# Effectiveness of interventions delivered within inpatient perioperative care in adults undergoing surgery: scoping review of systematic reviews

## TL;DR

This review summarizes which interventions during inpatient perioperative care for adults are most effective in improving recovery and reducing complications.

## Contribution

A comprehensive scoping review of systematic reviews on perioperative interventions, identifying key themes and their effectiveness across surgical specialties.

## Key findings

- ERAS interventions consistently improve length of hospital stay and postoperative complications.
- Nutritional strategies reduce surgical site infections and hospital stay duration.
- CGA interventions benefit mortality and daily living activities in older patients.

## Abstract

Many perioperative interventions have been developed to improve care and health outcomes for patients. Interventions that are effective, reduce adverse events, and improve patient recovery are hugely important to patients and healthcare systems. This study provides a contemporary overview of the effectiveness of interventions delivered within inpatient perioperative care in adults undergoing surgery.

A scoping review of systematic reviews (SRs) was performed according to Joanna Briggs Institute methodology and PRISMA-ScR guidelines. The following databases were searched: Medline, Embase, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, and Physiotherapy Evidence Database, last update 2 December 2025.

In all, 190 SRs were included in the review, incorporating 10 themes: enhanced recovery after surgery (ERAS; 77 SRs, 39%); diet/nutritional (31 SRs; 16%); pharmaceutical (20 SRs, 10.8%); respiratory (15 SRs, 8.5%); ‘other’ (e.g. sleep, body warming and personalized nursing interventions, goal directed haemodynamic and acupuncture therapy) (13 SRs, 7.4%); exercise/physical activity (12 SRs, 6.5%); comprehensive geriatric assessment (CGA; 9 SRs, 4.5%); care bundles (5 SRs, 2.8%); multimodal (5 SRs, 2.8%); and physiotherapy (3 SRs, 1.7%). Key intervention themes showed consistent benefit across a range of surgical specialities. These consisted of: respiratory/aerobic strategies on length of hospital stay (LoS), postoperative complications, and the 6-minute walk test, with little evidence for effect on mortality; diet/nutritional strategies, which had significant benefits with regard to LoS, postoperative complications, and surgical site infections, with little or no effect on mortality; CGA, which had a beneficial effect on mortality, LoS, and activities of daily living, with little evidence of effect on readmission; and ERAS, which showed improvements in LoS, postoperative complications, and morbidity, with less evidence of effect on mortality and readmission across specialities.

Key interventions showed consistent patterns of improvement. Before improving or designing new perioperative interventions, it is important to consider and deliver strategies that have already been evaluated and are effective.

This study provides a contemporary overview of the effectiveness of interventions delivered within inpatient perioperative care to adults undergoing surgery. The scoping review provides much needed clarity in a complex and diverse field, and can valuably inform research priorities to allocate often limited resources and help focus on intervention strategies that are likely to provide the most benefit and have the greatest impact on patients after surgery.