Enhanced recovery after surgery continuity nursing in elderly gastric cancer patients.

Abstract

Background: Gastric cancer predominantly affects the elderly, who face significant challenges due to high postoperative complications and stress. These challenges include comorbidities, reduced physiological reserves, and increased risks of infections and delayed healing. Traditional postoperative care often falls short in addressing these issues effectively. Enhanced recovery after surgery (ERAS) principles have revolutionized surgical care by reducing stress and promoting recovery through a holistic approach. ERAS emphasizes preoperative optimization, intraoperative care, and postoperative rehabilitation tailored to patient needs. Despite its recognized benefits, the impact of continuity nursing care within the ERAS framework on elderly gastric cancer patients remains underexplored. This study examines the influence of ERAS-based continuity nursing care on postoperative satisfaction, inflammation, stress, and quality of life in elderly patients undergoing gastric cancer resection.

Aim: To investigate the effects of ERAS-based continuity nursing care on postoperative satisfaction, inflammation, stress, and quality of life in elderly gastric cancer patients.

Methods: A retrospective cohort analysis was conducted on 322 elderly patients who underwent gastric cancer resection between January 2020 and January 2022. Patients were assigned to a routine care group (n = 156) or an ERAS-control (ERAS-C) group (n = 166). Data collected included demographic information, inflammatory and stress markers, satisfaction scores using the patient satisfaction questionnaire-18, and quality of life measured using the European Organization for Research and Treatment of Cancer 22-item quality of life questionnaire specific to gastric cancer.

Results: The ERAS-C group exhibited significantly lower postoperative interleukin-6 levels than the routine care group (12.97 ± 4.02 pg/mL vs 14.37 ± 3.86 pg/mL; P = 0.002). This finding indicates that the ERAS-C group experienced reduced inflammation. The ERAS-C group also had a higher cluster of differentiation (CD) 4:CD8 ratio than the routine care group (2.34 ± 0.35 vs 2.13 ± 0.61; P < 0.001), suggesting the former's enhanced immune response. Postoperative stress markers, including norepinephrine, cortisol, and aldosterone, were significantly lower in the ERAS-C group than in the routine care group (P < 0.05 for all). Compared with the routine care group, the ERAS-C group showed increased nursing satisfaction scores (80.36 ± 7.24 vs 75.23 ± 7.03; P < 0.001) and improved quality of life indicators, such as reduced dysphagia and pain, (P < 0.05). The ERAS-C group also experienced fewer complications than the routine care group (5.42% vs 11.54%, P = 0.048).

Conclusion: Continuity nursing care within the ERAS framework significantly enhances postoperative outcomes for elderly gastric cancer patients by reducing inflammation, stress, and complications while improving satisfaction and quality of life.