Category Archives: Peri-Operative Medicine
This cohort found patients age >65 undergoing elective colorectal or cardiac surgery who had a history of falls in the past 6 months had significantly higher 30 day rates of complications, readmissions, and need for institutionalization. Asking about a history … Continue reading
This cohort of 20 surgeons were videotaped and rated on their skill performing laparoscopic gastric bypass surgery. Lower skill ratings were associated with significantly longer operations, rates of reoperations and readmissions, and higher rates of complications and mortality (abstract).
This large Medicare cohort found the rate of 30 day readmits after selected major surgical procedures (CABG, lobectomy, AAA, colectomy, THA) was 13.1%. Higher volume, lower mortality, and higher compliance with quality process measures were all associated with lower readmission … Continue reading
This trial randomized patients undergoing spinal anethesia for THA to indwelling urinary catheters or none. Of 200 patients, 9 in the no-catheter group and 3 in the catheter group needed a single in-out cath (the latter group after the catheter … Continue reading
This meta analysis found the new oral anticoagulants had similar VTE outcomes compared to LMWH, but the risk of bleeding is higher, in patients status post TKA/THA (abstract).
This cohort from a single hospital system found those with SSIs (versus those without) had charges ~$500 higher, LOS ~5 days longer, and readmission rates ~6X higher. The prevention of SSIs should reduce charges, LOS, and readmission rates (abstract).
This simple evidence-based bundle reduced post operative pneumonia and reintubations (I:Incentive spirometry; C:Coughing-deep breathing; O:Oral care; U:Understanding from the patient-family; G:Getting out of bed at least tid; H:Head of bed >30 degrees) (abstract).
This large analysis from NSQUIP found past smokers (>1 year quit) had similar post-op mortality compared to non-smokers, but current smokers had an odds ratio of post-op mortality of 1.17. Arterial events and respiratory events were higher in past smokers … Continue reading
This large cohort of elective surgical patients found those that underwent surgery later in the week or on a weekend had higher 30 day mortality compared to those that underwent surgery earlier in the week. Although uncontrolled confounding may have … Continue reading