Study: Advanced recovery room care could reduce long-term postoperative mortality

Editor's Note

Findings from The ARRC II study show using advanced recovery room care (ARRC) for medium-risk surgical patients significantly reduces 18-month postoperative mortality compared to standard ward care. As detailed in a December 11 research letter in JAMA Surgery, this benefit appears linked to minimizing early postoperative complications, which are associated with delayed mortality.

Researchers grouped 348 patients into the ARRC group and 348 propensity-matched patients into the usual care group, with a median age of 72 years. The cohort study also incorporated mortality data from March 2021 to October 2023, as well as an analysis of survival curves. Researchers found that the 18-month mortality was significantly lower in the ARRC group, with a hazard ratio of 0.65 (95% CI, 0.44-0.98; P = .04).

Previous research has shown a clear association between early postoperative complications and increased long-term mortality, with studies reporting hazard ratios ranging from 1.9 to 3.5 for mortality at 12 months in patients experiencing early complications, researchers write. These findings suggest that interventions through ARRC—such as better management of blood pressure, heart rate, and oxygen saturation—may mitigate risks related to systemic inflammatory response syndrome (SIRS) and improve recovery trajectories.

Citing small sample size and the observational nature of the study, researchers emphasize the need for larger, definitive trials to confirm the effectiveness of ARRC in reducing postoperative mortality.