Evidence map›Paper›PMID 24337734›Full record

Trial reportLangenbeck's archives of surgery2014

Fast-track surgery decreases the incidence of postoperative delirium and other complications in elderly patients with colorectal carcinoma.

Yitao Jia, Guixing Jin, Shangwei Guo, Bin Gu, Zujian Jin, Xing Gao, Zhongxin Li

Registry-linked trialOpen access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Langenbeck's archives of surgery, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04016740 (Perioperative Multimodal General Anesthesia Focusing on Specific CNS Targets in Patients Undergoing Cardiac Surgeries), which is not on this map. Cited by 55 papers, 16 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
55citing papers in PubMed, 16 pooled it
3.8field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04016740 early_phase1completednot on this mapstarted 2019, after this paper: background citation

Perioperative Multimodal General Anesthesia Focusing on Specific CNS Targets in Patients Undergoing Cardiac Surgeries

TypeinterventionalSponsorBeth Israel Deaconess Medical CenterRan2019 to 2020Enrolled22ConditionsCoronary Artery Disease, DeliriumArmsRopivacaine, Ketamine, Remifentanil, Dexmedetomidine, Rocuronium
3 · Its place in the literature

Who cites it

55 citing papers in PubMed, 16 syntheses or guidelines pooled it, 121 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Pooled it
  10. Pooled it
  11. Pooled it
  12. Pooled it
  13. Pooled it
  14. Enhanced Recovery After Surgery (ERASWorld journal of surgery · 2017
    Pooled it
  15. Pooled it
  16. Interventions for preventing delirium in hospitalised non-ICU patients.The Cochrane database of systematic reviews · 2016
    Pooled it
  17. Trial
  18. Feasibility of Fast-Track Surgery in Elderly Patients with Gastric Cancer.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2015
    Trial
  19. Review
  20. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 1 country.

Yitao JiaOncology Department, Hebei General Hospital, Shijiazhuang, Hebei, China, jiayitao99@163.com.
Guixing Jin
Shangwei Guo
Bin Gu
Zujian Jin
Xing Gao
Zhongxin Li
Second Hospital of Hebei Medical University · CNFirst Affiliated Hospital of Hebei Medical University · CNHebei General Hospital · CNHebei Medical University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis study aims to investigate the role of fast-track surgery in preventing the development of postoperative delirium and other complications in elderly patients with colorectal carcinoma.

methodsA total of 240 elderly patients with colorectal carcinoma (aged ≥70 years) undergoing open colorectal surgery was randomly assigned into two groups, in which the patients were managed perioperatively either with traditional or fast-track approaches. The length of hospital stay (LOS) and time to pass flatus were compared. The incidence of postoperative delirium and other complications were evaluated. Serum interleukin-6 (IL-6) levels were determined before and after surgery.

resultsThe LOS was significantly shorter in the fast-track surgery (FTS) group than that in the traditional group. The recovery of bowel movement (as indicated by the time to pass flatus) was faster in the FTS group. The postoperative complications including pulmonary infection, urinary infection and heart failure were significantly less frequent in the FTS group. Notably, the incidence of postoperative delirium was significantly lower in patients with the fast track therapy (4/117, 3.4 %) than with the traditional therapy (15/116, 12.9 %; p = 0.008). The serum IL-6 levels on postoperative days 1, 2, and 3 in patients with the fast-track therapy were significantly lower than those with the traditional therapy (p < 0.001).

conclusionsCompared to traditional perioperative management, fast-track surgery decreases the LOS, facilitates the recovery of bowel movement, and reduces occurrence of postoperative delirium and other complications in elderly patients with colorectal carcinoma. The lower incidence of delirium is at least partly attributable to the reduced systemic inflammatory response mediated by IL-6.

Indexed as

AgedAged, 80 and overColorectal NeoplasmsDeliriumFemaleHumansIncidenceInterleukin-6Length of StayMaleNeoplasm StagingPerioperative CarePostoperative ComplicationsInterleukin-6

Identifiers

PMID24337734
PMCPMC3890038
OpenAlexW2017074925

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.