Associations Between Care Bundles and Postoperative Outcomes After Major Emergency Abdominal Surgery: A Systematic Review and Meta-Analysis.
J Surg Res
; 283: 469-478, 2023 Mar.
Article
en En
| MEDLINE
| ID: mdl-36436282
ABSTRACT
INTRODUCTION:
Care bundles were found to improve postoperative outcomes in elective surgery. However, in major emergency general surgery studies show a divergent impact on mortality and length of stay. This meta-analysis aimed to evaluate associations between care bundles and mortality, complications, and length of stay when applied in major emergency general surgery.METHODS:
A systematic literature search in PubMed and Embase was performed on the May 1, 2021. Only comparative studies on care bundles in major emergency general surgery were included. Meta-analysis and trial sequential analysis were performed on 30-d mortality. We undertook a narrative approach of long-term mortality, complications, and length of stay.RESULTS:
Meta-analysis of 13 studies with 35,771 patients demonstrated that care bundles in emergency surgery were not associated with a significant reduction in odds of 30-d mortality (odds ratio = 0.8, 95% confidence interval 0.62-1.03). Trial sequential analysis confirmed that the meta-analysis was underpowered with a minimum of 78,901 patients required for firm conclusions. Seven studies reported complication rates whereof six reported lower complication rates using care bundles.CONCLUSIONS:
Care bundles were reported to decrease postoperative complications in five out of seven studies and seven out of 11 studies reported a shortening in length of stay.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Paquetes de Atención al Paciente
Tipo de estudio:
Risk_factors_studies
/
Systematic_reviews
Límite:
Humans
Idioma:
En
Año:
2023
Tipo del documento:
Article