Enhanced Recovery after Emergency Surgery: A Systematic Review
Journal Title: Bulletin of Emergency And Trauma - Year 2017, Vol 5, Issue 2
Abstract
Objective: To evaluate the current scientific evidence for the applicability, safety and effectiveness of pathways of enhanced recovery after emergency surgery (ERAS). Methods: We undertook a search using PubMed and Cochrane databases for ERAS protocols in emergency cases. The search generated 65 titles; after eliminating the papers not meeting search criteria, we selected 4 cohort studies and 1 randomized clinical trial (RCT). Data extracted for analysis consisted of: patient age, type of surgery performed, ERAS elements implemented, surgical outcomes in terms of postoperative complications, mortality, length of stay (LOS) and readmission rate. Results: The number of ERAS items applied was good, ranging from 11 to 18 of the 20 recommended by the ERAS Society. The implementation resulted in fewer postoperative complications. LOS for ES patients was shorter when compared to conventional care. Mortality, specifically reported in three studies, was equal or lower with ERAS. Readmission rates varied widely and were generally higher for the intervention group but without statistical significance. Conclusions: The studies reviewed agreed that ERAS in emergency surgery (ES) was feasible and safe with generally better outcomes. Lower compliance with some of the ERAS items shows the need for the protocol to be adapted to ES patients. More evidence is clearly required as to what can improve outcomes and how this can be formulated into an effective care pathway for the heterogeneous ES patient.
Authors and Affiliations
Mihai Paduraru, Luca Ponchietti, Isidro Martinez Casas, Peter Svenningsen, Mauro Zago
Keywords
Related Articles
- EP ID EP296421
- DOI -
- Views 51
- Downloads 0
Functional Outcome of Resection versus Reconstruction in Mason II-III Radial Head Fractures; A Short-Term Prospective Study
Objective: To compare the short-term functional outcome between resection and reconstruction in Mason Type II and Type III radial head fractures using Broberg and Morrey score. Methods: A prospective cohort study was con...
Symptomatic Chiari Malformation with Syringomyelia after Severe Traumatic Brain Injury: Case Report
Chiari malformation Type I (CM-I) is a congenital disorder, which is basically a tonsillar herniation (≥ 5 mm) below the foramen magnum with or without syringomyelia. The real cause behind this malformation is still unkn...
Tips on Reporting a Systematic Review
Dear Editor, Dehghani et al. have provided remarkable results in their recent article in your esteemed journal; A Step-by-Step Framework on Discrete Events Simulation in Emergency Department; A Systematic Review, Volume...
Experience and Availability of Pelvic Binders at Swedish Trauma Units; A Nationwide Survey
Objective: To assess availability, experience, and knowledge about the Pelvic Circumferential Compression Device (PCCD) in Sweden. Methods: A telephone interview with the current on-call trauma doctors at all trauma unit...
Functional, Histopathological and Immunohistichemical Assessments of Cyclosporine A on Sciatic Nerve Regeneration Using Allografts: A Rat Sciatic Nerve Model
Objectives: To study the functional, histopathological and immunohistochemical effect of cyclosporine A on sciatic nerve regeneration using allografts in a rat sciatic nerve model. Methods: Thirty male white Wistar rats...