The present systematic review shows that , with the exception of laparoscopic surgery , objective evidence of the effect of individual components of ERAS protocol s in reducing the stress response following colorectal surgery is limited
Abstract Enhanced Recovery or Fast Track Recovery after Surgery protocol s ( ERAS ) have significantly changed perioperative care following colorectal surgery and are promoted as reducing the stress response to surgery .
Prognostic Significance of Postoperative In-Hospital Complications in Elderly Patients. I. Long-Term Survival
To determine the impact of in-hospital postoperative complications on long-term survival , we prospect ively studied consecutive patients ≥70 yr of age undergoing noncardiac surgery .  Potential clinical risk factors were measured and evaluated for their association with the occurrence of long-term postoperative mortality . Long-term survival was determined by using the Kaplan-Meier method . Multivariate correlates of survival were analyzed with the Cox proportional hazards model . The survival of the study group was also compared with the age- and gender-matched general United States population . Five hundred seventeen patients who survived the initial hospitalization were studied . The mean follow-up duration was 28.6 ± 12.8 mo . One hundred sixty-four of 517 patients ( 31.7 % ) were deceased at the time of follow-up . A history of cancer ( hazard ratio [ HR ] 2.44 , 95 % confidence interval [ CI ] 1.78–3.38 , P < 0.0001 ) , ASA physical status > II ( HR 2.27 , 95 % CI 1.61–3.21 , P < 0.0001 ) , neurologic disease ( HR 1.59 , 95 % CI 1.13–2.24 , P = 0.008 ) , age ( HR 1.42 per decade , 95 % CI 1.11–1.81 , P = 0.005 ) , postoperative pulmonary complications ( HR 2.41 , 95 % CI 1.30–4.48 , P = 0.005 ) , and renal complications ( HR 6.07 , 95 % CI 2.23–16.52 , P < 0.0001 ) were significant independent predictors of decreased long-term survival . Compared with the United States population , patients with complications had a greater increase in mortality risk in the first 3 mo after surgery ( HR 7.3 versus general population ) than those without complications ( HR 2.9 , P = 0.023 ) . An effort to improve perioperative care delivery to elderly surgical patients must include measures to minimize in-hospital postoperative complications , particularly those involving the pulmonary and renal systems
The present systematic review shows that , with the exception of laparoscopic surgery , objective evidence of the effect of individual components of ERAS protocol s in reducing the stress response following colorectal surgery is limited
Abstract Enhanced Recovery or Fast Track Recovery after Surgery protocol s ( ERAS ) have significantly changed perioperative care following colorectal surgery and are promoted as reducing the stress response to surgery .