Search results for "Perioperative Care"
Buprenorphine, cannabis, and other periop challenges
Perioperative medication management is particularly tricky when it comes to patients who are already taking drugs for chronic pain.
https://acphospitalist.acponline.org/archives/2023/11/22/buprenorphine-cannabis-and-other-periop-challenges.htm
22 Nov 2023
Two common assessment methods highlight link between frailty and postoperative delirium
An analysis of elective surgery patients ages 70 years or older found that those assessed as frail by the frailty index or frailty phenotype had double the risk of postoperative delirium versus those who weren't frail.
https://acphospitalist.acponline.org/archives/2023/11/22/two-common-assessment-methods-highlight-link-between-frailty-and-postoperative-delirium.htm
22 Nov 2023
Adding vancomycin to cefazolin didn't reduce infections among arthroplasty patients
Cefazolin plus vancomycin did not lead to lower surgical-site infection rates compared with cefazolin plus placebo in patients getting knee, hip, or shoulder replacement surgery, a randomized trial in Australia found.
https://acphospitalist.acponline.org/archives/2023/10/25/free/adding-vancomycin-to-cefazolin-didnt-reduce-infections-among-arthroplasty-patients.htm
25 Oct 2023
Use of preoperative cardiac testing varies problematically, can be changed, review finds
Patients who were older or had more comorbidities were more likely to get preoperative cardiac testing, but so were those seen by a preoperative clinic or a cardiologist rather than in primary care, according to a systematic review.
https://acphospitalist.acponline.org/archives/2023/09/27/use-of-preoperative-cardiac-testing-varies-problematically-can-be-changed-review-finds.htm
27 Sep 2023
Haloperidol, atypical antipsychotics carry similar risks for older patients after surgery
Low to moderate doses of haloperidol, olanzapine, quetiapine, or risperidone didn't differ in risk of inpatient mortality, arrhythmia, pneumonia, and stroke or transient ischemic attack, according to a retrospective study of postoperative patients ages 65 years and older.
https://acphospitalist.acponline.org/archives/2023/09/06/haloperidol-atypical-antipsychotics-carry-similar-risks-for-older-patients-after-surgery.htm
6 Sep 2023
Recommendations on preventing surgical-site infections updated
The latest recommendations from the Society for Healthcare Epidemiology of America lowered the recommended postoperative target glucose level from less than 180 mg/dL to between 110 and 150 mg/dL, among other changes.
https://acphospitalist.acponline.org/archives/2023/05/10/recommendations-on-preventing-surgical-site-infections-updated.htm
10 May 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
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
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
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