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,…
Editor's Note Implementing the Perioperative Surgical Home (PSH) model resulted in improved patient outcomes, patient satisfaction, and shorter hospital stays in this study presented October 22 at the Anesthesiology 2016 annual meeting. The study included 1,356 patients who had total knee, hip, or shoulder replacements. Half received care under the…
Editor's Note Identifying frailty in older patients could increase their chances of surviving surgery and improve their overall outcomes, this study finds. Researchers conducted frailty screening using five characteristics: weight loss, weakness (grip strength), exhaustion, low activity level, and slow gait. Of 125 patients screened in a thoracic surgery clinic,…
Editor's Note The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) has developed a pediatric surgical risk calculator based on 181,353 cases covering 382 CPT codes across all specialties. It was found to have excellent discrimination for mortality, morbidity, and seven additional complications. The calculator can be…
Editor's Note Postoperative readmissions are difficult to predict when the patient is discharged, and of the information available at that time, preoperative factors are the most important, this study finds. Of nearly 240,000 surgical patients included in the analysis, 43% were orthopedic, 39% were general, and 18% were vascular. The…
Editor's Note The implementation of Lean system redesigns was associated with a significant and sustained wait list reduction from 33.4 days to 12.0 days for patients waiting for elective general surgery in a Veterans Affairs (VA) hospital, this study finds. Along with the three-fold decrease in wait times from 2014…