A systematic review of enhanced recovery care after colorectal surgery in elderly patients

Bagnall, Nigel Mark; Malietzis, George; Kennedy, Robin H.; Athanasiou, Thanos; Faiz, Omar; Darzi, Ara

doi:10.1111/codi.12718

Cited by 180 publications

(119 citation statements)

References 53 publications

(148 reference statements)

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“…This finding is in line with other reports [13]. A recent systematic review on the efficacy of the ERAS protocol in bowel surgery suggests the efficacy of the same protocol of perioperative management in terms of outcomes (morbidity, mortality, and length of stay in hospital post-surgery) without substantial differences between the youngest and very old [14]. Analysis of pharmacological data for the region of Lazio, which gathers data related to pharmacological prescriptions delivered by public and private pharmacies of the Region, showed of prevalence of pharmaceutical drug use in the 65+ age-group in 2010 [15].…”

Section: Importance Of the Issue And Epidemiological Datasupporting

confidence: 91%

Age-related prevalence of non-cardiac surgery indications

Agabiti

2017

Monaldi Arch Chest Dis

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A clear trend in Italy over the last 20 years has been the increasing prevalence of "very old" people (over 75 years of age) within the general population. Routine statistics as well as population surveys and ad hoc epidemiological studies all confirm this trend. The proportion of socalled "very old patients in good health" is the category which is increasing the most. This is due to the economic well-being and generally good living conditions in Italy as well as progress in medical care and the introduction of new treatments and technologies in clinical practice that have improved survival and quality of life. The presence of an increasing number of very old people in the population, with consequent change of the population's health needs, represents a great challenge both for the healthcare system and for society as a whole. Importance of the issue and epidemiological dataBased on ISTAT (Italian National Bureau of Statistics), Italy has 6,828,610 individuals who are aged over 75 years, corresponding to 11% of the total population, and more than 4.7 million elderlies aged between 75 and 84 years, representing as much as 7.8% of the total population. The group of the "oldest old" (aged ≥ 85 years) comprises more than 1.9 million individuals, corresponding to 3.2% of the total population living in Italy. The category of the "oldest old" is the one showing the greatest increase over the years, passing from 3.5% (of the >65 years of age) in 2010 to 5.2% in 2016 [1][2][3]. Among the conditions of surgical risk in the elderly, one of the most frequent is hip fracture. In Italy, in 2014, there were reported 117,436 hospital admissions for hip fracture, 80% of which were among people aged >75 years [4]. Data on the clinical characteristics of patients who undergo non cardiac surgery are available in the international literature. Guidelines recommend standardized management protocols for elderly surgery patients and diverse strategies have been proposed for assessing the preoperative risk in the more advanced ages [5][6][7][8]. Also in Italy, several studies have documented the impact of elderly age in non cardiac surgery and, in particular, the problem of comorbidity [2,9]. A recent epidemiological study reported the clinical characteristics of patients admitted for hip fracture between 2007 and 2010 to hospitals in the Lazio region, based on data from the Hospital Information System (Sistema Informativo Ospedaliero, SIO). The prevalence of diabetes was 6.1%, heart disease 21.2%, cerebrovascular disease 14.7%, hypertension 30.7%, diseases of the central nervous system 11.6%, chronic kidney disease (CKD) 6.3%, and chronic obstructive pulmonary disease (COPD) 6.3%. These comorbidities played a significant role both in reducing the probability of early surgery (considered fundamental for a good prognosis, but overall only 20.3% were operated within 48 hours) -as well as an adverse prognostic factor for mortality at 30 days (overall 30-day mortality 7.5%) [10]. In a larger sample of patients with hip fracture ident...

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Section: Importance Of the Issue And Epidemiological Datasupporting

confidence: 91%

Age-related prevalence of non-cardiac surgery indications

Agabiti

2017

Monaldi Arch Chest Dis

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“…A systematic review focusing on elderly colorectal patients and enhanced recovery protocols conducted by Bagnall et al (34) had similar findings. However in this systematic review studies prior to the publication of ERAS consensus guidelines were included and the mean age was used to meet the criterion for elderly.…”

Section: Discussionmentioning

confidence: 65%

“…It is the first of its kind with this focus. Several well documented systematic reviews have been undertaken with regard to the feasibility of ERAS, but less so for ERAS and elderly (34). and none in relation to emergency surgery.…”

Section: Discussionmentioning

confidence: 99%

Enhanced Recovery After Surgery (ERAS) - The Evidence in Geriatric Emergency Surgery: A Systematic Review

Paduraru¹,

Ponchietti²,

Casas³

et al. 2017

chr

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“…В то же время существуют опасения, что для пациентов пожилого и старческого возраста чрезмерно ранние активизация и питание могут быть непереносимы или вредны. Систематиче-ский обзор проведенных в данном отношении иссле-дований, включая 2 рандомизированных контроли-руемых исследования, показал, что даже у пожилых пациентов ERAS-протоколы позволяют значительно снизить долю осложнений (по данным одного из них -с 57 до 27 %) и сократить время госпитализации (с 13 до 9 сут) [11]. Онкологическая ONCOLOGY ТОМ 6 / VOL.…”

Section: Discussionunclassified

Effect of standardized algorithm for perioperative management on the results of right-sided hemicolectomy in elderly patients

Лядов¹,

Кочатков²,

Negardinov³

2016

Onkol. koloproktol.

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A systematic review of enhanced recovery care after colorectal surgery in elderly patients

Abstract: ERAS can be safely applied to elderly patients to reduce complications and shorten length of hospital stay. Further studies are required to assess whether elderly patients are able to adhere to, and benefit from, ERAS protocols to the same extent as younger patients.

Cited by 180 publications

References 53 publications

Age-related prevalence of non-cardiac surgery indications

Age-related prevalence of non-cardiac surgery indications

Enhanced Recovery After Surgery (ERAS) - The Evidence in Geriatric Emergency Surgery: A Systematic Review

Effect of standardized algorithm for perioperative management on the results of right-sided hemicolectomy in elderly patients

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