1. Enhanced recovery after cesarean from the patient perspective: a prospective study of the ERAC Questionnaire (ERAC-Q).
- Author
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Meyer, Jessica A., Alton, Suzanne, Seung, Hyunuk, Pahlavan, Autusa, Trilling, Ariel R., Coghlan, Martha, Goetzinger, Katherine R., and Cojocaru, Liviu
- Subjects
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PATIENTS' attitudes , *PRE-tests & post-tests , *MEDICAL protocols , *QUESTIONNAIRES , *QUALITY of life , *POSTOPERATIVE period , *DESCRIPTIVE statistics , *ENHANCED recovery after surgery protocol , *CESAREAN section , *DATA analysis software , *ADVERSE health care events , *OPIOID analgesics , *LONGITUDINAL method , *POSTOPERATIVE pain - Abstract
To evaluate the impact of an Enhanced Recovery After Cesarean (ERAC) protocol on the post-cesarean recovery experience using a validated ten-item questionnaire (ERAC-Q). This is a prospective cohort study of patients completing ERAC quality-of-life questionnaires (ERAC-Q) during inpatient recovery after cesarean delivery (CD) between October 2019 and September 2020, before and after the implementation of our ERAC protocol. Patients with non-Pfannenstiel incision, ICU admission, massive transfusion, bowel injury, existing chronic pain disorders, acute postpartum depression, or neonatal demise were excluded. The ERAC-Q was administered on postoperative day one and day of discharge to the pre- and post-ERAC implementation cohorts, rating aspects of their recovery experience on a scale of 0 (best) to 10 (worst). The primary outcome was ERAC-Q scores. Statistical analysis was performed with SAS software. There were 196 and 112 patients in the pre- and post-ERAC cohorts, respectively. The post-ERAC group reported significantly lower total ERAC-Q scores compared to the pre-ERAC group, reflecting fewer adverse symptoms and greater perceived recovery on postoperative day one (1.6 [0.7, 2.8] vs. 2.7 [1.6, 4.3]) and day of discharge (0.8 [0.3, 1.5] vs. 1.4 [0.7, 2.2]) (p<0.001). ERAC-Q responses did not predict the time to achieve objective postoperative milestones. However, worse ERAC-Q pain and total scores were associated with higher inpatient opiate use. ERAC implementation positively impacts patient recovery experience. The administration of ERAC-Q can provide real-time feedback on patient-perceived recovery quality and how healthcare protocol changes may impact their experience. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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