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Cited by 476

The DOI matches its Crossref record; 42 of the 42 references it cites were found in a registry or an index.

Systematic review and meta-analysis of enhanced recovery programmes in surgical patients

Open access
Nicholson, A, Lowe, M C, Parker, J, Lewis, S R, Alderson, P, Smith, A F·2014·British Journal of Surgery
DOI 10.1002/bjs.9394
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Abstract

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.

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Metadata

Authors
Nicholson, A., Lowe, M. C., Parker, J., Lewis, S. R., Alderson, P., & Smith, A. F.
Venue
British Journal of Surgery
Publisher
Oxford University Press (OUP)
Published
2014-01-27
Volume
101
Issue
3
Pages
172-188
ISSN
  • 0007-1323 (ISSN-L)
  • 1365-2168
DOI
10.1002/bjs.9394
OpenAlex
W1717040908
Cited by
476
References
42
FWCI
10.01
Type
journal article
Language
en
Open access
bronze

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