Monday August 26, 2019

Deadliest Time for Many Surgery Patients isn’t When They’re on Operating Table

Researchers monitored patients for complications and deaths within 30 days of surgery

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FILE - A medical team performs hernia surgery in an operating room near Riohacha, Colombia, Nov. 27, 2018. VOA

The deadliest time for many surgery patients isn’t when they’re on the operating table, it’s while they’re recovering in the hospital and after they go home, a new study suggests.

For the study, researchers examined outcomes for more than 40,000 patients age 45 and older who underwent non-cardiac surgery at 28 hospitals in 14 countries. Researchers monitored patients for complications and deaths within 30 days of surgery.

Overall, five people, or less than 1% of patients, died on the operating table, and another 500 patients, or 70%, died in the hospital. Another 210 deaths, or 29%, didn’t happen until after patients were sent home.

Nearly half of all the deaths were associated with three complications: major bleeding, heart damage, and bloodstream infections.

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The deadliest time for many surgery patients isn’t when they’re on the operating table, it’s while they’re recovering in the hospital and after they go home, a new study suggests. Pixabay

“Many families anxiously wait to hear from the surgeon whether their loved one survived the operation, but our research demonstrates that very few of the deaths occur in the operating room,” said Dr. P.J. Devereaux, senior author of the study and director of the Division of Perioperative Care at McMaster University in Canada.

“Our research now demonstrates that there is a need to focus on postoperative care and transitional care into the home setting to improve outcomes,” Devereaux said by email.

Worldwide, 100 million patients age 45 and older undergo inpatient surgery unrelated to cardiac issues every year, researchers note in CMAJ.

Study details

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A wide range of technological and medical advances have made surgery safer and less invasive in recent years, the study team notes. But at the same time, patients also are coming to the hospital sicker and being sent home with complex care needs that once would have meant a lengthy hospital stay.

In the study, roughly half of the patients had high blood pressure, one in five had diabetes, and 13% had coronary artery disease.

More than one-third of them came in only for low-risk procedures that were not emergencies. Many of the rest had major general, orthopedic, urological, gynecological, vascular or neurological operations.

Patients who experienced major bleeding after surgery were more than twice as likely to die within 30 days as people who didn’t have this complication.

 

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For the study, researchers examined outcomes for more than 40,000 patients age 45 and older who underwent non-cardiac surgery at 28 hospitals in 14 countries. Pixabay

And patients who developed heart injuries even though they didn’t have heart surgery were also more than twice as likely to die.

Patients who got sepsis, a serious bloodstream infection, were more than five times more likely to die within 30 days than people who didn’t get these infections.

Inflammation 

The study wasn’t a controlled experiment designed to identify which if any complications actually caused any deaths. Inflammation may be a common denominator in the complications that were most responsible for deaths, said Barnaby Charles Reeves of the University of Bristol in the U.K., author of an editorial accompanying the study.

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“Surgery causes a body-wide inflammatory reaction,” Reeves said by email. “This can lead to single or multi-organ failure (kidney, heart, lungs, sepsis etc.) which leads to death.”

Patients may also not recognize that something is wrong when they’re coming off anesthesia or taking narcotic painkillers after surgery, Devereaux said.

“This makes patients after surgery vulnerable to delays in recognizing complications and hence delays in treatment,” Devereaux said.

Surgery also activates patients’ inflammatory, stress, and coagulation systems. The activation of these systems can also predispose patients to major complications. Patients should advocate and support research into enhanced monitoring techniques after surgery, which can help sort out identifying ways to lower the risk of death after surgery. (VOA)

Next Story

Medical Selfies can Improve Relationship between Patient and Doctor: Study

For the study published in the Journal of Medical Internet Research, researchers first interviewed 30 patients, clinicians and caregivers

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For the study published in the Journal of Medical Internet Research, researchers first interviewed 30 patients, clinicians and caregivers. Pixabay

Taking medical ‘selfies’ and sharing them with a doctor empowers and reassures patients and can improve their relationship with the medical practitioner, a research has found.

“Healthcare consumers feel this data is valuable, it helps them have a sense of autonomy in their care, improves their view of the service they are being provided and it enhances the relationship between doctor and patient because there is a sense of mutual respect and communication,” said Kara Burns from the Queensland University of Technology in Australia.

To gauge experiences with and attitudes to consumer-generated health photographs, the researchers conducted a two-part study. For the study published in the Journal of Medical Internet Research, researchers first interviewed 30 patients, clinicians and caregivers.

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Women taking selfie (Representational Image). VOA

In the second part, parents were asked to take photos of their children’s surgical wounds at the hospital and send it to the surgeon so that he could review healing.

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Parents said it improved their confidence in and satisfaction with the medical service and taking the photos was a useful reminder for them to check how the surgical sites were healing. The findings from the photographic trial supported conclusions drawn from the interview study.

“The parents who took part in the trial said they felt reassured and that the service was going above and beyond. They said normally the door feels shut when you leave a hospital and providing the photos was a way to stay connected and contact the surgeon afterwards,” Burns said. (IANS)