Enhanced recovery after surgery (ERAS) program in octogenarian patients: a propensity score matching analysis on the "Lazio Network" database.
Colorectal surgery
ERAS guidelines
Elderly
Oncologic surgery
Journal
Langenbeck's archives of surgery
ISSN: 1435-2451
Titre abrégé: Langenbecks Arch Surg
Pays: Germany
ID NLM: 9808285
Informations de publication
Date de publication:
Nov 2022
Nov 2022
Historique:
received:
18
11
2021
accepted:
01
06
2022
pubmed:
14
6
2022
medline:
10
11
2022
entrez:
13
6
2022
Statut:
ppublish
Résumé
The aim of this study was to evaluate the safety and compliance with the enhanced recovery after surgery (ERAS) protocol in octogenarian patients undergoing colorectal surgery in 12 Italian high-volume centers. A retrospective analysis was conducted in a consecutive series of patients who underwent elective colorectal surgery between 2016 and 2018. Patients were grouped by age (≥ 80 years vs < 80 years), propensity score matching (PSM) analysis was performed, and the groups were compared regarding clinical outcomes and the mean number of ERAS items applied. Out of 1646 patients identified, 310 were octogenarians. PSM identified 2 cohorts of 125 patients for the comparison of postoperative outcomes and ERAS compliance. The 2 groups were homogeneous regarding the clinical variables and mean number of ERAS items applied (11.3 vs 11.9, p-ns); however, the application of intraoperative items was greater in nonelderly patients (p 0.004). The functional recovery was similar between the two groups, as were the rates of postoperative severe complications and 30-day mortality rate. Elderly patients had more overall complications. Furthermore, the mean hospital stay was higher in the elderly group (p 0.027). Multivariable analyses documented that postoperative stay was inversely correlated with the number of ERAS items applied (p < 0.0001), whereas age ≥ 80 years significantly correlated with the overall complication rate (p 0.0419). The ERAS protocol is safe in octogenarian patients, with similar levels of compliance and surgical outcomes. However, octogenarian patients have a higher rate of overall complications and a longer hospital stay than do younger patients.
Identifiants
pubmed: 35697818
doi: 10.1007/s00423-022-02580-y
pii: 10.1007/s00423-022-02580-y
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3079-3088Investigateurs
Domenico Spoletini
(D)
Rosa Marcellinaro
(R)
Filippo Palla
(F)
Gian Marco Giorgetti
(GM)
Domenico D 'Ugo
(D)
Liliana Sollazzi
(L)
Maria Cristina Mele
(MC)
Antonio Gasbarrini
(A)
Francesco Brunetti
(F)
Emanuele Rinninnella
(E)
Marco Cintoni
(M)
Enrica Adducci
(E)
Giovanni Battista Levi Sandri
(GB)
Paola Marino
(P)
Raffaello Mancini
(R)
Marcello Gasparrini
(M)
Fabrizio Apponi
(F)
Fabiana Troisi
(F)
Gherardo Romeo
(G)
Giuseppe Pedullà
(G)
Raffaele Donadio
(R)
Giulia Russo
(G)
Lorenzo Firmi
(L)
Andrea Mazzari
(A)
Paolo Diamanti
(P)
Lucilla Muccichini
(L)
Damiano Menghetti
(D)
Augusto Belardi
(A)
Riccardo Angeloni
(R)
Elena Bonasera
(E)
Danela Cappelloni
(D)
Luciana Minieri
(L)
Andrea Sagnotta
(A)
Gloria Folliero
(G)
Luigi Solinas
(L)
Pietro Maria Amodio
(PM)
Alessandro Arturi
(A)
Corrado Ferraris
(C)
Giorgio Capuano
(G)
Eugenia Puleo
(E)
Matteo De Stefano
(M)
Marcello Palladino
(M)
Francesca Pietrosanti
(F)
Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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