Implementation of the Exeter enhanced recovery programme for patients undergoing radical cystectomy

2.50
Hdl Handle:
http://hdl.handle.net/11287/593864
Title:
Implementation of the Exeter enhanced recovery programme for patients undergoing radical cystectomy
Authors:
Dutton, Thomas J.; Daugherty, Mark O.; Mason, R. G.; McGrath, John S
Abstract:
OBJECTIVES: To describe our experience with the implementation and refinement of an enhanced recovery programme (ERP) for radical cystectomy (RC) and urinary diversion. To assess the impact on length of stay (LOS), complication and readmission rates. PATIENTS AND METHODS: In all, 165 consecutive patients undergoing open RC (ORC) and urinary diversion between January 2008 and April 2013 were entered into an ERP. A retrospective case note review was undertaken. Outcomes recorded included LOS, time to mobilisation, complication rates within the first 30 days (Clavien-Dindo classification) and readmissions. RESULTS: All patients were successfully entered into the ERP. As enhanced recovery principles became embedded in the unit, LOS reduced from a mean of 14 days over the initial year of the ERP to a mean of 9.2 days. The complication rate was 6.6% for Clavien >/=3, and 43.5% for Clavien </=2. The 30-day mortality rate was 1.2%. The 30-day readmission rate was 13.9%. In the most contemporary subset of 52 patients: the median time after ORC to sit out of bed, mobilise and open bowels was day 1, 2 and 6, respectively. CONCLUSIONS: The ERP described for patients undergoing ORC appears to be safe. Benefits include early feeding, mobilisation and hospital discharge. The ERP will continue to develop with the incorporation of advancing evidence and technology, in particular the introduction of robot-assisted RC.
Citation:
BJU Int. 2014 May;113(5):719-25.
Publisher:
Wiley
Journal:
BJU international
Issue Date:
1-May-2014
URI:
http://hdl.handle.net/11287/593864
DOI:
10.1111/bju.12533
PubMed ID:
24712746
Additional Links:
http://dx.doi.org/10.1111/bju.12533
Note:
This article is available via Open Access. Please click on the 'Additional Link' above to access the full-text.
Type:
Journal Article
Language:
eng
ISSN:
1464-410X
Appears in Collections:
Urology; 2014 RD&E publications; HeSRU publications

Full metadata record

DC FieldValue Language
dc.contributor.authorDutton, Thomas J.en
dc.contributor.authorDaugherty, Mark O.en
dc.contributor.authorMason, R. G.en
dc.contributor.authorMcGrath, John Sen
dc.date.accessioned2016-01-19T12:35:55Zen
dc.date.available2016-01-19T12:35:55Zen
dc.date.issued2014-05-01en
dc.identifier.citationBJU Int. 2014 May;113(5):719-25.en
dc.identifier.issn1464-410Xen
dc.identifier.pmid24712746en
dc.identifier.doi10.1111/bju.12533en
dc.identifier.urihttp://hdl.handle.net/11287/593864en
dc.description.abstractOBJECTIVES: To describe our experience with the implementation and refinement of an enhanced recovery programme (ERP) for radical cystectomy (RC) and urinary diversion. To assess the impact on length of stay (LOS), complication and readmission rates. PATIENTS AND METHODS: In all, 165 consecutive patients undergoing open RC (ORC) and urinary diversion between January 2008 and April 2013 were entered into an ERP. A retrospective case note review was undertaken. Outcomes recorded included LOS, time to mobilisation, complication rates within the first 30 days (Clavien-Dindo classification) and readmissions. RESULTS: All patients were successfully entered into the ERP. As enhanced recovery principles became embedded in the unit, LOS reduced from a mean of 14 days over the initial year of the ERP to a mean of 9.2 days. The complication rate was 6.6% for Clavien >/=3, and 43.5% for Clavien </=2. The 30-day mortality rate was 1.2%. The 30-day readmission rate was 13.9%. In the most contemporary subset of 52 patients: the median time after ORC to sit out of bed, mobilise and open bowels was day 1, 2 and 6, respectively. CONCLUSIONS: The ERP described for patients undergoing ORC appears to be safe. Benefits include early feeding, mobilisation and hospital discharge. The ERP will continue to develop with the incorporation of advancing evidence and technology, in particular the introduction of robot-assisted RC.en
dc.language.isoengen
dc.publisherWileyen
dc.relation.urlhttp://dx.doi.org/10.1111/bju.12533en
dc.titleImplementation of the Exeter enhanced recovery programme for patients undergoing radical cystectomyen
dc.typeJournal Articleen
dc.identifier.journalBJU internationalen
dc.description.noteThis article is available via Open Access. Please click on the 'Additional Link' above to access the full-text.en

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