Perioperative medicine & outcomes
Protocolized care pathways in emergency general surgery: a systematic review and meta-analysis
Authors' conclusion
Protocolized care pathways in the emergency setting currently lack standardization, with variable components and low compliance; however, despite this they are associated with short-term clinical benefits.
Study context
- Population
- Adults (>18 years old) undergoing major emergency abdominal surgery with 30-day follow-up
- Participants
- 20,927 adults · 17 studies
- Comparison
- Protocolized care pathways vs standard care pathways
- Protocolized caren = 12,359
- Standard caren = 8,568reference
Methodological detailsrandom effects modelling
- Random effects modelling
Further pooled results
| Outcome | MD (95% CI) | P value | |
|---|---|---|---|
| Hospital LOS | −2.47 (−4.01 to −0.93) | P = 0.002 | |
| −6−4−202Difference (linear scale) |
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Postoperative mortality | 0.87 (0.41–1.87) | P = 0.72 | |
| 0.512Odds ratio (log scale) |
Pathway components and compliance
- Unique protocolized pathways
- 13
- Median number of components (range 6-15)
- 8
- Compliance
- 24-100%
Safety
Postoperative pneumonia
- Reduction in postoperative pneumonia with protocolized care pathways
- OR 0.42 95% c.i. 0.24 to 0.73, P = 0.002
Surgical site infection
- Reduction in surgical site infection with protocolized care pathways
- OR 0.34, 95% c.i. 0.21 to 0.55, P < 0.001
Original publication
Protocolized care pathways in emergency general surgery: a systematic review and meta-analysis. Br J Surg. Published 21 March 2024. doi:10.
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