high risk surgical patient
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2022 ◽  
Vol 270 ◽  
pp. 394-404
Author(s):  
Adam R. Dyas ◽  
Michael R. Bronsert ◽  
Robert A. Meguid ◽  
Kathryn L. Colborn ◽  
Anne Lambert-Kerzner ◽  
...  

2021 ◽  
pp. 0310057X2110171
Author(s):  
Aidan I Fullbrook ◽  
Elizabeth P Redman ◽  
Kerry Michaels ◽  
Lisa R Woods ◽  
Aruntha Moorthy ◽  
...  

Various perioperative interventions have been demonstrated to improve outcomes for high-risk patients undergoing surgery. This audit assessed the impact of introducing a multidisciplinary perioperative medicine clinic on postoperative outcomes and resource usage amongst high-risk patients. Between January 2019 and March 2020, our institution piloted a Comprehensive High-Risk Surgical Patient Clinic. Surgical patients were eligible for referral when exhibiting criteria known to increase perioperative risk. The patient’s decision whether to proceed with surgery was recorded; for those proceeding with surgery, perioperative outcomes and bed occupancy were recorded and compared against a similar surgical population identified as high-risk at our institution in 2017. Of 23 Comprehensive High-Risk Surgical Patient Clinic referrals, 11 did not proceed with the original planned surgery. Comprehensive High-Risk Surgical patients undergoing original planned surgery, as compared to high-risk patients from 2017, experienced reduced unplanned intensive care unit admission (8% versus 19%, respectively), 30-day mortality (0% versus 13%) and 30-day re-admission to hospital (0% versus 20%); had shorter postoperative lengths of stay (median (range) 8 (7–14) days versus 10.5 (5–28)) and spent more days alive outside of hospital at 30 days (median (range) 18 (0–25) versus 21 (16–23)). Cumulatively, the Comprehensive High-Risk Surgical patient cohort compared to the 2017 cohort (both n=23) occupied fewer postoperative intensive care (total 13 versus 24) and hospital bed-days (total 106 versus 212). The results of our Comprehensive High-Risk Surgical Patient pilot project audit suggest improved individual outcomes for high-risk patients proceeding with surgery. In addition, the results support potential resource savings through more appropriate patient selection.


2021 ◽  
Vol 233 (5) ◽  
pp. e54-e55
Author(s):  
Adam R. Dyas ◽  
Michael R. Bronsert ◽  
Robert A. Meguid ◽  
Kathryn L. Colborn ◽  
Anne Lambert-Kerzner ◽  
...  

2021 ◽  
Vol 66 (8) ◽  
pp. 1337-1340
Author(s):  
Angela Meier ◽  
Diana Hylton ◽  
Ulrich H Schmidt

2021 ◽  
Vol 14 (5) ◽  
pp. e45-e47
Author(s):  
Deanna Gill ◽  
Sean Evans ◽  
Matthew T. Brown ◽  
Ananth Vadde ◽  
Ronald Chang ◽  
...  

Author(s):  
Christel A. van Beijsterveld ◽  
Bart C. Bongers ◽  
Marcel den Dulk ◽  
Cornelis H. Dejong ◽  
Nico L. van Meeteren

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