2022
Early Return to Intended Oncologic Therapy after implementation of an Enhanced Recovery After Surgery pathway for gastric cancer surgery
Garcia-Nebreda M, Zorrilla-Vaca A, Ripollés-Melchor J, Abad-Motos A, Alvaro Cifuentes E, Abad-Gurumeta A, Mena G, Grant M, Paseiro-Crespo G. Early Return to Intended Oncologic Therapy after implementation of an Enhanced Recovery After Surgery pathway for gastric cancer surgery. Langenbeck's Archives Of Surgery 2022, 407: 2293-2300. PMID: 35441358, DOI: 10.1007/s00423-022-02515-7.Peer-Reviewed Original ResearchMeSH KeywordsAdenocarcinomaDigestive System Surgical ProceduresEnhanced Recovery After SurgeryHumansLength of StayPostoperative ComplicationsStomach NeoplasmsConceptsGastric cancer surgeryCancer surgeryERAS pathwayAdjuvant therapySurgery pathwayOncologic therapyGastric adenocarcinomaEnhanced recoveryPostoperative oncologic outcomesPre-ERAS periodERAS groupHospital stayOncologic outcomesPrimary outcomeShorter LOSResultsSeventy patientsEarly returnSurgeryIntervention studiesTherapyPatientsMedian differenceAdenocarcinomaOutcomesPathwayAssociation between enrollment in an enhanced recovery program for colorectal cancer surgery and long‐term recurrence and survival
Zorrilla‐Vaca A, Ripolles‐Melchor J, Abad‐Motos A, Mingu I, Moreno‐Jurado N, Martínez‐Durán F, Pérez‐Martínez I, Abad‐Gurumeta A, FuenMayor‐Varela M, Mena G, Grant M. Association between enrollment in an enhanced recovery program for colorectal cancer surgery and long‐term recurrence and survival. Journal Of Surgical Oncology 2022, 125: 1269-1276. PMID: 35234283, DOI: 10.1002/jso.26836.Peer-Reviewed Original ResearchMeSH KeywordsColorectal NeoplasmsDigestive System Surgical ProceduresEnhanced Recovery After SurgeryHumansLength of StayPostoperative ComplicationsConceptsColorectal cancer surgeryCancer surgeryOncologic recurrenceColorectal cancerCancer stageCox hazard regression analysisMedian compliance rateSurgical inflammatory responseAdvanced colorectal cancerEnhanced recovery programmeOverall survival rateHazards regression analysisLong-term recurrenceAdvanced cancer stageERAS groupERAS interventionsERAS programOverall survivalMultivariable analysisSubgroup analysisInflammatory responseSurgery programLower riskEnhanced recoveryIntervention studies
2020
Goal-Directed Fluid Therapy and Postoperative Outcomes in an Enhanced Recovery Program for Colorectal Surgery: A Propensity Score-Matched Multicenter Study
Zorrilla-Vaca A, Mena G, Ripolles-Melchor J, Abad-Motos A, Aldecoa C, Lorente J, Ramirez-Rodriguez J, Grant M. Goal-Directed Fluid Therapy and Postoperative Outcomes in an Enhanced Recovery Program for Colorectal Surgery: A Propensity Score-Matched Multicenter Study. The American Surgeon 2020, 87: 1189-1195. PMID: 33342254, DOI: 10.1177/0003134820973365.Peer-Reviewed Original ResearchConceptsGoal-directed fluid therapyEnhanced recovery programmeAcute kidney injurySurgical site infectionColorectal surgeryPostoperative outcomesFluid therapyPostoperative acute kidney injuryPropensity score-matched analysisComparable baseline demographicsMajor postoperative outcomesAdequate tissue perfusionRates of morbidityHospital stayKidney injuryBaseline demographicsCohort studyConventional careERAS programAnastomotic dehiscenceMajor surgerySite infectionPulmonary edemaMulticenter studyTherapy patientsRisk factors for acute kidney injury in an enhanced recovery pathway for colorectal surgery
Zorrilla-Vaca A, Mena G, Ripolles-Melchor J, Lorente J, Ramirez-Rodriguez J, Grant M. Risk factors for acute kidney injury in an enhanced recovery pathway for colorectal surgery. Surgery Today 2020, 51: 537-544. PMID: 32785846, DOI: 10.1007/s00595-020-02107-2.Peer-Reviewed Original ResearchMeSH KeywordsAcute Kidney InjuryAge FactorsAgedAged, 80 and overColonCreatinineDigestive System Surgical ProceduresEnhanced Recovery After SurgeryFemaleHumansMaleMalnutritionMiddle AgedMulticenter Studies as TopicNutritional StatusPostoperative ComplicationsProspective StudiesRectumRisk FactorsROC CurveSerum AlbuminConceptsPostoperative acute kidney injuryAcute kidney injuryColorectal surgeryRisk factorsKidney injuryLow preoperative albumin levelRecovery pathwaysPerioperative patient outcomesPreoperative albumin levelEnhanced recovery pathwayIndependent risk factorProspective cohort studyPoor clinical outcomeDirect healthcare costsOpen surgical approachMalnourished patientsCohort studyAlbumin levelsASA IIILarge multicenterPreoperative interventionClinical outcomesMultivariable analysisOverall incidenceModifiable factors
2019
The Impact of Anesthesia-Influenced Process Measure Compliance on Length of Stay
Grant M, Pio Roda C, Canner J, Sommer P, Galante D, Hobson D, Gearhart S, Wu C, Wick E. The Impact of Anesthesia-Influenced Process Measure Compliance on Length of Stay. Anesthesia & Analgesia 2019, 128: 68-74. PMID: 29782405, DOI: 10.1213/ane.0000000000003458.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAnesthesiaAnesthesiologistsColonDigestive System Surgical ProceduresFemaleGuideline AdherenceHumansInterdisciplinary CommunicationLength of StayMaleMiddle AgedOutcome and Process Assessment, Health CarePatient Care TeamPerioperative CarePractice Guidelines as TopicPractice Patterns, Physicians'Program EvaluationQuality ImprovementQuality Indicators, Health CareRecovery of FunctionRectumTime FactorsTreatment OutcomeConceptsProcess measure complianceMeasure complianceProcess measuresAcute pain servicePain medication useLength of staySpecific process measuresImpact of complianceBreakthrough painHospital lengthPain serviceSurgery cohortERAS programSurgical encountersConsecutive patientsMedication usePerioperative careShorter LOSAnesthesia protocolImproved outcomesMultivariable regressionSurgery programEnhanced recoveryPatientsLOS
2017
Dedicated Operating Room Teams and Clinical Outcomes in an Enhanced Recovery after Surgery Pathway for Colorectal Surgery
Grant MC, Hanna A, Benson A, Hobson D, Wu CL, Yuan CT, Rosen M, Wick EC. Dedicated Operating Room Teams and Clinical Outcomes in an Enhanced Recovery after Surgery Pathway for Colorectal Surgery. Journal Of The American College Of Surgeons 2017, 226: 267-276. PMID: 29274837, DOI: 10.1016/j.jamcollsurg.2017.12.010.Peer-Reviewed Original ResearchMeSH KeywordsColonDigestive System Surgical ProceduresFollow-Up StudiesHumansOperating RoomsPatient Care TeamPostoperative CareRecovery of FunctionRectumRetrospective StudiesStandard of CareConceptsClinical outcomesProcess measure complianceEnhanced recoveryMeasure complianceOperating room teamSurgery programAnesthesia providersSurgical site infectionLength of stayHigh complianceColorectal surgeryERAS implementationERAS programSite infectionPerioperative careSurgery pathwayProvider teamProtocol elementsNurse anesthetistsIndividual providersDedicated teamOutcomesSignificant increaseSignificant reductionAnesthesiologistsOptimizing an Enhanced Recovery Pathway Program: Development of a Postimplementation Audit Strategy
Grant M, Galante D, Hobson D, Lavezza A, Friedman M, Wu C, Wick E. Optimizing an Enhanced Recovery Pathway Program: Development of a Postimplementation Audit Strategy. The Joint Commission Journal On Quality And Patient Safety 2017, 43: 524-533. PMID: 28942777, DOI: 10.1016/j.jcjq.2017.02.011.Peer-Reviewed Original ResearchMeSH KeywordsAcademic Medical CentersClinical ProtocolsDigestive System Surgical ProceduresElectronic Health RecordsFemaleGroup ProcessesHumansLength of StayMaleMiddle AgedOrganizational CulturePatient Care BundlesPatient Care TeamPerioperative CarePostoperative ComplicationsQuality Indicators, Health CareRetrospective StudiesSafety ManagementConceptsLength of stayOverall LOSAverage LOSProcess measuresThree-month followProcess measure complianceAcademic medical centerSystem-level interventionsSignificant reductionElectronic health recordsColorectal surgeryConsecutive patientsPathway implementationEarly mobilityMeasure complianceMedical CenterPreventable harmOne-year periodPatientsRecovery pathwaysHealth recordsSystem-level changesSurgeryComplianceSame procedureThoracic Epidural Anesthesia and Prophylactic Three Times Daily Unfractionated Heparin Within an Enhanced Recovery After Surgery Pathway for Colorectal Surgery
Stone A, Grant M, Lau B, Hobson D, Streiff M, Haut E, Wu C, Wick E. Thoracic Epidural Anesthesia and Prophylactic Three Times Daily Unfractionated Heparin Within an Enhanced Recovery After Surgery Pathway for Colorectal Surgery. Regional Anesthesia & Pain Medicine 2017, 42: 197-203. PMID: 28079734, DOI: 10.1097/aap.0000000000000542.Peer-Reviewed Original ResearchMeSH KeywordsAcademic Medical CentersAnalgesia, EpiduralAnesthesia, EpiduralAnticoagulantsBaltimoreCatheters, IndwellingColonDatabases, FactualDevice RemovalDigestive System Surgical ProceduresDrug Administration ScheduleEarly AmbulationHeparinHumansProgram EvaluationRectumRetrospective StudiesRisk FactorsTime FactorsTreatment OutcomeVenous ThromboembolismConceptsThoracic epidural analgesiaVTE prophylaxisEpidural removalERAS programVenous thromboembolismTEA patientsHeparin dosesEpidural analgesiaSurgery pathwayPerioperative thoracic epidural analgesiaColorectal surgery patientsDose of UFHOptimal VTE prophylaxisPercent of patientsThoracic epidural anesthesiaEpidural catheter placementSingle academic centerPreoperative dosesThrombohemorrhagic complicationsColorectal surgeryEpidural hematomaNeuraxial analgesiaSurgery patientsSurgical indicationsUnfractionated heparin