A systematic review and meta-analysis results of applying evidence-based practices on emergency surgery patients

Background: Care bundles, which are groups of evidence-based practices, have been extensively utilized to improve patient outcomes across various clinical environments. However, the exact impact of these bundles on mortality and complication rates in emergency abdominal surgery has not been thoroughly evaluated.Study Aim: This meta-analysis aims to evaluate the efficacy of applying evidence-based practices in reducing mortality and complication rates in patients undergoing emergency abdominal surgeries. 

Methodology: A thorough literature search was performed across PubMed, Embase, and Cochrane Library databases to identify studies assessing the effects of care bundles on outcomes in emergency abdominal surgeries. Included studies needed to report on mortality or complication rates for patients undergoing emergency surgery with and without the application of care bundles. Data were extracted and pooled using a fixed-effects model to compute the overall odds ratios (ORs) and 95% confidence intervals (CIs) for both mortality and complication rates.

Results: Fifteen studies were included in the meta-analysis. The pooled analysis indicated a significant decrease in mortality rates for the bundle group compared to the control group, with an odds ratio (OR) of 0.76 (95% CI: 0.68 to 0.85). Similarly, complication rates were also substantially lower in the bundle group, with a pooled OR of 0.77 (95% CI: 0.68 to 0.89). The heterogeneity for mortality (I² = 33%) and complication rates (I² = 29%) was minimal, suggesting consistent results across the studies.

Conclusion: The application of care bundles in emergency abdominal surgical settings is linked to a notable decrease in both mortality and complication rates. These results advocate for wider adoption of care bundles to improve patient outcomes in high-risk emergency surgeries. Future research should aim to conduct randomized controlled trials and assess the cost-effectiveness of care bundles in various healthcare environments.