Editor's Note A simple 6-minute walking test before cardiac surgery helped predict the risk for cognitive issues after surgery, in this study from Japan. A 6-minute walk distance (6MWD) test was performed preoperatively on 181 patients who had nonemergency cardiac surgery. After surgery, 51 patients had postoperative cognitive dysfunction (POCD).…

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The government and insurance companies have imposed increasing penalties on healthcare facilities in recent years for readmissions. And with good reason: High readmission rates greatly increase costs and sometimes signal poor patient safety practices. In 2015, roughly 2 million patients were readmitted, costing Medicare $27 billion, according to the Centers…

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Editor's Note Dedicated OR teams for a colorectal Enhanced Recovery after Surgery (ERAS) program at Johns Hopkins Hospital led to anesthesia providers becoming more central to the ERAS network, which increased process measure compliance and improved clinical outcomes in this study. Before the dedicated OR teams were instituted, surgeons were…

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Editor's Note Patients who lose some weight before bariatric surgery achieve greater weight loss after surgery, and they have shorter procedures and hospital stays, this study finds. Those (224 patients) who lost 8% of their excess weight by following a 1,200 calorie diet for 4 weeks before their surgeries had…

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Editor's Note In this study, an interdisciplinary program that includes a coordinated approach by healthcare professionals in surgery, geriatrics, and anesthesiology was associated with improved postoperative outcomes for high-risk older patients having elective abdominal surgery. Compared with a control group (143 patients), older patients participating in the Perioperative Optimization of…

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Editor's Note Poor preoperative cognition, as assessed by preoperative Mini-Cog screening, is prevalent among older total joint patients and predictive of adverse outcomes, including postoperative delirium, longer hospital stay, and greater likelihood of discharge to a place other than home, this study finds. Of 211 patients 65 years of age…

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Editor's Note Standardizing clinical processes for outpatient hernia repairs reduced postoperative pain and unplanned returns to the emergency department (ED), finds this study presented October 23 at the American College of Surgeons 2017 Clinical Congress in San Diego. Researchers developed a standardized eight-step protocol that incorporated best practices and enhanced…

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Editor's Note A new pilot study from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) finds that adding geriatric-specific risk factors to traditional risk factors could significantly improve the ability of surgeons to predict poor surgical outcomes in older patients. The study involved 36,399 older surgical…

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Editor's Note In this study, preadmission clinical frailty independently predicted adverse discharge destination (ie, death or discharge to a long-term, chronic or acute care facility) in geriatric trauma patients. The analysis of 266 trauma patients 65 years and older using the Clinical Frailty Scale (CFS) and the laboratory Frailty Index…

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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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