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Effect of Index Complications on Surgical Outcomes

Study of over 570,000 patients reveals that the type of index complication in noncardiac surgeries significantly impacts patients’ outcomes. Patients with specific complications like bleeding, cardiac, or graft issues are more likely to experience secondary complications, failure to rescue, longer hospital stays, or reoperations. Tailoring quality improvement strategies to address different index complications could improve overall surgical outcomes.

Journal Article by Chen VW, Portuondo J and Massarweh NN in BMC Surg

Copyright © 2024 Elsevier Inc. All rights reserved.

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Decrease in Postoperative Complications Over Time

Analysis of 7,474,298 patients revealed decreasing preoperative risk and unadjusted postoperative complication rates from 2005 to 2018 within ACS-NSQIP. While mortality levels remained stable, other complications saw reductions, except for cardiac issues. Hospitals in the program experienced enhanced risk-adjusted outcomes, indicating a positive trend in surgical care quality improvement.

Journal Article by Stuart CM, Henderson WG (…) Meguid RA et 2 al. in BMC Surg

Copyright © 2024 Elsevier Inc. All rights reserved.

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CRP-to-Albumin Ratio Predicts Anastomotic Leakage in Rectal Cancer Patients Using ICG-FI

Preoperative C-reactive protein-to-albumin ratio (CAR) ≥ 0.049 was identified as an independent risk factor for anastomotic leakage (AL) in rectal cancer patients undergoing surgery with intraoperative indocyanine green fluorescence imaging (ICG-FI). CAR could serve as a criterion for early surgical intervention or consideration of interventions like diverting stoma creation, potentially lowering the incidence of AL in this group of patients.

Journal Article by Harada T, Numata M (…) Saito A et 14 al. in Surg Endosc

© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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Aprepitant Effectively Prevents Post-bariatric Surgery Nausea and Vomiting

Aprepitant significantly reduces postoperative nausea and vomiting in patients undergoing metabolic bariatric surgery, improving recovery and patient satisfaction. Meta-analysis of six studies involving 929 patients showed a significant decrease in ponv incidence with aprepitant, particularly at 0, 6, and 12 hours postoperatively. Administering aprepitant within the first 24 hours post-surgery is recommended for optimal efficacy.

Journal Article by Zhu C, Zhao T, Wu Q and Da M in Obes Surg

© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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Perioperative Biobank Study: Examining High-Risk Surgical Complications

Postoperative complications in high-risk surgical populations increase mortality, disability, and costs. BIGPROMISE cohort profile discusses rationale and scope to investigate risk factors and outcomes related to postoperative complications. Over 3000 adult patients undergoing major surgery contribute data and biomarkers for analysis. With a focus on pathophysiological processes, the study aims to improve risk stratification for adverse postoperative outcomes. NCT05199025.

Multicenter Study by Noordzij PG, Ruven HJ (…) Rettig TC et 8 al. in BMJ Open

© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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Food Environment Impacts Gastrointestinal Cancer Outcomes

Patients in regions with poorer food environments exhibit higher odds of late-stage gastrointestinal cancer diagnosis and worse survival rates. These disparities are pronounced across various cancer types, highlighting the need for targeted interventions to mitigate socioeconomic and dietary influences on cancer outcomes.

Journal Article by Fei-Zhang DJ, Schellenberg SJ (…) Pawlik TM et 2 al. in J Surg Oncol

© 2024 The Authors. Journal of Surgical Oncology published by Wiley Periodicals LLC.

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Thick mesopancreas predicts surgical outcomes in pancreaticoduodenectomy

Patients undergoing pancreaticoduodenectomy with a thick mesopancreas face significantly longer operative times, higher estimated blood loss, fewer resected lymph nodes, increased overall and major morbidities, and prolonged hospital stays. This study underscores the mesopancreas thickness as a critical predictor of surgical outcomes, surpassing the predictive value of body mass index. Tailoring surgical strategies based on mesopancreas thickness could optimize outcomes and guide preoperative planning in pancreaticoduodenectomy.

Journal Article by Endo Y, Noda H (…) Rikiyama T et 6 al. in Langenbecks Arch Surg

© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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Comparable Postoperative Outcomes by IMG Surgeons

Postoperative outcomes among patients treated by international medical graduate (IMG) surgeons were comparable to those by United States medical graduate (USMG) surgeons. IMG surgeons had lower rates of adverse postoperative outcomes, such as 90-day readmission and index complications. They were also more likely to care for patients with multiple comorbidities and from vulnerable communities, showcasing their effectiveness in delivering quality care across diverse patient populations.

Journal Article by Khan MMM, Munir MM (…) Pawlik TM et 9 al. in Ann Surg

Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

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Postoperative Complications and Patient-Reported Outcomes

Postoperative complications were associated with significantly worse patient-reported outcomes, including lower physical and mental health scores, higher pain interference and fatigue, and lower physical function. A substantial number of patients reported outcomes below national benchmarks, emphasizing the need for improved post-surgical care to enhance patients’ quality of life. This study highlights the critical impact of complications on various dimensions of health-related quality of life, indicating a crucial opportunity for quality improvement in surgical care.

Journal Article by Liu JB, Pusic AL (…) Temple LK et 5 al. in Ann Surg

Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

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Complications Associated with 30-Day Mortality After General Surgery

Among general surgery patients, major bleeding, sepsis, and myocardial injury after non-cardiac surgery (MINS) were independently associated with 30-day mortality. These complications had the largest attributable fraction of post-operative deaths. Findings suggest the need for strategies, such as perioperative bleeding prophylaxis, to reduce mortality in this patient population.

Journal Article by Park LJ, Borges FK (…) Devereaux PJ et 17 al. in Ann Surg

Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

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