Key interventions and outcomes in perioperative care pathways in emergency laparotomy: a systematic review

作者：Deena Harji, Ben Griffiths, Deborah Stocken, Rupert M. Pearse, Jane Blazeby, Julia Brown · 发表于：World Journal of Emergency Surgery · 年份：2025 · DOI：10.1186/s13017-025-00597-4 · 被引用次数：6 · 研究领域：Cardiac, Anesthesia and Surgical Outcomes、Enhanced Recovery After Surgery、Trauma and Emergency Care Studies

INTRODUCTION: Emergency laparotomy (EmLap) is a complex clinical arena, delivering time-sensitive, definitive care to a high-risk patient cohort, with significant rates of post-operative morbidity and mortality. Embedding perioperative care pathways within this complex setting has the potential to improve post-operative outcomes, however, requires an in-depth understanding of their design, delivery and outcome assessment. Delivering and implementing complex interventions such as perioperative pathways require transparent reporting with detailed and indepth description of all components during the assessment and evaluation phase. The aim of this systematic review was to identify the current design and reporting of perioperative pathways in the EmLap setting. METHODS: The OVID SP versions of MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials were searched between January 1950 and December 2023. All randomised and non-randomised cohort studies reporting outcomes on perioperative care pathways in adult patients (> 18 years old) undergoing major emergency abdominal surgery were included. A narrative description of all perioperative pathways included was reported to identify design and description of the pathway including the delivery and timing of component interventions. All pathways were evaluated against the Template for Intervention Description and Replication (TIDieR) checklist. RESULTS: Eleven RCTs and 19 non-randomised studies were identified, with most ...