Are enhanced recovery protocols after pancreatoduodenectomy still efficient when applied in elderly patients? A systematic review and individual patient data meta‐analysis
Rattachement africain : ch, gb, it, nl, us, gr, kr, ca, se. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
BACKGROUND: This meta-analysis investigated the effects of enhanced recovery after surgery (ERAS) protocols compared to conventional care on postoperative outcomes in patients aged 70 years or older undergoing pancreatoduodenectomy (PD). METHODS: Five databases were systematically searched. Comparative studies with available individual patient data (IPD) were included. The main outcomes were postoperative morbidity, length of stay, readmission and postoperative functional recovery elements. To assess an age-dependent effect, the group was divided in septuagenarians (70-79 years) and older patients (≥80 years). RESULTS: IPD were obtained from 15 of 31 eligible studies comprising 1109 patients. The overall complication and major complication rates were comparable in both groups (OR 0.92 [95% CI: 0.65-1.29], p = .596 and OR 1.22 [95% CI: 0.61-2.46], p = .508). Length of hospital stay tended to be shorter in the ERAS group compared to the conventional care group (-0.14 days [95% CI: -0.29 to 0.01], p = .071) while readmission rates were comparable and the total length of stay including days in hospital after readmission tended to be shorter in the ERAS group (-0.28 days [95% CI: -0.62 to 0.05], p = .069). In the subgroups, the length of stay was shorter in octogenarians treated with ERAS (-0.36 days [95% CI: -0.71 to -0.004], p = .048). The readmission rate increased slightly but not significantly while the total length of stay was not longer in the ERAS group. CONCLUSION: ERAS in the elderly is safe and its benefits are preserved in the care of even in patients older than 80 years. Standardized care protocol should be encouraged in all pancreatic centers.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Are enhanced recovery protocols after pancreatoduodenectomy still efficient when applied in elderly patients? A systematic review and individual patient data meta‐analysis
- Date Crossref
- 29/01/2024
- Éditeur
- Wiley
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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University Hospital of Basel pays non établi dans la noticeÉtablissement de santé
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University Hospital Southampton NHS Foundation Trust Hepatobiliary and Pancreatic Surgical Unit pays non établi dans la noticeÉtablissement de santé
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Fondazione Poliambulanza Istituto Ospedaliero pays non établi dans la noticeÉtablissement de santé
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Vita-Salute San Raffaele University pays non établi dans la noticeUniversité ou école supérieure
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Maastricht University Department of Surgery pays non établi dans la noticeUniversité ou école supérieure
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University of Milano-Bicocca Department of Surgery pays non établi dans la noticeUniversité ou école supérieure
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University of Washington HPB Surgery pays non établi dans la noticeUniversité ou école supérieure
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University of Washington Applied Physics Laboratory pays non établi dans la noticeStructure de recherche
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Metropolitan Hospital Department of HPB Surgery pays non établi dans la noticeÉtablissement de santé
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Ulsan College Department of Surgery pays non établi dans la noticeUniversité ou école supérieure
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Asan Medical Center pays non établi dans la noticeÉtablissement de santé
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University of Ulsan pays non établi dans la noticeUniversité ou école supérieure
University Hospital of Basel, Hepatobiliary and Pancreatic Surgical Unit — University Hospital Southampton NHS Foundation Trust et Fondazione Poliambulanza Istituto Ospedaliero, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.