Factors influencing enhanced recovery and length of stay among surgery patients in a specialist hospital in the Kingdom of Saudi Arabia

Abstract

Enhanced Recovery After Surgery was first implemented in 2010 and became known worldwide as a multimodal care pathway with the aim to enhance recovery of patients that have undergone major surgeries. In the specialist hospital here in Saudi Arabia, it was first implemented in 2019. This correlational study was conducted to determine the demographics of the patients, to ascertain the relationship between influencing factors and post operative complication to the length of stay, and the incidence of post-operative complications among gyne-oncology surgery patients under ERAS protocol. As the study has revealed, all age group in the study, from young adults, middle age and older adult participants under ERAS protocol, stayed within almost the same length of days in the hospital. It was also found that patients with minimal invasive surgery have faster full recovery versus open surgery. Carbohydrate loading has also showed that it has great impact in the early recovery thus shorten the length of stay of post-operative patients. On the other hand, multimodal analgesia, early nutrition and early ambulation was found significant in relation to shorter hospital stay. PONV (post-operative nausea and vomiting) is claimed in studies to be the most common post-operative complication in all ages. It has affected some of the participants in varied frequency, intensity and time of manifestations, some within 24 hours and others after 24 hours. Hospital length of stay was greatly affected as data showed average of 80% full improvement on patients without PONV and an average of 20% partial improvement to participants with PONV. Post operative nausea and vomiting definitely affects negatively total patient outcome when the data showed 3.8 days hospital stay on patients affected and 2.9 days on unaffected patients. It is apparent that quality outcome in ERAS implementation will only be achieved with strict compliance to the standard protocol.