Universität zu Köln

Mueller, P. C., Kapp, J. R., Vetter, D., Bonavina, L., Brown, W., Castro, S., Cheong, E., Darling, G. E., Egberts, J., Ferri, L., Gisbertz, S. S., Gockel, I, Grimminger, P. P., Hofstetter, W. L., Hoelscher, A. H., Low, D. E., Luyer, M., Markar, S. R., Moenig, S. P., Moorthy, K., Morse, C. R., Mueller-Stich, B. P., Nafteux, P., Nieponice, A., Nieuwenhuijzen, G. A. P., Nilsson, M., Palanivelu, C., Pattyn, P., Pera, M., Rasanen, J., Ribeiro, U., Rosman, C., Schroeder, W., Sgromo, B., van Berge Henegouwen, M., I, van Hillegersberg, R., van Veer, H., van Workum, F., Watson, D., I, Wijnhoven, B. P. L. and Gutschow, C. A. (2021). Fit-for-Discharge Criteria after Esophagectomy: An International Expert Delphi Consensus. Dis. Esophagus, 34 (6). CARY: OXFORD UNIV PRESS INC. ISSN 1442-2050

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Abstract

There are no internationally recognized criteria available to determine preparedness for hospital discharge after esophagectomy. This study aims to achieve international consensus using Delphi methodology. The expert panel consisted of 40 esophageal surgeons spanning 16 countries and 4 continents. During a 3-round, web-based Delphi process, experts voted for discharge criteria using 5-point Likert scales. Data were analyzed using descriptive statistics. Consensus was reached if agreement was >= 75% in round 3. Consensus was achieved for the following basic criteria: nutritional requirements are met by oral intake of at least liquids with optional supplementary nutrition via jejunal feeding tube. The patient should have passed flatus and does not require oxygen during mobilization or at rest. Central venous catheters should be removed. Adequate analgesia at rest and during mobilization is achieved using both oral opioid and non-opioid analgesics. All vital signs should be normal unless abnormal preoperatively. Inflammatory parameters should be trending down and close to normal (leucocyte count <= 12G/l and C-reactive protein <= 80 mg/dl). This multinational Delphi survey represents the first expert-led process for consensus criteria to determine 'fit-for-discharge' status after esophagectomy. Results of this Delphi survey may be applied to clinical outcomes research as an objective measure of short-term recovery. Furthermore, standardized endpoints identified through this process may be used in clinical practice to guide decisions regarding patient discharge and may help to reduce the risk of premature discharge or prolonged admission.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Mueller, P. C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kapp, J. R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Vetter, D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bonavina, L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Brown, W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Castro, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Cheong, E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Darling, G. E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Egberts, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ferri, L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gisbertz, S. S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gockel, I UNSPECIFIED UNSPECIFIED UNSPECIFIED Grimminger, P. P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hofstetter, W. L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoelscher, A. H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Low, D. E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Luyer, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Markar, S. R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Moenig, S. P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Moorthy, K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Morse, C. R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller-Stich, B. P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Nafteux, P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Nieponice, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Nieuwenhuijzen, G. A. P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Nilsson, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Palanivelu, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Pattyn, P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Pera, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Rasanen, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ribeiro, U. UNSPECIFIED UNSPECIFIED UNSPECIFIED Rosman, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schroeder, W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Sgromo, B. UNSPECIFIED UNSPECIFIED UNSPECIFIED van Berge Henegouwen, M., I UNSPECIFIED UNSPECIFIED UNSPECIFIED van Hillegersberg, R. UNSPECIFIED UNSPECIFIED UNSPECIFIED van Veer, H. UNSPECIFIED UNSPECIFIED UNSPECIFIED van Workum, F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Watson, D., I UNSPECIFIED UNSPECIFIED UNSPECIFIED Wijnhoven, B. P. L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gutschow, C. A. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-607731
DOI:	10.1093/dote/doaa101
Journal or Publication Title:	Dis. Esophagus
Volume:	34
Number:	6
Date:	2021
Publisher:	OXFORD UNIV PRESS INC
Place of Publication:	CARY
ISSN:	1442-2050
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language LENGTH-OF-STAY; ENHANCED RECOVERY; COLORECTAL SURGERY; RISK-FACTORS; READMISSION; MULTICENTER; CARE Multiple languages Gastroenterology & Hepatology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/60773