Enhanced recovery after surgery in elderly and high-risk patients

Abstract

Enhanced recovery after surgery (ERAS) programs are multidisciplinary pathways that were created to reduce stress response to surgery and improve outcomes. These pathways have been demonstrated to decrease length of stay (LOS) after surgery and reduce postoperative complications in several types of abdominal surgery. Their application in elderly or older patients and in high risk patients has had a slower uptake due to concerns about the possible risks and/or lack of benefit in these groups of patients. Prehabilitation has become an important part of ERAS programs and could also benefit elderly and high-risk patients. This updated review of the literature suggests that “tailored” ERAS programs can be beneficial in elderly, high-risk and frail patients, and should be offered to these populations.