학술논문
A Multidisciplinary High-Risk Surgery Committee May Improve Perioperative Decision Making for Patients and Physicians.
Document Type
Article
Author
Source
Subject
*PERIOPERATIVE care
*VETERANS' hospitals
*COMMITTEES
*DISCUSSION
*OPERATIVE surgery
*SURGERY
*PATIENTS
*RETROSPECTIVE studies
*RISK assessment
*MEDICAL protocols
*HUMAN services programs
*HEALTH care teams
*QUALITY assurance
*DESCRIPTIVE statistics
*INTERPROFESSIONAL relations
*COMMUNICATION
*PHYSICIANS
*DECISION making in clinical medicine
SURGICAL complication risk factors
MORTALITY risk factors
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Language
ISSN
1096-6218
Abstract
Background: Surgeons must evaluate and communicate the risk associated with operative procedures for patients at high risk of poor postoperative outcomes. Multidisciplinary approaches to complex decision making are needed. Objective: To improve physician decision making for high-risk surgical patients. Design: This is a retrospective review of patients presented to a multidisciplinary committee for three years. Setting/Subjects: Evaluation of patients was done in a single-center U.S. veterans affairs (VA) hospital. All patients who were considered for surgery had a VA Surgical Quality Improvement Program (VASQIP) risk calculator 30-day mortality >5%. Measurements: Thirty-day and one-year mortality were measured. Results: Seventy-six patients were reviewed with an average expected 30-day mortality of 14.2%. Forty-two patients (57%) had a recommended change in the care plan before surgery. Fifty-four patients (71%) proceeded with surgery and experienced a 30-day mortality of 7.4%. Conclusions and Relevance: Multidisciplinary discussion of high-risk surgical patients may help surgeons make perioperative recommendations for patients. Implementation of a multidisciplinary high-risk committee should be considered at facilities that manage high-risk surgical patients. [ABSTRACT FROM AUTHOR]