Compliance with Guidelines of Enhanced Recovery After Surgery in Elderly Patients Undergoing Gastrectomy

Enhanced recovery after surgery (ERAS) aims at expediting postoperative recovery by implementing specific strategies in perioperative management. However, the tolerance to such fast-tracking protocols is under debate, especially in elderly patients. We aimed to investigate rate of compliance with th...

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Bibliographic Details
Published in:World journal of surgery 2017-04, Vol.41 (4), p.1040-1046
Main Authors: Jeong, Oh, Park, Young Kyu, Jung, Mi Ran, Ryu, Seong Yeob
Format: Article
Language:English
Subjects:
Aged
Clinical Protocols - standards
Compliance
Complications
Criteria
Female
Gastrectomy
Gastrectomy - methods
Gastric cancer
Gastrointestinal surgery
Guideline Adherence
Guidelines
Humans
Intravenous administration
Male
Middle Aged
Older people
Patient Compliance
Patients
Postoperative Care - methods
Recovery
Recovery (Medical)
Recovery of Function
Stomach Neoplasms - surgery
Surgery
Surgical outcomes
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Description
Summary:Enhanced recovery after surgery (ERAS) aims at expediting postoperative recovery by implementing specific strategies in perioperative management. However, the tolerance to such fast-tracking protocols is under debate, especially in elderly patients. We aimed to investigate rate of compliance with the main ERAS guidelines in elderly gastrectomy patients. Using data for 168 gastric cancer patients who underwent ERAS after gastrectomy as part of Clinical Trial NCT01653496, we calculated the rates of compliance with nine main ERAS guidelines and compared the compliance rates of elderly (≥70 years) and non-elderly (90%) for every ERAS guideline. Notably, the overall compliance rates did not differ significantly between the groups. Postoperatively, the mean time to fulfillment of discharge criteria was slightly longer for elderly patients (4.7 vs. 4.2 days, p = 0.005), but there were no significant differences between the groups with respect to the incidence of postoperative complications, length of hospitalization, and readmission rate. Compliance of the medically and physically fit elderly patients with the main ERAS guidelines is comparable to that of non-elderly patients, and such protocols can be safely applied to elderly patients without significant modification.
ISSN:0364-2313
1432-2323
DOI:10.1007/s00268-016-3845-y