ERAS Compliance

A higher overall ERAS completion rate independently reduces the number of postoperative recovery days. PONV prevention is the single cost-increasing ERAS measure that also significantly shortens recovery duration, and has the smallest cost impact of the five cost-increasing measures, making it the highest-priority measure to retain in simplified ERAS versions. A compliance threshold of ≥70% was defined as adequate, based on evidence that this level carries an odds ratio of 0.15 for complications and is associated with shorter length of stay. The very high completion rates for avoidance-based measures reflected both the centre's mature ERAS protocol and the predominantly young-to-middle-aged patient demographic with few comorbidities. Chewing gum was not routinely used because most patients achieved early postoperative intestinal recovery, making this ERAS measure clinically unnecessary.