Perioperative Medicine最新文献

{"title":"Development and validation of a post-operative delirium prediction model for patients undergoing abdominal surgery: a retrospective, observational, single-center study.","authors":"Zhi-Hua Huang, Maneesh Kumarsing Beeharry, Xiao-Ying Xu, Cheng-Rong Bao, Lei Tao, Yan Luo","doi":"10.1186/s13741-025-00639-0","DOIUrl":"10.1186/s13741-025-00639-0","url":null,"abstract":"<p><strong>Background: </strong>Postoperative delirium (POD) is a common complication following major surgery in elderly. The purpose of this study was to develop and evaluate a POD prediction model for patients undergoing abdominal surgery.</p><p><strong>Methods: </strong>One thousand consecutive patients scheduled for elective abdominal surgery from July 2019 to March 2021 in Ruijin Hospital, Shanghai China, were retrospectively analysed, and their demographics, pre-operative evaluation, and intra-operative parameters were collected and cross-analysed. The primary outcome was the POD incidence. A prediction model of POD was established and internal validation was conducted with various analyses including univariate and multivariate regression. Data from another cohort of346 patients enrolled from July 2021 to December 2021 were used for model external validation.</p><p><strong>Results: </strong>After screening, 838 patients were included as the training cohort and 10.9% (91/838) of the patients manifested POD. Old age, cerebrovascular disease and diazepam use history and intraoperative fluid imbalance were the main contributors of the POD prediction model. The optimum cut-off point of the predicted probability that maximised the sum of sensitivity and specificity was 0.12. The fitting set AUC was 0.703 (95% Confidence interval (CI) 0.637-0.753). The sensitivity and specificity of the model were 0.556 and 0.754 respectively. The mean AUC during the cross and external validation of the model was 0.684 [Standard Deviation (SD) 0.068] and 0.634 (95%CI 0.511-0.758) respectively.</p><p><strong>Conclusions: </strong>Our data indicated that improving perioperative management may reduce POD incidence in patients who are old age and have cerebrovascular disease history.</p><p><strong>Trial registration: </strong>The retrospective data (ChiCTR2100047405) of this study was registered in the Chinese Clinical Trial registry ( https://www.chictr.org.cn/ ).</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13020371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147321798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep neuromuscular blockade improves surgical conditions during laparoendoscopic single-site (LESS) surgery for total hysterectomy and reduces postoperative pain: a randomized controlled trial.","authors":"Yiwei Shen, Jingjie Hu, Feng Lv, Chang Yu, Yao Gong, Dan Wang, Xing Zeng","doi":"10.1186/s13741-026-00664-7","DOIUrl":"10.1186/s13741-026-00664-7","url":null,"abstract":"","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13059396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147317685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrolaminar versus erector spinae plane block for enhanced recovery after cesarean section: a retrospective study.","authors":"Serpil Bayındır, Cengiz Şanlı","doi":"10.1186/s13741-026-00657-6","DOIUrl":"10.1186/s13741-026-00657-6","url":null,"abstract":"","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12964910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147308845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An integrated random forest- and LASSO-derived nomogram for predicting postoperative nosocomial infections in colorectal cancer patients.","authors":"Ranran Lu, Xiujuan Xue, Tongtong Chen, Yanhong Wang","doi":"10.1186/s13741-026-00667-4","DOIUrl":"10.1186/s13741-026-00667-4","url":null,"abstract":"","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13041146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147308801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of the hypotension prediction index as an indicator of hypotensive haemodynamic instability in surgical patients.","authors":"Simon Davies, Sai Buddi, Zhongping Jian, Neal W Fleming, Maxime Cannesson, Michael Sander, Denise P Veelo, Alexander P J Vlaar, Thomas W L Scheeren, Monty Mythen, Feras Hatib","doi":"10.1186/s13741-026-00661-w","DOIUrl":"https://doi.org/10.1186/s13741-026-00661-w","url":null,"abstract":"","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147284783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bayesian statistics: a primer for perioperative medicine clinicians.","authors":"Guido Mazzinari, Fernando G Zampieri, Michael O Harhay, Marcus J Schultz, David M van Meenen, Ary Serpa-Neto","doi":"10.1186/s13741-026-00659-4","DOIUrl":"10.1186/s13741-026-00659-4","url":null,"abstract":"<p><p>Bayesian methods offer an intuitive and coherent statistical framework for updating probabilistic beliefs by integrating prior knowledge-whether from existing data or expert consensus-with new evidence via likelihood functions to generate posterior probability distributions. This approach yields clinically meaningful outputs, such as credible intervals and probabilities of treatment benefit, and can incorporate thresholds relevant to practice, like the region of practical equivalence (ROPE). Recent advances in computation-including Markov chain Monte Carlo (MCMC) sampling, Hamiltonian Monte Carlo algorithms, and probabilistic programming languages like Stan and JAGS- have made Bayesian approaches feasible even for complex hierarchical models. In perioperative medicine, these methods are particularly valuable for (1) complementing trial results by quantifying clinically important effects in the context of statistically nonsignificant findings or modest probabilities of benefit despite statistical significance, (2) enhancing meta-analyses through coherent integration of heterogeneous studies and sparse data, and (3) enabling adaptive and platform trial designs through continuous evidence synthesis. The ability to incorporate informative priors can complement existing knowledge, especially in small-sample studies, which are common in perioperative medicine, where traditional approaches provide insufficient precision. Although concerns remain regarding subjectivity in prior specification, these are increasingly addressed through structured guidelines, benchmark priors, and comprehensive sensitivity analyses. Altogether, Bayesian methods provide a flexible and powerful alternative for generating actionable insights in complex clinical settings, including in perioperative care.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13037322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147284758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined epidural-general anesthesia reduces opioid use and improves recovery after laparoscopic hysterectomy: a retrospective cohort study.","authors":"Shufen Jiang, Songquan Kong, Qianqian Fang","doi":"10.1186/s13741-026-00654-9","DOIUrl":"10.1186/s13741-026-00654-9","url":null,"abstract":"","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13032700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146776482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative anesthesia management of GLP-1 receptor agonists: a systematic review of potential risks.","authors":"Zachary I Merhavy, Zachary Kowal, Taylor Spencer, Anna Maria Trachuk, Alexander Aldanese, Zulfiqar Ahmed, Camelia Arsene","doi":"10.1186/s13741-026-00662-9","DOIUrl":"10.1186/s13741-026-00662-9","url":null,"abstract":"","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13032261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146776522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of perioperative tight glycemic control on prognosis in diabetic abdominal surgery patients: a systematic review and meta-analysis.","authors":"Tianle Zhang, Danni Song, Mingyue Shao, Gang Wang, Zhiwei Jiang","doi":"10.1186/s13741-026-00651-y","DOIUrl":"10.1186/s13741-026-00651-y","url":null,"abstract":"","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13045101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146227495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RAPID-CHD pathway improves clinical outcomes in neonates with congenital heart disease.","authors":"Chenyu Li, Zhongyuan Lu, Shilin Wang, Xia Li, Xiaofeng Wang, Qinnan Chen, Xu Wang","doi":"10.1186/s13741-026-00650-z","DOIUrl":"10.1186/s13741-026-00650-z","url":null,"abstract":"<p><strong>Background: </strong>Timely and effective management is crucial for neonates with critical congenital heart disease (CCHD). This study investigated the impact of the RAPID-CHD Pathway, a coordinated referral and transport system, compared with conventional management models.</p><p><strong>Methods: </strong>This retrospective study included neonates (≤ 28 days) with CCHD admitted between January 2019 and December 2024. Group 1 comprised neonates enrolled in the RAPID-CHD Pathway: prenatally diagnosed, delivered in designated maternity hospitals, and transferred via a dedicated fast-track pathway. Group 2 included those referred from other hospitals or self-admitted. Major adverse events (MAEs) were defined as in-hospital death or discharge against medical advice. Logistic regression was used to assess associations between management strategies and MAEs.</p><p><strong>Results: </strong>Among 587 neonates (Group 1: n = 141; Group 2: n = 446), 439 underwent surgery (Group 1: n = 116; Group 2: n = 323). Group 1 had earlier ICU admission (0 vs 6 days, P < 0.001), earlier surgery (7 vs 15 days, P < 0.001), lower rates of low birth weight (< 2.5 kg: 5.7% vs 18.2%, P < 0.001), fewer emergency surgeries (9.5% vs 18.9%, P = 0.028), and higher surgical rates (82.3% vs 72.4%, P = 0.025). MAEs were lower in Group 1 (5.7% vs 12.6%, P = 0.033). Among patients who underwent surgery, the RAPID-CHD pathway remained associated with a trend toward reduced MAEs after adjustment (aOR 0.36; 95% CI, 0.11-1.20).</p><p><strong>Conclusions: </strong>The RAPID-CHD Pathway improves early access to care, surgical opportunities, and outcomes in neonates with CCHD. It supports wider adoption in tertiary pediatric cardiac centers.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13019993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146220757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}