Enhanced recovery pathway in elderly patients undergoing colorectal surgery: is there an effect of increasing ages? Results from the perioperative Italian Society Registry.

Marco Braga, Luigi Beretta, Nicolo Pecorelli, Marianna Maspero, Umberto Casiraghi, Felice Borghi, Luca Pellegrino, Stefano Bona, Roberta Monzani, Gianluigi Ferrari, Danilo Radrizzani, Riccardo Iuliani, Carlo Bima, Marco Scatizzi, Giancarlo Missana, Marco Azzola Guicciardi, Andrea Muratore, Michele Crespi, Hedayat Bouzari, Andrea Pisani CerettiFerdinando Ficari

Research output: Contribution to journalArticle

Abstract

Previous studies reported that enhanced recovery pathway (ERP) is safe in elderly who did not require a specifically tailored protocol. In previous studies, elderly have been considered as a homogeneous cohort and the cut-off value to identify them was different. The aim of the present study is to assess the compliance to ERP and its impact on postoperative outcome in three subgroups of elderly patients with increasing ages. Prospectively collected data entered in an electronic Italian registry specifically designed for ERP were reviewed. 315 elderly patients undergoing elective colorectal resection were divided into three groups. Group 1: 71-75 years (n = 105), Group 2: 76-80 years (n = 117), Group 3: over 80 years (n = 93). Primary endpoints of the study were adherence to ERP and time to readiness for discharge (TRD). Compliance to ERP was similar in the three groups. No difference among groups was found for mortality, overall morbidity, major complications, reoperation rate and readmission rate. Median TRD and length of hospital stay (LOS) were progressively longer with increasing age (p = 0.018 and p = 0.078, respectively). Increasing age did not impact on adherence to ERP and postoperative morbidity, but delayed both TRD and LOS.
Original languageEnglish
JournalUpdates in Surgery
Publication statusPublished - Jun 1 2017

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Colorectal Surgery
Registries
Length of Stay
Morbidity
Reoperation
Mortality

Keywords

  • Colorectal surgery, Elderly, Enhanced recovery after surgery, Length of stay, Postoperative morbidity

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Enhanced recovery pathway in elderly patients undergoing colorectal surgery: is there an effect of increasing ages? Results from the perioperative Italian Society Registry. / Braga, Marco; Beretta, Luigi; Pecorelli, Nicolo; Maspero, Marianna; Casiraghi, Umberto; Borghi, Felice; Pellegrino, Luca; Bona, Stefano; Monzani, Roberta; Ferrari, Gianluigi; Radrizzani, Danilo; Iuliani, Riccardo; Bima, Carlo; Scatizzi, Marco; Missana, Giancarlo; Guicciardi, Marco Azzola; Muratore, Andrea; Crespi, Michele; Bouzari, Hedayat; Ceretti, Andrea Pisani; Ficari, Ferdinando.

In: Updates in Surgery, 01.06.2017.

Research output: Contribution to journalArticle

Braga, M, Beretta, L, Pecorelli, N, Maspero, M, Casiraghi, U, Borghi, F, Pellegrino, L, Bona, S, Monzani, R, Ferrari, G, Radrizzani, D, Iuliani, R, Bima, C, Scatizzi, M, Missana, G, Guicciardi, MA, Muratore, A, Crespi, M, Bouzari, H, Ceretti, AP & Ficari, F 2017, 'Enhanced recovery pathway in elderly patients undergoing colorectal surgery: is there an effect of increasing ages? Results from the perioperative Italian Society Registry.', Updates in Surgery.
Braga, Marco ; Beretta, Luigi ; Pecorelli, Nicolo ; Maspero, Marianna ; Casiraghi, Umberto ; Borghi, Felice ; Pellegrino, Luca ; Bona, Stefano ; Monzani, Roberta ; Ferrari, Gianluigi ; Radrizzani, Danilo ; Iuliani, Riccardo ; Bima, Carlo ; Scatizzi, Marco ; Missana, Giancarlo ; Guicciardi, Marco Azzola ; Muratore, Andrea ; Crespi, Michele ; Bouzari, Hedayat ; Ceretti, Andrea Pisani ; Ficari, Ferdinando. / Enhanced recovery pathway in elderly patients undergoing colorectal surgery: is there an effect of increasing ages? Results from the perioperative Italian Society Registry. In: Updates in Surgery. 2017.
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abstract = "Previous studies reported that enhanced recovery pathway (ERP) is safe in elderly who did not require a specifically tailored protocol. In previous studies, elderly have been considered as a homogeneous cohort and the cut-off value to identify them was different. The aim of the present study is to assess the compliance to ERP and its impact on postoperative outcome in three subgroups of elderly patients with increasing ages. Prospectively collected data entered in an electronic Italian registry specifically designed for ERP were reviewed. 315 elderly patients undergoing elective colorectal resection were divided into three groups. Group 1: 71-75 years (n = 105), Group 2: 76-80 years (n = 117), Group 3: over 80 years (n = 93). Primary endpoints of the study were adherence to ERP and time to readiness for discharge (TRD). Compliance to ERP was similar in the three groups. No difference among groups was found for mortality, overall morbidity, major complications, reoperation rate and readmission rate. Median TRD and length of hospital stay (LOS) were progressively longer with increasing age (p = 0.018 and p = 0.078, respectively). Increasing age did not impact on adherence to ERP and postoperative morbidity, but delayed both TRD and LOS.",
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AU - Braga, Marco

AU - Beretta, Luigi

AU - Pecorelli, Nicolo

AU - Maspero, Marianna

AU - Casiraghi, Umberto

AU - Borghi, Felice

AU - Pellegrino, Luca

AU - Bona, Stefano

AU - Monzani, Roberta

AU - Ferrari, Gianluigi

AU - Radrizzani, Danilo

AU - Iuliani, Riccardo

AU - Bima, Carlo

AU - Scatizzi, Marco

AU - Missana, Giancarlo

AU - Guicciardi, Marco Azzola

AU - Muratore, Andrea

AU - Crespi, Michele

AU - Bouzari, Hedayat

AU - Ceretti, Andrea Pisani

AU - Ficari, Ferdinando

PY - 2017/6/1

Y1 - 2017/6/1

N2 - Previous studies reported that enhanced recovery pathway (ERP) is safe in elderly who did not require a specifically tailored protocol. In previous studies, elderly have been considered as a homogeneous cohort and the cut-off value to identify them was different. The aim of the present study is to assess the compliance to ERP and its impact on postoperative outcome in three subgroups of elderly patients with increasing ages. Prospectively collected data entered in an electronic Italian registry specifically designed for ERP were reviewed. 315 elderly patients undergoing elective colorectal resection were divided into three groups. Group 1: 71-75 years (n = 105), Group 2: 76-80 years (n = 117), Group 3: over 80 years (n = 93). Primary endpoints of the study were adherence to ERP and time to readiness for discharge (TRD). Compliance to ERP was similar in the three groups. No difference among groups was found for mortality, overall morbidity, major complications, reoperation rate and readmission rate. Median TRD and length of hospital stay (LOS) were progressively longer with increasing age (p = 0.018 and p = 0.078, respectively). Increasing age did not impact on adherence to ERP and postoperative morbidity, but delayed both TRD and LOS.

AB - Previous studies reported that enhanced recovery pathway (ERP) is safe in elderly who did not require a specifically tailored protocol. In previous studies, elderly have been considered as a homogeneous cohort and the cut-off value to identify them was different. The aim of the present study is to assess the compliance to ERP and its impact on postoperative outcome in three subgroups of elderly patients with increasing ages. Prospectively collected data entered in an electronic Italian registry specifically designed for ERP were reviewed. 315 elderly patients undergoing elective colorectal resection were divided into three groups. Group 1: 71-75 years (n = 105), Group 2: 76-80 years (n = 117), Group 3: over 80 years (n = 93). Primary endpoints of the study were adherence to ERP and time to readiness for discharge (TRD). Compliance to ERP was similar in the three groups. No difference among groups was found for mortality, overall morbidity, major complications, reoperation rate and readmission rate. Median TRD and length of hospital stay (LOS) were progressively longer with increasing age (p = 0.018 and p = 0.078, respectively). Increasing age did not impact on adherence to ERP and postoperative morbidity, but delayed both TRD and LOS.

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JO - Updates in Surgery

JF - Updates in Surgery

SN - 2038-131X

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