Search results for "Perioperative Care"
New guideline released on periop management of antithrombotic therapy
The American College of Chest Physicians issued 44 recommendations, covering use of vitamin K antagonists, heparin bridging, direct oral anticoagulants, and antiplatelet drugs in patients undergoing surgeries or procedures.
https://acphospitalist.acponline.org/archives/2022/08/17/free/new-guideline-released-on-periop-management-of-antithrombotic-therapy.htm
17 Aug 2022
Gabapentin associated with delirium, pneumonia in older postop patients
A propensity-matched study found that patients ages 65 years and older who received gabapentin after surgery had a 3.4% risk of delirium and 1.3% risk of pneumonia, compared to 2.6% and 1.2%, respectively, in patients not taking the drug. Risk of in-hospital death was similar between groups.
https://acphospitalist.acponline.org/archives/2022/09/28/gabapentin-associated-with-delirium-pneumonia-in-older-postop-patients.htm
28 Sep 2022
Nearly 1 in 7 community-living Medicare patients died within year after major surgery
Mortality rates after major surgery were 28% among patients who were frail and 33% among those with dementia, a prospective longitudinal cohort study of Medicare fee-for-service beneficiaries found.
https://acphospitalist.acponline.org/archives/2022/10/26/nearly-1-in-7-community-living-medicare-patients-died-within-year-after-major-surgery.htm
26 Oct 2022
ESKD patients more likely to survive procedures when dialysis done closer to surgery
The 90-day mortality rate after a surgical procedure was 5.2% in Medicare patients with end-stage kidney disease (ESKD) who last underwent dialysis three days prior to surgery, compared to 4.7% with dialysis two days prior and 4.2% with it one day prior, a retrospective study found.
https://acphospitalist.acponline.org/archives/2022/11/09/eskd-patients-more-likely-to-survive-procedures-when-dialysis-done-closer-to-surgery.htm
9 Nov 2022
Guidelines recommend universal screening for cannabinoids prior to surgery
New recommendations from the American Society of Regional Anesthesia and Pain Medicine aim to help clinicians make safe, evidence-based decisions regarding the perioperative management of patients who consume cannabis.
https://acphospitalist.acponline.org/archives/2023/01/11/free/guidelines-recommend-universal-screening-for-cannabinoids-prior-to-surgery.htm
11 Jan 2023
Restrictive postop opioid protocols associated with changes in opioid prescribing, chronic use
Opioids prescribed after surgery and rates of conversion to long-term therapy decreased after a protocol limiting postop opioid prescriptions to three days or fewer was implemented at a tertiary care cancer center.
https://acphospitalist.acponline.org/archives/2023/01/11/restrictive-postop-opioid-protocols-associated-with-changes-in-opioid-prescribing-chronic-use.htm
11 Jan 2023
Antimicrobial prophylaxis guidelines often not followed after elective surgery
A retrospective cohort study of 521,091 inpatient surgeries at 825 U.S. hospitals found that vancomycin was the most frequently misused agent and its use was associated with increased rates of acute kidney injury.
https://acphospitalist.acponline.org/archives/2023/02/22/antimicrobial-prophylaxis-guidelines-often-not-followed-after-elective-surgery.htm
22 Feb 2023
Frailty screening intervention linked to reduced mortality in year after elective surgery
A best practice alert identified patients with frailty and prompted surgeons to document a frailty-informed shared decision-making process and/or refer for additional evaluation by a multidisciplinary presurgery clinic or a primary care physician.
https://acphospitalist.acponline.org/archives/2023/03/01/frailty-screening-intervention-linked-to-reduced-mortality-in-year-after-elective-surgery.htm
1 Mar 2023
Postoperative mortality risk low by one month after COVID-19, study finds
An analysis of surgeries in England since COVID-19 vaccines were widely available found that surgery within two weeks of a positive SARS-CoV-2 test carried a 1.1% mortality rate, which declined to 0.3% by four weeks after infection.
https://acphospitalist.acponline.org/archives/2023/04/05/free/postoperative-mortality-risk-low-by-one-month-after-covid-19-study-finds.htm
5 Apr 2023
Withholding antihypertensives around surgery didn't affect vascular complication rate
Patients who didn't take their hypertension medications before and for two days after surgery had a lower incidence of intraoperative hypotension, but no difference in hypotension after surgery compared to those who continued medications.
https://acphospitalist.acponline.org/archives/2023/04/26/withholding-antihypertensives-around-surgery-didnt-affect-vascular-complication-rate.htm
26 Apr 2023