Preoperative internal medicine evaluation is associated with a reduction in 30-Day postoperative mortality risk in patients with cancer

Q2 Nursing

Perioperative Care and Operating Room Management Pub Date : 2022-03-01 DOI:10.1016/j.pcorm.2021.100240

Tacara N. Soones , Anna Guo , Jessica T. Foreman , Cheuk Hong Leung , Heather Y. Lin , Shannon Popovich , Sunil K. Sahai , Jessica P. Hwang

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引用次数: 0

Abstract

Background

Patients commonly undergo evaluation by internists prior to surgery. However, the impact of preoperative internal medicine evaluations on the postoperative outcomes of patients with cancer is uncertain.

Methods

We conducted a retrospective cohort study of patients who had been included in the National Surgery Quality Improvement Program from 2011 to 2014 from a single hospital specializing in cancer care to determine the effect of an Internal Medicine Perioperative Assessment Center (IMPAC) evaluation (IMPAC group) on the risk of 30-day mortality compared to that of patients who proceeded directly to surgery (control group).

Results

Of the 11,577 participants, 3,589 underwent an IMPAC evaluation. The absolute 30-day mortality was 0.47% for the IMPAC group and 0.50% for the control group. After propensity matching, the odds ratio (OR) of 30-day mortality was 0.39 (95% CI=0.18–0.84) for the IMPAC group in comparison to the control group.

Conclusions

Our findings demonstrate that a preoperative internal medicine evaluation was associated with lower 30-day mortality. Additional studies are needed to identify which patient populations are most likely to benefit and which attributes of the internal medicine evaluation are most beneficial.

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术前内科评估与癌症患者术后30天死亡风险降低相关

背景:患者通常在手术前接受内科医生的评估。然而，术前内科评估对癌症患者术后预后的影响尚不确定。方法对2011年至2014年入选国家手术质量改进计划的某肿瘤专科医院患者进行回顾性队列研究，以确定内科围手术期评估中心(IMPAC)评估(IMPAC组)与直接进行手术的患者(对照组)对30天死亡率风险的影响。结果在11577名参与者中，3589人接受了IMPAC评估。IMPAC组的绝对30天死亡率为0.47%，对照组为0.50%。倾向匹配后，与对照组相比，IMPAC组30天死亡率的比值比为0.39 (95% CI= 0.18-0.84)。结论我们的研究结果表明，术前内科评估与较低的30天死亡率相关。需要进一步的研究来确定哪些患者群体最有可能受益，哪些内科评估属性最有益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Perioperative Care and Operating Room Management Nursing-Medical and Surgical Nursing

CiteScore

1.30

自引率

0.00%

发文量

审稿时长

56 days

期刊介绍： The objective of this new online journal is to serve as a multidisciplinary, peer-reviewed source of information related to the administrative, economic, operational, safety, and quality aspects of the ambulatory and in-patient operating room and interventional procedural processes. The journal will provide high-quality information and research findings on operational and system-based approaches to ensure safe, coordinated, and high-value periprocedural care. With the current focus on value in health care it is essential that there is a venue for researchers to publish articles on quality improvement process initiatives, process flow modeling, information management, efficient design, cost improvement, use of novel technologies, and management.