British journal of anaesthesia最新文献

Curriculum for neuraxial procedural training using medical extended reality.

IF 9.8 1区医学

British journal of anaesthesia Pub Date : 2025-04-24 DOI: 10.1016/j.bja.2025.03.007

John E Rubin,Rohan Jotwani

引用次数: 0

Near-fatal perfluorocarbon-induced gas embolism after complex vitreoretinal surgery.

IF 9.8 1区医学

British journal of anaesthesia Pub Date : 2025-04-23 DOI: 10.1016/j.bja.2025.03.021

Oskar Voegtlin,Eliana Tadini,Nicolas Milliet,Romain Guyot,Thomas Wolfensberger,Marc Augsburger,Jean-Daniel Chiche

引用次数: 0

Palliative prognostic tools in surgical patients at the end of life: a systematic review.

IF 9.8 1区医学

British journal of anaesthesia Pub Date : 2025-04-23 DOI: 10.1016/j.bja.2025.03.008

Chuan-Whei Lee,Aaron B Wong,Smaro Lazarakis,Wen Kwang Lim,Jai Darvall

{"title":"Palliative prognostic tools in surgical patients at the end of life: a systematic review.","authors":"Chuan-Whei Lee,Aaron B Wong,Smaro Lazarakis,Wen Kwang Lim,Jai Darvall","doi":"10.1016/j.bja.2025.03.008","DOIUrl":"https://doi.org/10.1016/j.bja.2025.03.008","url":null,"abstract":"BACKGROUNDIdentifying surgical patients at the end of life (EOL) is the first step in integrating palliative and perioperative practices. Palliative prognostic tools (PPTs) are established frameworks from palliative care that assess patients at risk of early death. We conducted a systematic review investigating PPTs in adult surgical populations, their role in surgical decision-making, and their association with perioperative outcomes.METHODSA prospectively registered systematic review was performed (PROSPERO registration: CRD42023411303). Ovid MEDLINE, Ovid EMBASE, and Cochrane CENTRAL (Wiley) databases were searched for studies investigating PPTs in surgical patients. The primary outcome was the decision to proceed to surgery; secondary outcomes included mortality, quality of life, palliative care consultation, and EOL documentation completion. Abstract screening, full-text review, and study quality appraisal were performed by two authors independently. Results were synthesised narratively owing to study heterogeneity.RESULTSSeven studies assessing four different PPTs were included in the review. Studies identified that 12-61% of surgical patients were at the EOL. Patients identified as being at the EOL by a PPT using an illness phase, trajectory approach, or both had an increased in-hospital and 12-month mortality. The impact on decisions to proceed to surgery was uncertain because of conflicting results. Palliative care referral and EOL document completion occurred in <15% of surgical patients at the EOL. No studies described patient-reported outcomes.CONCLUSIONSPalliative prognostic tools have significant potential for incorporation into preoperative assessment. Future research should focus on preoperative end of life assessments and patient-reported outcomes such as quality of life, decision satisfaction, and disability-free survival.","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"219 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143876415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Frailty and long-term survival of non-cancer patients admitted to intensive care after surgery: a retrospective multicentre cohort study.

IF 9.8 1区医学

British journal of anaesthesia Pub Date : 2025-04-23 DOI: 10.1016/j.bja.2025.03.002

Ryo Ueno,Rachel Chan,Ryan Ruiyang Ling,Ryan Slack,Sandra Lussier,Daryl Jones,David Pilcher,Ashwin Subramaniam

{"title":"Frailty and long-term survival of non-cancer patients admitted to intensive care after surgery: a retrospective multicentre cohort study.","authors":"Ryo Ueno,Rachel Chan,Ryan Ruiyang Ling,Ryan Slack,Sandra Lussier,Daryl Jones,David Pilcher,Ashwin Subramaniam","doi":"10.1016/j.bja.2025.03.002","DOIUrl":"https://doi.org/10.1016/j.bja.2025.03.002","url":null,"abstract":"BACKGROUNDAs the global population ages and older patients undergo surgery, understanding the association between frailty and postoperative outcomes is crucial to informed decision-making and patient care. There is a lack of research assessing the association between frailty and long-term outcomes in patients admitted to ICUs after surgery.METHODSWe conducted a multicentre retrospective cohort study using Australian and New Zealand Intensive Care Society Adult Patient Database, linked with the Australian National Death Index. Adults aged ≥16 yr admitted to the 175 ICUs in Australia between January 1, 2018, and March 31, 2022, after surgery were included. We excluded patients with cancer or admission to ICU for palliation or organ donation purpose. Patients with Clinical Frailty Scale score 5-8 were considered frail. The primary outcome was survival time up to 4 yr after ICU admission. Survival analysis was performed using mixed-effects Cox regression models and adjusted for age, sex, comorbidities, acute illness severity, and hospital types.RESULTSWe included 216 922 patients of whom 30 860 (14.2%) were frail. Patients with frailty had shorter overall survival time (median [IQR]: 16 [6-29] vs 21 [10-34] months; P<0.01) when compared with patients without frailty. After adjusting for confounders, frailty was associated with a shorter time to death (HR: 2.33, 95% CI: 2.26-2.40). This association was consistent across sensitivity analyses and subgroups. Of note, this association between frailty and shorter time to death was more pronounced in patients aged <65 yr, those undergoing elective surgery, and those without treatment limitations.CONCLUSIONSIn this multicentre study, frailty was associated with shorter time to death amongst postoperative ICU patients without cancer. The association was concordant across all subgroups.","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"7 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143876417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of grit levels on surgical patients' quality of postoperative recovery.

IF 9.8 1区医学

British journal of anaesthesia Pub Date : 2025-04-23 DOI: 10.1016/j.bja.2025.02.033

Joshua G Kovoor,Daksh Tyagi,Brandon Stretton,Aashray K Gupta,Matthew Marshall-Webb,Stephen Bacchi,Christopher Dobbins,Thomas J Hugh,Robert T Padbury,Markus I Trochsler,Guy J Maddern

引用次数: 0

Hospital length of stay, 30-day emergency readmissions and the role of the DrEaMing enhanced recovery pathways in colonic and rectal surgery in England.

IF 9.8 1区医学

British journal of anaesthesia Pub Date : 2025-04-22 DOI: 10.1016/j.bja.2025.02.034

Mindy Dawes,Zoë Packman,Ruth A McDonald,Mark J Cheetham,Nannette M T Gallagher-Ball,Eleanor Warwick,Maria Oyston,Emma McCone,Chris Snowden,Michael Swart,Tim W R Briggs,William K Gray

{"title":"Hospital length of stay, 30-day emergency readmissions and the role of the DrEaMing enhanced recovery pathways in colonic and rectal surgery in England.","authors":"Mindy Dawes,Zoë Packman,Ruth A McDonald,Mark J Cheetham,Nannette M T Gallagher-Ball,Eleanor Warwick,Maria Oyston,Emma McCone,Chris Snowden,Michael Swart,Tim W R Briggs,William K Gray","doi":"10.1016/j.bja.2025.02.034","DOIUrl":"https://doi.org/10.1016/j.bja.2025.02.034","url":null,"abstract":"BACKGROUNDEnhanced recovery pathways (ERPs) are designed to improve patient outcomes after elective surgery. Our primary aim was to examine whether shorter hospital stay, as a surrogate ERP outcome, was associated with higher 30-day emergency readmission rates for colonic and rectal surgery in England. A secondary aim was to assess how hospital trust compliance with a specific postoperative care bundle, drinking, eating, and mobilising (DrEaMing) within 24 h, relates to outcomes.METHODSThis was a retrospective analysis of observational data from the Hospital Episode Statistics dataset for England. All patients aged ≥17 yr undergoing elective colonic or rectal surgery for cancer between April 1, 2014, and March 31, 2024, were included.RESULTSShorter hospital stays were significantly associated with a lower rate of 30-day emergency readmission among 124 580 colonic and 87 036 rectal surgery patients. Comparing the first (reference) and fourth quartile of length of stay, the odds of 30-day emergency readmission increased by 2.16 (95% confidence interval [CI] 2.04-2.30) and 2.41 (95% CI 2.26-2.57) for colonic and rectal surgery, respectively. Increased hospital trust DrEaMing compliance was associated with a reduction in the number of patients with extended length of stay (colonic surgery: X2=24.885, P<0.001; rectal surgery: X2=61.670, P<0.001) and was not associated with 30-day emergency readmission.CONCLUSIONSWe found no evidence that shorter length of stay, or greater DrEaMing compliance, were associated with higher emergency admission rates. These findings should not be interpreted as causal.","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"1 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143871981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Optimal securement techniques for peripheral nerve catheters: a quality improvement cycle.

IF 9.8 1区医学

British journal of anaesthesia Pub Date : 2025-04-22 DOI: 10.1016/j.bja.2025.03.016

Li Ching Ooi,Bernadette R Findlay,Joshua M Wiesel,Renata Hadzic,Jonathan Penm,Jennifer A Stevens

引用次数: 0

Associate Editorial Board and cover image caption 副编委和封面图片说明

IF 9.1 1区医学

British journal of anaesthesia Pub Date : 2025-04-20 DOI: 10.1016/S0007-0912(25)00175-8

引用次数: 0

Mind the messenger: role of extracellular vesicle signalling in postoperative neurocognitive dysfunction.

IF 9.8 1区医学

British journal of anaesthesia Pub Date : 2025-04-17 DOI: 10.1016/j.bja.2025.03.003

Samarjit Das,Michael J Devinney,Miles Berger,Charles H Brown

引用次数: 0

Global synergy in anaesthesia training: the crucial role of international collaborations for trainees from low-resource countries.

IF 9.8 1区医学

British journal of anaesthesia Pub Date : 2025-04-17 DOI: 10.1016/j.bja.2025.03.020

Baththirange Malaka Munasinghe,Jayasuriya N J A Sahan Sachitra,Martin F Mayall

引用次数: 0