Surgery/Specialties Editor's Note Many total hip and knee patients are still taking opioid pain medication up to 6 months after surgery, finds this study. The study identifies several predictors for persistent opioid use: Of patients taking opioids before surgery, 53% of total knee and 35% of total hip patients were still…
Editor's Note As part of the drive to reduce opioid use, rotator-cuff repairs are becoming a testing ground for alternative approaches to pain management, the May 23 Wall Street Journal reports. Because rotator-cuff surgery is one of the most painful procedures to recover from, physicians hope that if alternative painkilling…
Editor's Note This study found that implementation of a clinical practice guideline for management of pediatric complicated appendicitis standardized practice patterns among surgeons and was associated with reduced resource use and improved patient outcomes. Compared with the pre-guideline group, patients in the post-guideline group were less likely to: receive a…
Editor's Note In this study, patient factors, hospital case volume, and practice patterns were found to be associated with in-hospital mortality after elective abdominal aortic aneurysm (AAA) repair. Of 166, 443 AAA repairs performed at 1,207 hospitals, in-hospital mortality was 0.7% for endovascular AAA repair and 3.8% for open AAA…
Editor's Note Fast-track total hip and knee arthroplasties with a median length of stay of 3 days and discharge to home are feasible in most patients 85 years of age or older, this study finds. Of 13,775 procedures included in the analysis: median age was 87 years and median length…
Editor's Note Medical chart review for surgical site infections (SSIs) that were identified through administrative data is an efficient supplemental SSI surveillance strategy following total hip and knee arthroplasty, this study finds. Of 162 patients with potential SSIs identified by diagnosis or procedure code, 46 (28%) were confirmed as an…
Editor's Note In this study, researchers concluded that risk-adjusted postoperative 30-day mortality is useful as a surrogate for long-term outcomes in patients at Veterans Health Administration (VHA) hospitals. Though the VHA has used 30-day mortality as a measure of surgical quality for more than 20 years, the measure has been…
Editor's Note The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) Surgical Risk Calculator accurately estimates the risk of postoperative complications, and the calculator’s performance would improve with recalibration, this study finds. The statistical analysis for this study was based on 2.7 million surgical records collected between…
Editor's Note Arthroscopic surgery may not be the best option for patients over 60 years of age with hip arthritis, this study finds. Though most patients prefer minimally invasive hip arthroscopy rather than total hip replacement, researchers from the Hospital for Special Surgery, New York City, found that more than…
Editor's Note In this study, Medicare patients having common surgical procedures at critical access hospitals had no significant difference in 30-day mortality than those at noncritical access hospitals (5.4% vs 5.6%), and they had lower rates of serious complications (6% vs 14%) and lower expenditures ($14,450 vs $15, 845). The…
