Adherence to the acceleration of total postoperative recovery protocol and perioperative complications in cancer patients.

Revista da Escola de Enfermagem da U S P Pub Date : 2025-11-17 eCollection Date: 2025-01-01 DOI:10.1590/1980-220X-REEUSP-2025-0022en
Silvia Paulino Ribeiro Albanese, Caroline Tolentino Sanches, Karine Silva de Oliveira, Maria Laura Albanese, Marcos Toshiyuki Tanita, Cíntia Magalhães Carvalho Grion
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Abstract

Objective: To describe postoperative complications in patients undergoing oncological surgeries, and to analyze adherence to the recommendations of the project Acceleration of Total Postoperative Recovery (ACERTO) in these patients and the risk factors for death.

Method: Retrospective longitudinal study. Sample of 229 patients in the immediate postoperative period admitted to the intensive care unit from July to December 2021.

Results: The frequency of complications was 68.5%. There was adherence to the recommendation of fluid resuscitation ≤ 30 mL/kg in 56.6% intraoperatively and greater adherence in the postoperative period (90.4%) and in the prescription of nausea and vomiting prophylaxis in the intraoperative (93%) and postoperative (100%) periods. An association was observed between adherence to recommendations and a reduction in complications. The independent risk factors for death were age (p = 0.031) and the score Sequential Organ Failure Assessment (SOFA) (p = 0.004).

Conclusion: A high frequency of complications was observed in the postoperative period and a mortality rate of 11.8%. Adherence to the protocol ACERTO was associated with a reduction in postoperative complications in cancer patients. Age and SOFA score were independent risk factors for death.

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癌症患者遵守加速术后完全恢复方案及围手术期并发症。
目的:描述肿瘤手术患者的术后并发症,并分析这些患者对加速术后完全恢复(ACERTO)项目建议的依从性以及死亡的危险因素。方法:回顾性纵向研究。样本为2021年7月至12月住院重症监护室术后即刻收治的229例患者。结果:并发症发生率为68.5%。术中有56.6%的患者坚持推荐≤30 mL/kg的液体复苏,术后更坚持(90.4%),术中(93%)和术后(100%)坚持恶心和呕吐预防处方。观察到依从建议与并发症减少之间存在关联。死亡的独立危险因素为年龄(p = 0.031)和顺序器官衰竭评分(SOFA) (p = 0.004)。结论:术后并发症发生率高,死亡率为11.8%。遵守ACERTO方案与癌症患者术后并发症的减少有关。年龄和SOFA评分是死亡的独立危险因素。
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