Gaps in literature on enhanced recovery after thoracic surgery: Considering social determinants of health

•Disparities across social determinants of health exist in thoracic diseases.•Enhanced recovery after surgery is a potential means in mitigating such disparities.•Literature comparing ERAS outcomes across SDOH is limited in thoracic surgery.•Future research is needed to fully elucidate ERAS benefits...

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Published inThe American journal of surgery Vol. 230; pp. 111 - 114
Main Authors Mathew, Dave M., Khusid, Elizabeth, Lui, Briana, Weber, Marissa, Boyer, Richard, White, Robert S., Walsh, Spencer
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.04.2024
Elsevier Limited
Subjects
Analgesia
Cardiovascular diseases
Comorbidity
Complications
Cost analysis
Geography
Health risks
Insurance
Mortality
Pain perception
Patients
Postoperative
Recovery (Medical)
Risk
Socioeconomic factors
Subgroups
Surgery
Surgical outcomes
Thorax
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Abstract •Disparities across social determinants of health exist in thoracic diseases.•Enhanced recovery after surgery is a potential means in mitigating such disparities.•Literature comparing ERAS outcomes across SDOH is limited in thoracic surgery.•Future research is needed to fully elucidate ERAS benefits in this context.
AbstractList •Disparities across social determinants of health exist in thoracic diseases.•Enhanced recovery after surgery is a potential means in mitigating such disparities.•Literature comparing ERAS outcomes across SDOH is limited in thoracic surgery.•Future research is needed to fully elucidate ERAS benefits in this context.
Emerging anesthetic modalities, such as opioid-free analgesia, may not only improve overall patient care, but may also mitigate disparities associated with unequal access to pain management resources.6 Literature assessing ERAS outcomes by SDOH is advancing across various specialties.7,8 One cohort study described that both Black and White patients undergoing colorectal surgery saw reductions in postoperative length of stay after ERAS; this reduction was greater for Black patients, illustrating the efficacy of ERAS in reducing preoperative disparities.7 ERAS implementation was not associated with any differences in readmission, mortality, or other complications. Thoracic surgery patients are a high-risk population, often with multiple cardiopulmonary and systemic comorbidities that predispose them to significant postoperative complications.3 Disparities across SDOH may only serve to exacerbate these complication risks. [...]we read with great interest four systematic reviews published in PubMed regarding the effectiveness of ERAS in thoracic surgery. The authors showed that ERAS is associated with reduced hospital length of stay, postoperative complication risk, and patient costs.3 The authors further conducted an extensive subgroup analysis, which revealed that ERAS significantly decreased the risk of cardiovascular, pulmonary, urinary, and surgical complications. [...]Maruyama et al. mentioned insurance when describing how they calculated hospitalization costs, as expenses depend on a patient's length of stay under the Japanese medical insurance system.
Author Mathew, Dave M.
Lui, Briana
Weber, Marissa
Boyer, Richard
Khusid, Elizabeth
Walsh, Spencer
White, Robert S.
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10.1016/j.jss.2021.01.004
10.1016/j.ygyno.2023.02.005
10.2147/CMAR.S150500
10.21037/jtd-21-433
10.1097/SLA.0000000000002307
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Snippet •Disparities across social determinants of health exist in thoracic diseases.•Enhanced recovery after surgery is a potential means in mitigating such...
Emerging anesthetic modalities, such as opioid-free analgesia, may not only improve overall patient care, but may also mitigate disparities associated with...
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SubjectTerms Analgesia
Cardiovascular diseases
Comorbidity
Complications
Cost analysis
Geography
Health risks
Insurance
Mortality
Pain perception
Patients
Postoperative
Recovery (Medical)
Risk
Socioeconomic factors
Subgroups
Surgery
Surgical outcomes
Thorax
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Title Gaps in literature on enhanced recovery after thoracic surgery: Considering social determinants of health
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