The Effect of Enhanced Recovery After Surgery (ERAS®) on Individuals with Diabetes

• Author / Creator

  Albalawi, Zaina H

• Individuals with diabetes experience higher postoperative morbidity and mortality. This thesis aims to evaluate the effect of a multimodal care pathway package; the Enhanced Recovery after Surgery (ERAS®) program, on those with diabetes. The first section systematically evaluated the state of the evidence, and found a lack of robust evidence assessing the impact of ERAS® in the diabetes population.
  To address a knowledge gap, the second section of this thesis focused on analyzing the “real-world” findings of implementing ERAS® program on length of stay (LOS) and postoperative outcomes in the province of Alberta in a retrospective cohort of all colorectal surgical patients and the diabetes subgroup while accounting for secular trends overtime utilizing an interrupted time series (ITS) model. The diabetes subgroup did not demonstrate any benefit post implementation of ERAS® for 12 months, but reassuringly, no harm was observed in any of the postoperative outcomes. Future intervention studies are still required to improve postoperative outcomes in colorectal surgical patients with diabetes. On the other hand, despite a lower LOS post ERAS® in the full cohort, the ITS analysis found this to be secondary to a background trend predicted by the 12-month period preceding ERAS® and may not be directly attributable to ERAS® program implementation. This unexpected finding is contrary to the ERAS® literature and necessitates further evaluation of the impact of ERAS® program in real world settings, using robust study designs.

• Subjects / Keywords

  • Postoperative
  • Alberta
  • Diabetes
  • Enhanced Recovery After Surgery (ERAS)

• Graduation date

  Fall 2018

• Type of Item

  Thesis

• Degree

  Master of Science

• DOI

  https://doi.org/10.7939/R34Q7R59P

• License

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