IMPACT OF COMORBIDITY ON THE FEASIBILITY OF IMPLEMENTING AN ERAS PROGRAM IN PATIENTS UNDERGOING ELECTIVE SURGERY
DOI:
https://doi.org/10.32782/2411-9164.23.2-10Keywords:
comorbidity, ERAS program, colorectal surgery, Charlson Comorbidity Index, Goldman risk score, perioperative management, enhanced recoveryAbstract
Introduction. Implementation of ERAS protocols in elective colorectal surgery requires optimized perioperative management, which may be significantly affected by patient comorbidity. Different types of comorbidities can alter postoperative recovery and influence the feasibility of ERAS pathways; however, the extent of this impact remains insufficiently explored. Objective. To evaluate the influence of various types of comorbidities on the feasibility of implementing an ERAS program in patients undergoing elective colorectal surgery. Materials and Methods. A cohort prospective randomized open clinical study was conducted involving 120 patients (2021–2024). Comorbidity types (causal, complicated, iatrogenic, unspecified, accidental, geriatric), Charlson Comorbidity Index, and Goldman Cardiac Risk Index were assessed. Correlation analysis was performed to determine the relationship between baseline somatic status and ERAS feasibility. Results. Causal comorbidity had no significant effect on ERAS implementation (r = –0.3). A negative correlation was observed for complicated (r = –0.7), iatrogenic (r = –0.5), unspecified (r = –0.5), and accidental (r = –0.7) comorbidities. Geriatric comorbidity demonstrated the strongest negative association (r = –0.8). Conclusions. The type of comorbidity is a critical predictor of ERAS protocol feasibility. Geriatric and complicated comorbidities impose the greatest limitations on the implementation of enhanced recovery strategies in elective colorectal surgery.
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