Surgery/Specialties Editor's Note This study from Johns Hopkins Bayview Medical Center, Baltimore, found a significant relationship between OR door openings and room pressure. The OR door was opened, on average, once every 2.5 minutes of surgery. For 77 of 191 knee and hip arthroplasties, the doors were open long enough for…
Editor's Note The Centers for Medicare and Medicaid Services (CMS) has finalized the rule that will require hospitals in 67 geographic areas to participate in a test of bundled payments for hip and knee replacements, Modern Healthcare reports. Medicare's average bundled payment ranges from $16,500 to $33,000 for surgery, hospitalization,…
Editor's Note In patients requiring long coronary stents, the use of intravascular ultrasound (IVUS)-guided vs angiography-guided drug-eluting stent implantation resulted in a significantly lower rate (2.9% absolute reduction, 48% relative reduction) of major adverse cardiac events at 1 year, finds this study. These differences were mainly driven by the reduction…
Editor's Note A condition known as “post hospital syndrome” (PHS) is a significant risk factor for readmissions in patients who undergo elective ambulatory surgery, this study finds. Post hospital syndrome (PHS) is defined as having been hospitalized within 90 days before surgery. During hospitalization, patients are often sleep deprived and…
Editor's Note Though recent studies using large databases have concluded that neuraxial compared with general anesthesia is associated with a decreased incidence of SSIs in total joint patients, this 11-year retrospective, controlled study found no difference. The use of peripheral nerve blocks also was not found to influence the incidence…
Editor's Note Since publication of the Appropriate Use Criteria for Coronary Revascularization in 2009, the number of nonacute percutaneous coronary interventions (PCIs) has declined significantly (89,704 vs 59,375). The proportion of nonacute PCIs classified as inappropriate has also declined (26.2% vs 13.3%), although hospital-level variation persists. These findings indicate that…
Editor's Note Blacks are at a significantly higher risk of having total knee revision surgery within 5 years than whites, finds a study presented at the American College of Rheumatology Annual Meeting in San Francisco. The risk of revision was 38% higher in blacks. When blacks undergo knee replacement they…
Editor's Note Referred to as the “July phenomenon,” the influx of new surgical residents and interns at the beginning of the academic year is assumed to be associated with poor outcomes. This study of nearly 1.5 million patients who had emergency general surgery either early (July-August) or late (September-June) in…
Editor's Note Quality improvement initiatives combined with pulsed xenon ultraviolet room disinfection reduced total knee surgical site infections (SSIs) from four to zero and total hip SSIs from three to zero for a combined prevention of seven SSIs and a savings of $290,990 in 1 year at Trinity Medical Center,…
Editor's Note Quest Medical, Inc (Allen, Texas), on October 28 initiated a nationwide recall of its Myocardial Protection System delivery sets, Models 5001102, 5001102-AS, and 7001102 of specified lots. The sets have shown possible seal failure along the blood source channel of the main pump cassette, resulting in blood loss…
