced length of hospital stay but may be associated with a higher readmission rate. Morbidity and mortality appears to be similar with either approach. Prospective evaluation of the potential benefits of the fast-track approach in different European centres is merited.
Authors: Lidewij Spelt; Daniel Ansari; Christian Sturesson; Bobby Tingstedt; Roland Andersson Journal: HPB (Oxford) Date: 2011-09-26 Impact factor: 3.647
Authors: T Hasenberg; M Niedergethmann; P Rittler; S Post; K W Jauch; M Senkal; C Spies; W Schwenk; E Shang Journal: Anaesthesist Date: 2007-12 Impact factor: 1.041
Authors: O Gralla; F Haas; N Knoll; D Hadzidiakos; M Tullmann; A Romer; S Deger; V Ebeling; M Lein; A Wille; B Rehberg; S A Loening; J Roigas Journal: World J Urol Date: 2006-12-15 Impact factor: 4.226
Authors: Pertti Turunen; Monika Carpelan-Holmström; Pekka Kairaluoma; Heidi Wikström; Olli Kruuna; Pertti Pere; Martina Bachmann; Seppo Sarna; Tom Scheinin Journal: Surg Endosc Date: 2008-09-24 Impact factor: 4.584