Evidence map›Paper›PMID 32542413›Full record

ArticleSurgery today2020

Long-term outcomes of major abdominal surgery and postoperative delirium after multimodal prehabilitation of older patients.

Ties L Janssen, Ewout W Steyerberg, Chantal C H A van Hoof-de Lepper, Tom C J Seerden, Dominique C de Lange, Jan H Wijsman, Gwan H Ho, Paul D Gobardhan, Lijckle van der Laan

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In one paragraph

Article in Surgery today, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 5 pooled it
1.7field-weighted citation impact, top 14% 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

14 citing papers in PubMed, 5 syntheses or guidelines pooled it, 26 citations in OpenAlex.

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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

9 authors at 3 institutions in 2 countries.

Ties L JanssenDepartment of Surgery, Amphia Hospital, P.O. Box 90518, 4800 RK, Breda, The Netherlands. Tjanssen@amphia.nl.ORCID http://orcid.org/0000-0002-0102-1183
Ewout W SteyerbergDepartment of Public Health, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands.
Chantal C H A van Hoof-de LepperDepartment of Surgery, Amphia Hospital, P.O. Box 90518, 4800 RK, Breda, The Netherlands.
Tom C J SeerdenDepartment of Gastroenterology, Amphia Hospital, Breda, The Netherlands.
Dominique C de LangeDepartment of Geriatrics, Amphia Hospital, Breda, The Netherlands.
Jan H WijsmanDepartment of Surgery, Amphia Hospital, P.O. Box 90518, 4800 RK, Breda, The Netherlands.
Gwan H HoDepartment of Surgery, Amphia Hospital, P.O. Box 90518, 4800 RK, Breda, The Netherlands.
Paul D GobardhanDepartment of Surgery, Amphia Hospital, P.O. Box 90518, 4800 RK, Breda, The Netherlands.
Lijckle van der LaanDepartment of Surgery, Amphia Hospital, P.O. Box 90518, 4800 RK, Breda, The Netherlands.
Amphia Ziekenhuis · NLErasmus MC · NLUniversitair Ziekenhuis Leuven · BE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe long-term outcomes of surgery followed by delirium after multimodal prehabilitation program are largely unknown. We conducted this study to assess the effects of prehabilitation on 1-year mortality and of postoperative delirium on 1-year mortality and functional outcomes.

methodsThe subjects of this study were patients aged ≥ 70 years who underwent elective surgery for abdominal aortic aneurysm (AAA) or colorectal cancer (CRC) between January 2013, and June 2018. A prehabilitation program was implemented in November 2015, which aimed to optimize physical health, nutritional status, factors of frailty and preoperative anemia prior to surgery. The outcomes were assessed as mortality after 6 and 12 months, compared between the two treatment groups; and mortality and functional outcomes, compared between patients with and those without delirium.

resultsThere were 627 patients (controls N = 360, prehabilitation N = 267) included in this study. Prehabilitation did not reduce mortality after 1 year (HR 1.31 [95% CI 0.75-2.30]; p = 0.34). Delirium was significantly associated with 1-year mortality (HR 4.36 [95% CI 2.45-7.75]; p < 0.001) and with worse functional outcomes after 6 and 12 months (KATZ ADL p = 0.013 and p = 0.004; TUG test p = 0.041 and p = 0.011, respectively).

conclusionsThe prehabilitation program did not reduce 1-year mortality. Delirium and the burden of comorbidity are both independently associated with an increased risk of 1-year mortality and delirium is associated with worse functional outcomes.

trial registrationDutch Trial Registration, NTR5932. https://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5932 .

Indexed as

Program EvaluationAgedAged, 80 and overAge FactorsAortic Aneurysm, AbdominalColorectal NeoplasmsCombined Modality TherapyDeliriumElective Surgical ProceduresFemaleHumansMalePostoperative ComplicationsPsychiatric RehabilitationTime FactorsTreatment OutcomeFunctional outcomesOlder patientsPostoperative deliriumPrehabilitation

Identifiers

PMID32542413
OpenAlexW3034930115

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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.