Impacto da implementação do protocolo ERAS na taxa de readmissão hospitalar em pacientes submetidos a colectomias em um hospital público

Abstract

This article reviews the scientific literature on the impact of implementing the Enhanced Recovery After Surgery (ERAS) protocol on hospital readmission rates in patients undergoing colectomy, with emphasis on short-term clinical outcomes, patient safety, and efficiency of care in a public hospital setting. The literature search was conducted in the PubMed, Scopus, and Web of Science databases using the descriptors “Enhanced Recovery After Surgery,” “ERAS,” “Colectomy,” “Hospital Readmission,” “Colorectal Surgery,” and “Perioperative Protocols.” Analysis of the studies demonstrates that patients undergoing colectomy are at significant risk for postoperative complications and hospital readmissions, commonly associated with inadequate pain control, postoperative ileus, infections, dehydration, and failures in post-discharge follow-up. Consistent evidence indicates that implementation of the ERAS protocol, based on multimodal interventions throughout the preoperative, intraoperative, and postoperative periods, reduces the surgical stress response, improves functional recovery, and optimizes length of hospital stay without increasing complication rates. Observational studies and clinical trials show that systematic adoption of ERAS is associated with reduced hospital readmission rates, particularly when high adherence to its core components is achieved, including nutritional optimization, multimodal analgesia with reduced opioid use, early mobilization, early resumption of oral intake, and well-defined discharge criteria. In public hospitals, ERAS implementation is also associated with improved healthcare system efficiency, reduced costs, better utilization of hospital beds, and standardized perioperative care, despite structural and logistical challenges that may affect full protocol compliance. Thus, current evidence suggests that implementation of the ERAS protocol in patients undergoing colectomy is a safe and effective strategy for reducing hospital readmission rates, contributing to improved clinical outcomes and greater sustainability of public healthcare services.