From Pathways to Practice: Impact of Implementing Mobilization Recommendations in Head and Neck Cancer Surgery with Free Flap Reconstruction

Twomey, Rosie; Matthews, T. Wayne; Nakoneshny, Steven C.; Schrag, Christiaan; Chandarana, Shamir; Matthews, Jennifer; McKenzie, D. C.; Hart, Robert D.; Li, Na; Dort, Joseph C.; Sauro, Khara M.

doi:10.3390/cancers13122890

Cited by 6 publications

(3 citation statements)

References 37 publications

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“…Like with other guidelines, ERAS outcomes depends on adoption of ERAS guidelines . Indeed, greater compliance with ERAS has been shown to improve outcomes . Since only about 20% of included studies reported compliance with ERAS, and reporting of these estimates were too heterogeneous to include in the analysis, it is likely that mean compliance was lower than 75% and that our findings underestimate the outcomes of ERAS.…”

Section: Discussionmentioning

confidence: 69%

“…[127][128][129] Indeed, greater compliance with ERAS has been shown to improve outcomes. [129][130][131] Since only about 20% of included studies reported compliance with ERAS, and reporting of these estimates were too heterogeneous to include in the analysis, it is likely that mean compliance was lower than 75% and that our findings underestimate the outcomes of ERAS. If compliance is important for ERAS outcomes, how can compliance be improved?…”

Section: Discussionmentioning

confidence: 90%

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Enhanced Recovery After Surgery Guidelines and Hospital Length of Stay, Readmission, Complications, and Mortality

Sauro,

Smith,

Ibadin

et al. 2024

JAMA Netw Open

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ImportanceA comprehensive review of the evidence exploring the outcomes of enhanced recovery after surgery (ERAS) guidelines has not been completed.ObjectiveTo evaluate if ERAS guidelines are associated with improved hospital length of stay, hospital readmission, complications, and mortality compared with usual surgical care, and to understand differences in estimates based on study and patient factors.Data SourcesMEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Central were searched from inception until June 2021.Study SelectionTitles, abstracts, and full-text articles were screened by 2 independent reviewers. Eligible studies were randomized clinical trials that examined ERAS-guided surgery compared with a control group and reported on at least 1 of the outcomes.Data Extraction and SynthesisData were abstracted in duplicate using a standardized data abstraction form. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Risk of bias was assessed in duplicate using the Cochrane Risk of Bias tool. Random-effects meta-analysis was used to pool estimates for each outcome, and meta-regression identified sources of heterogeneity within each outcome.Main Outcome and MeasuresThe primary outcomes were hospital length of stay, hospital readmission within 30 days of index discharge, 30-day postoperative complications, and 30-day postoperative mortality.ResultsOf the 12 047 references identified, 1493 full texts were screened for eligibility, 495 were included in the systematic review, and 74 RCTs with 9076 participants were included in the meta-analysis. Included studies presented data from 21 countries and 9 ERAS-guided surgical procedures with 15 (20.3%) having a low risk of bias. The mean (SD) Reporting on ERAS Compliance, Outcomes, and Elements Research checklist score was 13.5 (2.3). Hospital length of stay decreased by 1.88 days (95% CI, 0.95-2.81 days; I2 = 86.5%; P &lt; .001) and the risk of complications decreased (risk ratio, 0.71; 95% CI, 0.59-0.87; I2 = 78.6%; P &lt; .001) in the ERAS group. Risk of readmission and mortality were not significant.Conclusions and RelevanceIn this meta-analysis, ERAS guidelines were associated with decreased hospital length of stay and complications. Future studies should aim to improve implementation of ERAS and increase the reach of the guidelines.

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Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 90%

Enhanced Recovery After Surgery Guidelines and Hospital Length of Stay, Readmission, Complications, and Mortality

Sauro,

Smith,

Ibadin

et al. 2024

JAMA Netw Open

Self Cite

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“…This study will assess the treatment patterns, compliance with guidelines and HPV status (for detailed information, see online supplemental table S1). [21][22][23][24] Patients in the conservative observation group will undergo routine follow-up. 25 The patients will be observed without any additional treatment.…”

Section: Definition Of Outcomesmentioning

confidence: 99%

Profiling the real-world management status of high-risk human papillomavirus infection: a protocol to establish a prospective cohort of high-risk human papillomavirus-infected women in Lueyang County, China

Yang

Li²,

et al. 2022

BMJ Open

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IntroductionPersistent infection with high-risk human papillomavirus (hrHPV) is the main cause of cervical cancer. Thus, the effective treatment against HPV represents an opportunity to reduce the incidence of cervical cancer. Although various treatments are effective in treating HPV infection, they still provide limited benefit in reducing the rate of cervical cancer due to the lack of implementation of a standardised protocol in many low/middle-income areas. This proposed cohort study aims to describe the status quo of treatment, attributions of the treatment decision-making process and potential factors influencing treatment decisions.Methods and analysisThis is a mixed-method, 5-year prospective longitudinal study in Lueyang County, China, one of the areas with the highest cervical cancer incidence rates and lowest mean income in China. We will enrol women with hrHPV infection (at least one HPV type in the 13 high‐risk subtypes) diagnosed via a county-wide HPV infection and cervical cancer screening programme. The study procedures describe the treatment patterns and explore the potential influencing factors in treatment decision-making through questionnaires, laboratory examinations and in-depth interviews. All participants will be evaluated at baseline and at 6, 12, 24, 36, 48 and 60 months. The primary outcome is the treatment pattern, the type and duration of which will be described later. The secondary outcomes include guideline compliance and changes in the HPV infection status. The HPV impact profile, intimate relationship satisfaction, and costs within different management groups are also described and compared.Ethics and disseminationThis study was reviewed, and all of the relevant approvals were obtained from the Ethics Committee of the Maternity Service Centre of Lueyang Maternal and Child Health Care Hospital (2021-001). The findings from this study will be disseminated through peer-reviewed publications, conference presentations and academic workshops.Trial registration numberChiCTR2100053757.

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Physical and Occupational Therapy

Gomez,

Wilson,

Black

et al. 2023

Complex Head and Neck Microvascular Surgery

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From Pathways to Practice: Impact of Implementing Mobilization Recommendations in Head and Neck Cancer Surgery with Free Flap Reconstruction

Cited by 6 publications

References 37 publications

Enhanced Recovery After Surgery Guidelines and Hospital Length of Stay, Readmission, Complications, and Mortality

Enhanced Recovery After Surgery Guidelines and Hospital Length of Stay, Readmission, Complications, and Mortality

Profiling the real-world management status of high-risk human papillomavirus infection: a protocol to establish a prospective cohort of high-risk human papillomavirus-infected women in Lueyang County, China

Physical and Occupational Therapy

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