Enhanced Recovery After Surgery® in Octogenarians Undergoing Hepatopancreatobiliary Surgery

Autor: Jordan N. Robinson, Joshua M. K. Davis, Ryan C. Pickens, Allyson R. Cochran, Lacey King, Patrick Salibi, David A. Iannitti, John B. Martinie, Erin H. Baker, Lee M. Ocuin, Dionisios Vrochides
Rok vydání: 2021
Předmět:
Zdroj: The American Surgeon. :000313482110540
ISSN: 1555-9823
0003-1348
Popis: Advances in perioperative care have increased the frequency of surgical intervention performed on the very elderly (≥80 years). This study aims to investigate the impact of Enhanced Recovery After Surgery (ERAS) on outcomes for octogenarians after major hepatopancreatobiliary (HPB) surgery. Patients ≥80 years old in a single HPB ERAS program (September 2015-July 2018) were prospectively tracked in the ERAS Interactive Audit System (EIAS). Postoperative length of stay (LOS) as well as 30-day major complications, readmissions, and mortality were compared to a pre-ERAS octogenarian control. Since ERAS implementation, octogenarians comprised 7.3% (27 of 370) of patients who underwent pancreaticoduodenectomy (n=17), distal pancreatectomy (n=7), or hepatectomy (n=3). Thirty-day readmissions decreased after ERAS implementation (50% to 15%, P=.037). Thirty-day major complications, mortality, and LOS were similar with 64% median protocol compliance. ERAS for octogenarians in HPB surgery is safe and may contribute to more sustainable recovery resulting in reduced readmissions.
Databáze: OpenAIRE