Enhanced recovery pathway in elderly patients undergoing colorectal surgery: is there an effect of increasing ages? Results from the perioperative Italian Society Registry.

Autor: Braga M; Department of Surgery, San Raffaele Hospital, Vita-Salute University, Via Olgettina 60, 20132, Milan, Italy. braga.marco@hsr.it., Beretta L; Department of Anesthesiology, San Raffaele Hospital, Vita-Salute University, Milan, Italy., Pecorelli N; Department of Surgery, San Raffaele Hospital, Vita-Salute University, Via Olgettina 60, 20132, Milan, Italy., Maspero M; Department of Surgery, San Raffaele Hospital, Vita-Salute University, Via Olgettina 60, 20132, Milan, Italy., Casiraghi U; Department of Surgery, San Raffaele Hospital, Vita-Salute University, Via Olgettina 60, 20132, Milan, Italy., Borghi F; Department of Surgery, Cuneo Hospital, Chicago, USA., Pellegrino L; Department of Surgery, Cuneo Hospital, Chicago, USA., Bona S; Department of Surgery, Humanitas Hospital Milan, Milan, Italy., Monzani R; Department of Anesthesiology, Humanitas Hospital Milan, Milan, Italy., Ferrari G; Department of Surgery, Legnano Hospital, Legnano, Italy., Radrizzani D; Department of Anesthesiology, Legnano Hospital, Legnano, Italy., Iuliani R; Department of Surgery, Cottolengo Hospital Turin, Turin, Italy., Bima C; Department of Surgery, Cottolengo Hospital Turin, Turin, Italy., Scatizzi M; Department of Surgery, Prato Hospital, Prato, Italy., Missana G; Department of Surgery, Casa di Cura Città di Udine, Udine, Italy., Guicciardi MA; Department of Surgery, Cantù Hospital, Cantù, Italy., Muratore A; Department of Surgery, Candiolo Hospital, Turin, Italy., Crespi M; Department of Surgery, Luigi Sacco Hospital, Milan, Italy., Bouzari H; Department of Surgery, Mauriziano Hospital Turin, Turin, Italy., Ceretti AP; Department of Surgery, San Paolo Hospital, São Paulo, Brazil., Ficari F; Department of Surgery, Careggi Hospital, University of Florence, Florence, Italy.
Jazyk: angličtina
Zdroj: Updates in surgery [Updates Surg] 2018 Mar; Vol. 70 (1), pp. 7-13. Date of Electronic Publication: 2017 Jun 15.
DOI: 10.1007/s13304-017-0474-4
Abstrakt: Previous studies reported that enhanced recovery pathway (ERP) is safe in elderly who did not require a specifically tailored protocol. In previous studies, elderly have been considered as a homogeneous cohort and the cut-off value to identify them was different. The aim of the present study is to assess the compliance to ERP and its impact on postoperative outcome in three subgroups of elderly patients with increasing ages. Prospectively collected data entered in an electronic Italian registry specifically designed for ERP were reviewed. 315 elderly patients undergoing elective colorectal resection were divided into three groups. Group 1: 71-75 years (n = 105), Group 2: 76-80 years (n = 117), Group 3: over 80 years (n = 93). Primary endpoints of the study were adherence to ERP and time to readiness for discharge (TRD). Compliance to ERP was similar in the three groups. No difference among groups was found for mortality, overall morbidity, major complications, reoperation rate and readmission rate. Median TRD and length of hospital stay (LOS) were progressively longer with increasing age (p = 0.018 and p = 0.078, respectively). Increasing age did not impact on adherence to ERP and postoperative morbidity, but delayed both TRD and LOS.
Databáze: MEDLINE
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