Implementation of an automated, sustainable quality improvement intervention significantly reduced operating room supply costs without compromising patient outcomes. Median costs per case decreased, and the incidence of out-of-control cases was lower, demonstrating enhanced value of care. The intervention, utilizing a data pipeline, involved sharing performance data with surgeons, enabling modifications to supply instructions, resulting in […]
Category: Perspectives, Opinions and Curiosities
Socioeconomic and Racial Privilege Linked to Improved Postoperative Outcomes in Medicare Beneficiaries
Among 1,885,889 Medicare beneficiaries included in the study, those residing in areas of higher privilege had lower chances of experiencing surgical complications, prolonged length of stay, 90-day readmission, and 90-day mortality. Moreover, individuals in the most privileged areas had a 19% increased odds of achieving a textbook outcome following surgery and a 6% reduction in […]
Low Physical Activity Linked to Postoperative Outcomes in Major Abdominal Cancer Surgery
According to a single-center prospective cohort study, physical activity levels are far from optimal following major abdominal cancer surgery. The study found that postoperative physical activity was low, with a median daily step count ranging from 71 steps on the first postoperative day to 918 steps on the seventh day. Furthermore, the study identified several […]
Impact of COVID-19 Pandemic Surge on Surgical Outcomes: No Increase in Mortality or Morbidity
Despite the challenges posed by the COVID-19 pandemic, a retrospective study of 7436 patients undergoing surgery found no evidence of increased 30-day mortality or morbidity during the pandemic surges compared to non-surge periods. Surgical care was successfully maintained, suggesting that healthcare systems effectively adapted to the challenges. The study analyzed data from the American College […]
Opoid-Free Analgesia Leads to Reduced Pain Severity and Risk of Side Effects After Surgery
Patients receiving opioid-free analgesia after surgery experience lower pain severity and decreased risk of side effects compared to those prescribed opioids, according to a multispecialty, prospective cohort study in 25 countries. The study involved 4273 patients from 144 centers, with 30.7% receiving opioid analgesia at discharge. The findings emphasize the need to routinely adopt opioid-free […]
Frailty Score Correlates with Surgical Outcomes in Optimization Before Surgery
Researchers investigated the correlation between frailty score, pre-surgical optimization, and surgical outcomes in frail patients undergoing optimization before surgery. A retrospective study was conducted on patients referred to the surgical optimization clinic and assessed for frailty, and outcomes were evaluated based on whether they proceeded to surgery or had their surgery cancelled or delayed. The […]
Procedure-specific Risks of Thrombosis and Bleeding in Abdominal Surgery Vary Significantly
This systematic review and meta-analysis of 285 studies, including over 8 million patients, evaluated the procedure-specific risks of symptomatic venous thromboembolism (VTE) and major bleeding in general abdominal, colorectal, upper gastrointestinal, and hepatopancreatobiliary surgeries. The risk of VTE varied widely among procedures, with VTE rates ranging from
Intraoperative Autonomic Physiology in Surgeons: Real-time Cardiac Reactivity Study
Surgeons’ autonomic physiology, specifically their heart rate (interbeat intervals), varies intraoperatively. Attending surgeons exhibit higher heart rate reactivity during high-risk operations, while residents show lower reactivity during high-risk procedures relative to low-risk ones. Nurses respond similarly during both low-risk and high-risk operations; however, they are more reactive when the resident is operating. Attending surgeons’ physiological […]
Extended Postoperative Antibiotic Prophylaxis Does Not Reduce Surgical-Site Infections in Low- and Middle-Income Countries
Extended postoperative antibiotic prophylaxis does not lower surgical-site infection rates in low- and middle-income countries, according to a study of 8,714 patients across 19 hospitals in Ethiopia, Madagascar, India, and Bolivia. Prolonged use of antibiotics did, however, increase hospital stays by 1.4 days. The findings highlight the need for surgical initiatives to implement antimicrobial stewardship […]
Faculty Entrustment Associated with Resident Entrustability in Surgical Training Programs
In a cross-sectional study across 4 university-based surgical training programs, researchers used a validated tool to assess intraoperative faculty entrustment and resident entrustability behaviors. They found that faculty entrustment was positively associated with resident entrustability, and this association was consistent across the different surgical programs. The results suggest that developing faculty entrustment behaviors can enhance […]