Evaluating enhanced recovery after surgery: time to cover new ground and discover the missing patient voice

Perioperative Medicine

Anthony Hemsley¹  Jo Thompson Coon²  Simon Briscoe²  Rob Anderson²  Michael Nunns²  Liz Shaw²  David Thomas³  Joseph B. John³  Christopher J. Lovegrove⁴  John S. McGrath⁵  Michael G. Mythen⁶ 

[1] Department of Healthcare for Older People, Royal Devon & Exeter NHS Foundation Trust, Exeter, UK;Exeter HS&DR Evidence Synthesis Centre, Institute of Health Research, University of Exeter Medical School, University of Exeter, South Cloisters, St Luke’s Campus, Heavitree Road, EX1 2 LU, Exeter, Devon, UK;Royal Devon & Exeter NHS Foundation Trust, Exeter, UK;Royal Devon & Exeter NHS Foundation Trust, Exeter, UK;School of Health Professions, Faculty of Health & Human Sciences, Plymouth University, Plymouth, UK;Royal Devon & Exeter NHS Foundation Trust, Exeter, UK;University of Exeter Medical School, Exeter, UK;University College London Hospitals, National Institute of Health Research Biomedical Research Centre, London, UK;

关键词: Enhanced recovery after surgery;    ERAS;    ERP;    Prehabilitation;    Rehabilitation;    Elective surgery;    Meta-analysis;    Recovery;    Complications;    Elderly;   

DOI  :  10.1186/s13741-020-00157-1

来源: Springer

【 摘 要 】

Multicomponent peri-operative interventions offer to accelerate patient recovery and improve cost-effectiveness. The recent National Institute of Health Research-commissioned evidence synthesis review by Nunns et al. considers the effectiveness and cost-effectiveness of all types of multicomponent interventions for older adults undergoing elective inpatient surgery. Enhanced recovery programmes (ERPs) were the most commonly evaluated intervention. An association between ERPs and decreased length of stay was observed, whilst complication rates and time to recovery were static or sometimes reduced. Important areas which lack research in the context of ERPs are patient-reported outcome measures, patients with complex needs and assessment of factors pertaining to successful ERP implementation. The next generation of ERP studies should seek to develop our understanding in these key areas.

【 授权许可】

CC BY