Evidence map›Paper›PMID 38940950›Full record

ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2024

Applying enhanced recovery principles to emergency laparotomy in penetrating abdominal trauma: a case-matched study.

Mariana Kumaira Fonseca, Laís Borges Rizental, Carlos Eduardo Bastian da Cunha, Neiva Baldissera, Mário Bernardes Wagner, Gustavo Pereira Fraga

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Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 3 pooled it
–field-weighted citation impact
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

5 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
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  3. Guideline
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  5. Article
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

6 authors.

Mariana Kumaira FonsecaHospital de Pronto Socorro de Porto Alegre, Porto Alegre, Brazil. marianakumaira@gmail.com.ORCID http://orcid.org/0000-0001-5921-1425
Laís Borges RizentalHospital de Pronto Socorro de Porto Alegre, Porto Alegre, Brazil.ORCID http://orcid.org/0009-0006-4277-6706
Carlos Eduardo Bastian da CunhaHospital de Pronto Socorro de Porto Alegre, Porto Alegre, Brazil.ORCID http://orcid.org/0000-0002-0645-9360
Neiva BaldisseraHospital de Pronto Socorro de Porto Alegre, Porto Alegre, Brazil.ORCID http://orcid.org/0000-0002-3213-2548
Mário Bernardes WagnerPontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.ORCID http://orcid.org/0000-0002-3661-4851
Gustavo Pereira FragaState University of Campinas, Campinas, Brazil.ORCID http://orcid.org/0000-0002-9524-1186

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe implementation of enhanced recovery after surgery programs (ERPs) has significantly improved outcomes within various surgical specialties. However, the suitability of ERPs in trauma surgery remains unclear. This study aimed to (1) design and implement an ERP for trauma laparotomy patients; (2) assess its safety, feasibility, and efficacy; and (3) compare the outcomes of the proposed ERP with conventional practices.

methodsThis case-matched study prospectively enrolled hemodynamically stable patients undergoing emergency laparotomy after penetrating trauma. Patients receiving the proposed ERP were compared to historical controls who had received conventional treatment from two to eight years prior to protocol implementation. Cases were matched for age, sex, injury mechanism, extra-abdominal injuries, and trauma scores. Assessment of intervention effects were modelled using regression analysis for outcome measures, including length of hospital stay (LOS), postoperative complications, and functional recovery parameters.

resultsThirty-six consecutive patients were enrolled in the proposed ERP and matched to their 36 historical counterparts, totaling 72 participants. A statistically significant decrease in LOS, representing a 39% improvement in average LOS was observed. There was no difference in the incidence of postoperative complications. Opioid consumption was considerably lower in the ERP group (p < 0.010). Time to resumption of oral liquid and solid intake, as well as to the removal of nasogastric tubes, urinary catheters, and abdominal drains was significantly earlier among ERP patients (p < 0.001).

conclusionThe implementation of a standardized ERP for the perioperative care of penetrating abdominal trauma patients yielded a significant reduction in LOS without increasing postoperative complications. These findings demonstrate that ERPs principles can be safely applied to selected trauma patients.

Indexed as

Abdominal InjuriesLaparotomyLength of StayWounds, PenetratingAdultCase-Control StudiesEnhanced Recovery After SurgeryFeasibility StudiesFemaleHumansInjury Severity ScoreMaleMiddle AgedPostoperative ComplicationsProspective StudiesRecovery of FunctionAbdominal injuriesEnhanced recovery after surgeryLaparotomyPenetratingPerioperative careTrauma surgeryWounds

Identifiers

PMID38940950

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

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.