Enhanced Recovery after Surgery (ERAS®) Outcomes in Patients with Prior Diagnosis of Diabetes

*Visual Abstracts prepared by Dr. Roy Raoul Felipe Objective:To determine whether a prior diagnosis of diabetes mellitus (DM) is associated with longer post-operative length of stay (LOS) and higher complication rates among patients who underwent colorectal surgery under an Enhanced Recovery After Surgery (ERAS) protocol in a single hospital setting. Methodology:  In a cross-sectional study, we grouped 157 consecutive patients who underwent elective colorectal surgery under ERAS protocol according to preoperative DM status. Patient data was abstracted from ERAS Interactive Audit Database from Jan 2016-Dec 2017. We compared LOS between groups. Secondary outcomes were post-operative complications, reoperations, pneumonia and wound infection.  Categorical and continuous variables were analyzed with Fisher’s exact test and student t-test, respectively using StataSE v13 with significance level of p=0.05. Results:  113 subjects were in the no T2DM while 44 patients had T2DM. Mean post- operative length of hospital stay was 6.4 +/- 5.1 days for the no T2DM group versus 5.8 +/- 3.8 in the T2DM group, (p=0.476).  Complications, reoperation rate, pneumonia and wound infection did not differ between groups.  Among subjects in the T2DM group, LOS did not differ among those that had preoperative Hba1c <7.0% and those with Hba1c >7.0% (5.7±3.7 vs 6.1±4.2 days, p=0.748). Conclusion: Among patients who underwent colorectal surgery under ERAS protocol, a prior diagnosis of diabetes was not associated with longer LOS or more complications.  A preoperative HBa1c of <7% did not affect length of stay in ERAS among patients with T2DM.