Editor's Note The American Society of Anesthesiologists (ASA) has published new “Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: Application to health patients undergoing elective procedures.” The document updates its guidelines published in 2011. The guidelines are intended for use…
Surgical site infections (SSIs) are a major cause of morbidity in surgical patients, leading to increased length of stay and healthcare costs. No single intervention has demonstrated efficacy in reducing SSIs. When SSIs rose to a rate of 16.3% in 2013 at St Elizabeth Boardman Hospital in Boardman, Ohio, perioperative…
Like a football team gathering to confirm tactical details before a play, surgical staff often form a huddle to ensure readiness of the providers, patient, and equipment for the upcoming procedure. In a twist on the traditional huddle the day before surgery, staff at the Hospital of Central Connecticut (HOCC)…
Editor's Note Engaging colon cancer patients in a prehabilitation program 4 weeks before surgery modified exercise behaviors and improved physical function, which improved postoperative outcomes, finds this study. Researchers randomized 116 patients to either a prehabilitation program (57 patients) or a control group (59 patients). After 4 weeks, compared with…
Editor's Note Chicacgo-area hospitals are using apps to help patients prepare for and recover from surgery and communicate their symptoms, the November 30 Chicago Tribune reports. Amita Health is now using the TapCloud app with good results−of 309 orthopedic patients who have used the app, none have had to be…
Editor's Note Implementation of a frailty screening initiative for preoperative patients was associated with reduced mortality, this study finds. In 9,153 patients screened, postoperative mortality decreased significantly at 30, 180, and 365 days, and improvements were noted in both frail and nonfrail patients. Multivariate analysis showed a three-fold survival benefit…
Editor's Note The Surgical Apgar Score (SAS) was found to be significantly predictive but weakly discriminative for major complications and death after emergency high-risk abdominal surgery in this study. The risk of major complications, death, and ICU admission increased significantly with decreasing SAS (P < .001). The score’s c-statistics were…
Editor's Note In this study, a Risk Analysis Index was found to measure frailty in surgical patients with predictive ability equal to other frailty tools, with an additional advantage of rapid, real-time, preoperative assessment feasible for guiding surgical decision making. The Index measures frailty prospectively using a questionnaire or retrospectively…
Editor's Note Total knee patients in enhanced recovery after surgery (ERAS) programs have less pain and recuperate faster, finds this study presented October 23 at the Anesthesiology 2016 annual meeting. The study, from Rush University Medical Center (Chicago), included 243 total knee patients, who were provided a combination of postoperative…
Editor's Note Patients were more likely to take their regularly prescribed medications correctly before surgery when they were provided a simple instruction sheet, finds this study presented October 24 at the Anesthesiology 2016 annual meeting. For the study, 48 patients were given verbal instructions and 57 were given a new,…