Category Archives: Peri-Operative Medicine

Pre-op fall assessment

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

Posted in Peri-Operative Medicine | Comments Off

Surgeon skill matters

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).

Posted in Peri-Operative Medicine | Comments Off

Surgical readmission rates in the US

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

Posted in Other, Peri-Operative Medicine | Comments Off

Urinary catheter not needed for THA with spinal anesthesia

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

Posted in Peri-Operative Medicine, Renal | Comments Off

New oral anticoagulants for VTE prophylaxis after TKA/THA

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).

Posted in Hematology and Oncology, Peri-Operative Medicine | Comments Off

Hospital implications for SSIs

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).

Posted in ID, Peri-Operative Medicine | Comments Off

I-COUGH reduces post-surgical complications

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).

Posted in Peri-Operative Medicine, Pulmonary and Critical Care | Comments Off

Quitting smoking before surgery

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

Posted in Peri-Operative Medicine | Comments Off

Mortality higher in late-week elective surgeries

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

Posted in Peri-Operative Medicine | Comments Off

ASA for post-THA VTE prophylaxis

This trial randomized post-THA patients to dalteparin or ASA for 28 days (after 10 days of dalteparin) and found no significant difference in VTE or bleeding rates. After 10 days of dalteparin, 28 days of ASA is safe and effective … Continue reading

Posted in Hematology and Oncology, Peri-Operative Medicine | Comments Off