In older adults undergoing surgery, new Do Not Resuscitate (DNR) orders often indicate significant risk factors and timing that can guide surgical decision-making. Only 2.3% of 47,564 cases resulted in new perioperative DNR orders. Key predictors of DNR orders: ASA IV/V (2.6x), disseminated cancer (3.3x), and emergent surgery (3.5x). DNR orders typically occur early post-surgery; […]

Surgeons need to enhance teamwork with anesthesiologists to improve patient safety and outcomes in the OR. Interviews with 40 surgeons and anesthesiologists revealed seven barriers to collaboration, including communication issues and professional identity conflicts. Five effective strategies were identified: fostering relationships, improving communication at all surgical phases, and adopting a mindset of respect and trust. […]

Surgeons should note that operating in high-markup hospitals significantly raises patient risks and costs for major surgeries. Patients at high-markup hospitals faced 50.3% higher costs and increased odds of in-hospital complications (adjusted odds ratio 1.07). Moderate-markup hospitals showed 24.7% higher costs and elevated mortality risks (adjusted odds ratio 1.07). Surgeons must consider hospital pricing when […]

Switching to a global budget revenue model can enhance surgical outcomes for cancer procedures. Textbook outcomes improved from 72.8% to 76.1% in GBR hospitals versus a slight change from 70.2% to 70.5% in controls, showing a 2.9 percentage point gain (p=0.02). Complication rates fell by 1.5 percentage points, and prolonged stays decreased by 1.8 percentage […]

Elective surgeries may carry different risks based on patients’ glycemic status rather than just diabetes diagnosis. In a study of over 2 million hospitalizations, 9.16% of patients with diabetes and hyperglycemia had major adverse events, compared to 5.31% without diabetes. Patients with diabetes without hyperglycemia had a modest increased risk (5.85%) with a number needed […]

Surgeons can significantly enhance antimicrobial prescribing practices through targeted education, tackling the critical issue of antibiotic misuse. Educational interventions led to better antibiotic selection, timing, and duration. Review included 17 studies, primarily from high-income, tertiary hospitals, emphasizing pre-post design effectiveness. These findings underscore the importance of implementing educational strategies to strengthen antimicrobial stewardship in surgical […]

Surgical subspecialties are striving for greater diversity through targeted mentorship for underrepresented minorities. Only 18 of 255 studies highlighted programs for URIM students, mainly at medical school (11) and high school (3) levels. Outreach can effectively boost interest in surgery among URIM individuals, though vascular surgery lacks any dedicated programs. Increasing mentorship initiatives across all […]

A novel journal club enhances resident training and engagement in trauma surgery. Residents improved critical appraisal skills and public speaking abilities. Faculty valued direct interactions with study authors on methodology and clinical relevance. This low-resource model fosters meaningful discussions without the logistical burdens of in-person events. Participating experts gained visibility and scholarly dissemination with minimal […]

Patients with gastrointestinal cancer face significant insurance instability that impacts surgery timelines and costs. 9.8% of GI cancer patients changed insurance within a year post-diagnosis, compared to 8.8% of controls (adjusted HR 1.18). Insurance instability led to delayed surgeries (adjusted rate ratio 1.15) and higher out-of-pocket costs ($3,675 vs $3,206). Employment disruptions accounted for 97.2% […]