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 63
- Downloads 0
Letter to the Editor Regarding “Tips on Reporting Systematic Reviews”
Dear Editor, In response to the letter, We are grateful to reader of paper for his interesting correspondence on our paper [1]. Actually in our paper we focused on generated framework rather than a review study. We syste...
Management of Intrarticular Fractures of Distal End of Humerus using Modification of the Triceps Aponeurosis Tongue Approach
Objective: To evaluate the functional outcome and extensor apparatus of operative management of intra-articular fractures of distal humerus using modification of the Triceps Tongue Flap approach. Methods: This prospectiv...
Management of Deep Vein Thrombosis (DVT) Prophylaxis in Trauma Patients
Deep vein thrombosis (DVT) and pulmonary embolism (PTE) are known as venous thromboembolism (VTE). DVT occurs when a thrombus (a blood clot) forms in deep veins of the body, usually in the lower extremities. It can cause...
Effects of Unilateral Iatrogenic Vas Deferens Trauma on Fertility: An Experimental In Vitro Fertilization Mice Model Study
Objective: To determine bilateral effects of unilateral iatrogenic vas deferens trauma (UIT) on epididymal sperm characteristics and in vitro fertilizing capacity in an experimental mouse model. Methods: Experiments were...
Modified Stoppa Approach versus Ilioinguinal Approach for Anterior Acetabular Fractures; A Systematic Review and Meta-Analysis
Introduction: Modified Stoppa approach was introduced as an alternative to ilioinguinal approach for management of anterior fractures of acetabulum in order to reduce complications of the latter. However, the efficacy of...