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老年患者结直肠手术后的加速康复(ERAS)是可行的,且能取得与年轻患者相似的效果。

Enhanced Recovery After Colorectal Surgery (ERAS) in Elderly Patients Is Feasible and Achieves Similar Results as in Younger Patients.

作者信息

Forsmo Håvard Mjørud, Erichsen Christian, Rasdal Anne, Körner Hartwig, Pfeffer Frank

机构信息

Haukeland University Hospital, Bergen, Norway.

University of Bergen, Norway.

出版信息

Gerontol Geriatr Med. 2017 May 2;3:2333721417706299. doi: 10.1177/2333721417706299. eCollection 2017 Jan-Dec.

Abstract

Enhanced recovery after surgery (ERAS) is a multimodal approach that aims to optimize perioperative treatment. Whether elderly patients receiving colorectal surgery can adhere to and benefit from an ERAS approach is uncertain. The aim of this study was to compare patients in different age groups participating in an ERAS program. In this substudy of a randomized controlled trial, we analyzed the interventional ERAS arm of adult patients eligible for laparoscopic or open colorectal resection with regard to the importance of age. Patients were divided into three groups based on age: ≤65 years ( = 79), 66-79 years ( = 56), and ≥80 years ( = 19). The primary end point was total postoperative hospital stay (THS). Secondary end points were postoperative hospital stay, postoperative complications, postoperative C-reactive protein levels, readmission rate, mortality, and patient adherence to the different ERAS elements. All parameters and measuring the adherence to the ERAS protocol were recorded before surgery, on the day of the operation, and daily until discharge. There were no significant differences in length of THS between age groups (≤65 years, median 5 [range 2-47] days; 66-79 years, median 5.5 [range 2-36] days; ≥80 years, median 7 [range 3-50] days; = .53). All secondary outcomes were similar between age groups. Patient adherence to the ERAS protocol was as good in the elderly as it was in the younger patients. Elderly patients adhered to and benefited from an ERAS program, similar to their younger counterparts.

摘要

术后加速康复(ERAS)是一种旨在优化围手术期治疗的多模式方法。接受结直肠手术的老年患者能否坚持并从ERAS方法中获益尚不确定。本研究的目的是比较参与ERAS项目的不同年龄组患者。在这项随机对照试验的子研究中,我们分析了符合腹腔镜或开放结直肠切除术条件的成年患者的介入性ERAS组,以探讨年龄的重要性。根据年龄将患者分为三组:≤65岁(n = 79)、66 - 79岁(n = 56)和≥80岁(n = 19)。主要终点是术后总住院时间(THS)。次要终点包括术后住院时间、术后并发症、术后C反应蛋白水平、再入院率、死亡率以及患者对不同ERAS要素的依从性。所有参数以及对ERAS方案依从性的测量均在手术前、手术当天以及直至出院每天进行记录。年龄组之间的THS长度无显著差异(≤65岁,中位数5天[范围2 - 47天];66 - 79岁,中位数5.5天[范围2 - 36天];≥80岁,中位数7天[范围3 - 50天];P = 0.53)。各年龄组之间所有次要结局均相似。老年患者对ERAS方案的依从性与年轻患者一样好。老年患者坚持并从ERAS项目中获益,与年轻患者相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6880/5419065/d2525478f1af/10.1177_2333721417706299-fig1.jpg

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