期刊
BRITISH JOURNAL OF SURGERY
卷 101, 期 3, 页码 172-188出版社
OXFORD UNIV PRESS
DOI: 10.1002/bjs.9394
关键词
-
类别
资金
- ESA Meta-Analysis Grants Programme of the European Society of Anaesthesiology
- National Institute for Health Research (NIHR) Cochrane Collaboration Programme [10/4001/04]
Background: Enhanced recovery programmes (ERPs) have been developed over the past 10 years to improve patient outcomes and to accelerate recovery after surgery. The existing literature focuses on specific specialties, mainly colorectal surgery. The aim of this review was to investigate whether the effect of ERPs on patient outcomes varies across surgical specialties or with the design of individual programmes. Methods: MEDLINE, Embase, CINAHL and the Cochrane Central Register of Controlled Trials were searched from inception to January 2013 for randomized or quasi-randomized trials comparing ERPs with standard care in adult elective surgical patients. Results: Thirty-eight trials were included in the review, with a total of 5099 participants. Study design and quality was poor. Meta-analyses showed that ERPs reduced the primary length of stay (standardized mean difference -1.14 (95 per cent confidence interval -1.45 to -0.85)) and reduced the risk of all complications within 30 days (risk ratio (RR) 0.71, 95 per cent c.i. 0.60 to 0.86). There was no evidence of a reduction in mortality (RR 0.69, 95 per cent c.i. 0.34 to 1.39), major complications (RR 0.95, 0.69 to 1.31) or readmission rates (RR 0.96, 0.59 to 1.58). The impact of ERPs was similar across specialties and there was no consistent evidence that elements included within ERPs affected patient outcomes. Conclusion: ERPs are effective in reducing length of hospital stay and overall complication rates across surgical specialties. It was not possible to identify individual components that improved outcome. Qualitative synthesis may be more appropriate to investigate the determinants of success.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据