A Meta-Analysis of Risk Factors for Postoperative Gastrointestinal Dysfunction in Elderly Patients Undergoing Abdominal Surgery

This is the authors' abstract. We don't add key points for this paper.

Objective: To systematically evaluate factors associated with postoperative gastrointestinal dysfunction in elderly patients undergoing abdominal surgery. Methods: PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructure, Wanfang Data, and the China Biomedical Literature Database were searched from inception to June 30, 2026. Two reviewers independently screened studies, extracted data, and assessed methodological quality. Unadjusted and multivariable-adjusted estimates were analyzed separately using RevMan 5.4. Results: Twelve observational studies involving 1,616 patients were included. Unadjusted analyses showed that several perioperative, patient-related, and disease-related characteristics were associated with impaired postoperative gastrointestinal recovery. In adjusted analyses, ascites, prolonged operative time, preoperative hypoalbuminemia, increased intraoperative blood loss, and diabetes were associated with higher odds of postoperative gastrointestinal dysfunction. However, except for ascites, each adjusted pooled estimate was based on only two studies. Considerable clinical and statistical heterogeneity was observed for several outcomes. Conclusion: Several perioperative and patient-related characteristics may be associated with postoperative gastrointestinal dysfunction in elderly patients undergoing abdominal surgery. Nevertheless, heterogeneous outcome definitions, limited numbers of studies, instability in some sensitivity analyses, and the geographic concentration of the evidence limit the certainty and generalizability of these findings. Further prospective multicenter studies using standardized outcome definitions are needed.