Editor's Note In patients 85 years of age and older, surgical complexity and certain geriatric variables (malnutrition, frailty), which are overlooked in American Society of Anesthesiologists and most other scores, were relevant in predicting postoperative outcomes and mortality, finds this study. Of 127 patients who completed follow-up, 30-day mortality was…

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Editor's Note This meta-analysis found that patients at higher risk for obstructive sleep apnea (OSA), as determined by preoperative STOP-Bang screening, had a higher risk of postoperative adverse events and longer length of hospital stay, compared with lower risk-OSA patients. The analysis included 10 studies with 23,609 patients (7,877 high-risk…

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Organizations that have adopted the perioperative surgical home (PSH) model of patient care have reaped the benefits of improved outcomes and a healthier bottom line. In particular, the PSH has a proven track record for colorectal surgery and orthopedic surgery. In part 1 of this two-part series (OR Manager, August…

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Uncertainties pepper the healthcare landscape, but the shift to value-based care is expected to continue, even though momentum may slow under the current administration. That means perioperative services leaders must continue to explore new care delivery options such as the perioperative surgical home (sidebar, p 17). “The demand for value…

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Editor's Note Using patient-specific preoperative variables, a validated logistic regression model predicted transfusions in total hip and knee patients in this study. The model identified preoperative hemoglobin, total hip arthroplasty, and females 65 years of age and older as predictors of perioperative transfusions. The model also may help identify those…

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Editor's Note Ketamine does not decrease delirium or lower levels of pain in older adults after major surgery and might cause harm by inducing hallucinations and nightmares, this study finds. A total of 672 patients were randomly assigned to a placebo group (222 patients), a 0.5 mg/kg ketamine group (227),…

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Editor's Note In this study, the use of preoperative and postoperative elements of a Perioperative Surgical Home model in total knee and hip patients was associated with improvements in operational outcomes. The study included 1,225 patients in a preintervention PSH group and 1,363 in a postintervention PSH group. Compared with…

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Editor's Note In this French study, the majority of ICU patients had at least one organ failure at the time of death. Of 698 patients analyzed, 84% had one or more organ failures and 89% required at least one organ support at the time of death. Deaths were considered unexpected…

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Editor's Note Implementation of a Perioperative Surgical Home (PSH) program for patients undergoing ambulatory laparoscopic cholecystectomy in a Kaiser Permanente practice model was associated with significantly reduced length of stay and unplanned hospital admission in this study. The analysis included 878 patients in the preimplementation period and 1,082 in the…

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Editor's Note In this study, Vanderbilt University Medical Center researchers created an automated system to identify diabetic patients, detect insulin administration, check for glucose measurement, and remind anesthesiologists to check intraoperative glucose. Implementation of the automated reminder system: improved glucose monitoring from 61.6% to 87.3% of cases reduced PACU hyperglycemia…

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