Evidence map›Paper›PMID 32488821›Full record

ArticleUpdates in surgery2020

Feasibility and safety of an enhanced recovery protocol (ERP) for upper GI surgery in elderly patients (≥ 75 years) in a high-volume surgical center.

Carlo Alberto De Pasqual, Lorena Torroni, Maria Clelia Gervasi, Luca Alberti, Valentina Mengardo, Beatrice Benedetti, Simone Giacopuzzi, Jacopo Weindelmayer

Abstract read
PubMed Publisher
In one paragraph

Article in Updates in surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.8field-weighted citation impact, top 27% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 6 citations in OpenAlex.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Carlo Alberto De PasqualDivision of General and Upper GI Surgery, Department of Surgery, University of Verona, Piazzale Stefani, 1, 37124, Verona, Italy. carlodepasqual@gmail.com.ORCID http://orcid.org/0000-0001-7719-258X
Lorena TorroniUnit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
Maria Clelia GervasiDivision of General and Upper GI Surgery, Department of Surgery, University of Verona, Piazzale Stefani, 1, 37124, Verona, Italy.
Luca AlbertiDivision of General and Upper GI Surgery, Department of Surgery, University of Verona, Piazzale Stefani, 1, 37124, Verona, Italy.
Valentina MengardoDivision of General and Upper GI Surgery, Department of Surgery, University of Verona, Piazzale Stefani, 1, 37124, Verona, Italy.
Beatrice BenedettiAnesthesia and Intensive Care Unit, Department of Surgery, Dentistry, Pediatrics and Gynecology, University of Verona, Verona, Italy.
Simone GiacopuzziDivision of General and Upper GI Surgery, Department of Surgery, University of Verona, Piazzale Stefani, 1, 37124, Verona, Italy.
Jacopo WeindelmayerDivision of General and Upper GI Surgery, Department of Surgery, University of Verona, Piazzale Stefani, 1, 37124, Verona, Italy.
University of Verona · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Enhanced recovery protocols (ERP) have demonstrated their efficacy after esophagectomy and gastrectomy but little is known about their feasibility and safety in elderly patients. Patients submitted to Ivor-Lewis esophagectomy or gastrectomy for cancer between January 2016 and June 2019 were divided into three age groups: young-age group, YG (≤ 65 years, n = 130); middle-age group, MG (66-74 years, n = 101); old-age group, OG (≥ 75 years, n = 74). The groups were compared for adherence to our ERP, morbidity and mortality rates. After esophagectomy, adherence to ERP was comparable between the three groups, overall morbidity was higher in OG, without statistically significant difference, while the incidence of cardiac complications was significantly higher in OG (p = 0.02). After gastrectomy, OG presented a lower adherence to urinary catheter removal and to early mobilization. No difference in overall morbidity rate was observed (p = 0.13). The median length of stay was comparable both after esophagectomy (p = 0.075) and gastrectomy (p = 0.07). Multivariable analysis showed that age ≥ 75 years was not associated with a higher risk of ERP failure either after esophagectomy (p = 0.59) or after gastrectomy (p = 0.83). After esophagectomy, the risk of failure of the ERP program was higher for patients with ASA grade 3-4 (p = 0.03) and for those with postoperative complications (p < 0.001) while after gastrectomy only postoperative complications were associated to higher risk of ERP failure (p < 0.001). In our series, adherence to ERP protocol of patients  ≥ 75 years old was similar to that of younger patients after esophagectomy and gastrectomy, without a significant increase in morbi-mortality rates.

Indexed as

Enhanced Recovery After SurgeryEsophagectomyGastrectomyAgedAge FactorsCardiovascular DiseasesFeasibility StudiesFemaleHumansIncidenceMalePatient CompliancePostoperative ComplicationsSafetyElderlyEnhanced recovery protocolEsophagectomyGastrectomy

Identifiers

PMID32488821
OpenAlexW3029121472

What OpenQuestion holds

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Registered trials

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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.