Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Feb 27, 2023; 15(2): 201-210
Published online Feb 27, 2023. doi: 10.4240/wjgs.v15.i2.201
Analysis of the impact of ERAS-based respiratory function training on older patients’ ability to prevent pulmonary complications after abdominal surgery
Yue-Xia Gu, Xin-Yu Wang, Mei-Xia Xu, Jia-Jie Qian, Yan Wang
Yue-Xia Gu, Mei-Xia Xu, Jia-Jie Qian, Yan Wang, Department of Nursing, Shanghai Fourth People’s Hospital Affiliated to Tongji University School of Medicine, Shanghai 200434, China
Xin-Yu Wang, Department of General Surgery, Shanghai Fourth People’s Hospital School of Medicine Tongji University, Shanghai 200434, China
Author contributions: Gu YX and Wang XY contributed equally in analysis of the data and writing of the manuscript; Wang Y designed the study; Xu MX and Qian JJ collected the data and corrected the paper; All authors have read and approved the final manuscript.
Supported by Project for Scientific Research by the Hongkou District Health Committee, No. Hong Wei 2002-08.
Institutional review board statement: The study was reviewed and approved by the Shanghai Fourth People’s Hospital Institutional Review Board (Approval No. 2022108-001).
Informed consent statement: Patients were not required to give informed consent to the study because it’s a retrospective study and the data came from electronic medical records in the hospital.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yan Wang, MBBS, Associate Chief Nurse, Nursing, Shanghai Fourth People’s Hospital Affiliated to Tongji University School of Medicine, No. 1279 Sanmen Road, Hongkou District, Shanghai 200434, China. 2205309@tongji.edu.cn
Received: September 9, 2022
Peer-review started: September 9, 2022
First decision: December 26, 2022
Revised: January 11, 2023
Accepted: January 30, 2023
Article in press: January 30, 2023
Published online: February 27, 2023
Abstract
BACKGROUND

In China, as the population grows older, the number of elderly people who have died from respiratory problems has increased.

AIM

To investigate whether enhanced recovery after surgery (ERAS)-based respiratory function training may help older patients who had abdominal surgery suffer fewer pulmonary problems, shorter hospital stays, and improved lung function.

METHODS

The data of 231 elderly individuals having abdominal surgery was retrospectively analyzed. Based on whether ERAS-based respiratory function training was provided, patients were divided into ERAS group (n = 112) and control group (n = 119). Deep vein thrombosis (DVT), pulmonary embolism (PE), and respiratory tract infection (RTI) were the primary outcome variables. Secondary outcome variables included the Borg score Scale, FEV1/FVC and postoperative hospital stay.

RESULTS

The percentage of 18.75% of ERAS group participants and 34.45% of control group participants, respectively, had respiratory infections (P = 0.007). None of the individuals experienced PE or DVT. The ERAS group’s median postoperative hospital stay was 9.5 d (3-21 d) whereas the control groups was 11 d (4-18 d) (P = 0.028). The Borg score decreased on the 4th d following surgery in the ERAS group compared to the 2nd d prior (P = 0.003). The incidence of RTIs was greater in the control group than in the ERAS group among patients who spent more than 2 d in the hospital before surgery (P = 0.029).

CONCLUSION

ERAS-based respiratory function training may reduce the risk of pulmonary complications in older individuals undergoing abdominal surgery.

Keywords: Pulmonary complications, Respiratory function training, Enhanced recovery after surgery, Abdominal surgery

Core Tip: One of the major factors contributing to morbidity and mortality during the perioperative period were postoperative pulmonary complications after abdominal surgery. Clinical judgment and improved outcomes required rapid identification of high-risk individuals and intervention. We compared the pulmonary complications between the two groups using the predefined observation indicators after retrospectively analyzing the postoperative data of 231 older patients divided into two groups based on various preoperative respiratory function training methods. As compared to traditional respiratory function training techniques, enhanced recovery after surgery-based respiratory function training may reduce the probability of pulmonary complications in older patients who have undergone abdominal surgery.