Jie Wang , Dewen Zhu , Xiaocou Wang , Chunwei Lian
{"title":"Hypotension after general anaesthesia induction using remimazolam or propofol in geriatric patients undergoing sevoflurane anaesthesia with remifentanil. Comment on Br J Anaesth 2024; 133: 24–32","authors":"Jie Wang , Dewen Zhu , Xiaocou Wang , Chunwei Lian","doi":"10.1016/j.bja.2024.11.015","DOIUrl":"10.1016/j.bja.2024.11.015","url":null,"abstract":"","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"134 2","pages":"Pages 597-598"},"PeriodicalIF":9.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812182","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}
Carolyn Deng, Tanisha Jowsey, Ines Becker, Doug Campbell, Jack Hill, Jignal Bhagvandas, Ralph Fuchs, Nicholas J Lightfoot, Kaveh Djamali, Jennifer Weller
{"title":"Patients' perceptions of brain health after surgery: a mixed-methods study of perioperative risk communication in older surgical patients in New Zealand.","authors":"Carolyn Deng, Tanisha Jowsey, Ines Becker, Doug Campbell, Jack Hill, Jignal Bhagvandas, Ralph Fuchs, Nicholas J Lightfoot, Kaveh Djamali, Jennifer Weller","doi":"10.1016/j.bja.2024.12.026","DOIUrl":"https://doi.org/10.1016/j.bja.2024.12.026","url":null,"abstract":"<p><strong>Background: </strong>We explored how adult surgical patients perceived their risk of major postoperative complications, including neurological complications, and how much information they wanted to receive about such risks.</p><p><strong>Methods: </strong>We undertook a mixed-methods study including a 13-item survey and thematic analysis of semi-structured interviews with patients undergoing noncardiac, non-neurologic surgery.</p><p><strong>Results: </strong>Of 557 distributed surveys, 547 were returned completed. Of these, 88% of respondents had previously undergone surgery. Respondents were most likely to indicate an extreme level of concern for major stroke (64%), followed by heart attack (56%), minor stroke (46%), and cognitive decline (43%). Women were more likely to indicate a higher level of concern for cognitive decline than men (odds ratio 1.6, 95% confidence interval 1.1-2.4, P=0.015). Seventeen people participated in interviews. Six themes were identified: (1) trust in healthcare professionals; (2) surgery to achieve hopes and ambitions; (3) previous experiences govern expectations and perception of risk; (4) positive outlook and spirituality as protective factors; (5) support matters; and (6) a personalised approach to risk discussion.</p><p><strong>Conclusions: </strong>Many participants did not know the risks of major perioperative complications but based their risk perception on previous experiences and trust in health professionals. Participants focused on hope more than their concerns. Information provision should be personalised as patients expressed differences in the desired amount of information on risks.</p>","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143077901","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}
{"title":"Use of glomerular filtration rate to estimate perioperative cardiac risk","authors":"Arman Valadkhani , Max Bell","doi":"10.1016/j.bja.2024.11.022","DOIUrl":"10.1016/j.bja.2024.11.022","url":null,"abstract":"<div><div>Preoperative estimated glomerular filtration rate is an inexpensive but useful tool in predicting cardiovascular perioperative complications. Estimated glomerular filtration rate, especially considering its interaction with age, might act as a proxy for severity of cardiovascular disease. Further studies regarding the predictive power of estimated glomerular filtration rate to identify patients at risk of perioperative cardiovascular complications are essential.</div></div>","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"134 2","pages":"Pages 263-265"},"PeriodicalIF":9.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063843","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}
Pavel S. Roshanov , Michael W. Walsh , Amit X. Garg , Meaghan Cuerden , Ngan N. Lam , Ainslie M. Hildebrand , Vincent W. Lee , Marko Mrkobrada , Kate Leslie , Matthew T.V. Chan , Flavia K. Borges , Chew Yin Wang , Denis Xavier , Daniel I. Sessler , Wojciech Szczeklik , Christian S. Meyhoff , Sadeesh K. Srinathan , Alben Sigamani , Juan Carlos Villar , Clara K. Chow , P.J. Devereaux
{"title":"Preoperative estimated glomerular filtration rate to predict cardiac events in major noncardiac surgery: a secondary analysis of two large international studies","authors":"Pavel S. Roshanov , Michael W. Walsh , Amit X. Garg , Meaghan Cuerden , Ngan N. Lam , Ainslie M. Hildebrand , Vincent W. Lee , Marko Mrkobrada , Kate Leslie , Matthew T.V. Chan , Flavia K. Borges , Chew Yin Wang , Denis Xavier , Daniel I. Sessler , Wojciech Szczeklik , Christian S. Meyhoff , Sadeesh K. Srinathan , Alben Sigamani , Juan Carlos Villar , Clara K. Chow , P.J. Devereaux","doi":"10.1016/j.bja.2024.10.039","DOIUrl":"10.1016/j.bja.2024.10.039","url":null,"abstract":"<div><h3>Background</h3><div>Optimised use of kidney function information might improve cardiac risk prediction in noncardiac surgery.</div></div><div><h3>Methods</h3><div>In 35,815 patients from the VISION cohort study and 9219 patients from the POISE-2 trial who were ≥45 yr old and underwent nonurgent inpatient noncardiac surgery, we examined (by age and sex) the association between continuous nonlinear preoperative estimated glomerular filtration rate (eGFR) and the composite of myocardial injury after noncardiac surgery, nonfatal cardiac arrest, or death owing to a cardiac cause within 30 days after surgery. We estimated contributions of predictive information, C-statistic, and net benefit from eGFR and other common patient and surgical characteristics to large multivariable models.</div></div><div><h3>Results</h3><div>The primary composite occurred in 4725 (13.2%) patients in VISION and 1903 (20.6%) in POISE-2; in both studies cardiac events had a strong, graded association with lower preoperative eGFR that was attenuated by older age (<em>P</em><sub>interaction</sub><0.001 for VISION; <em>P</em><sub>interaction</sub>=0.008 for POISE-2). For eGFR of 30 compared with 90 ml min<sup>−1</sup> 1.73 m<sup>−2</sup>, relative risk was 1.49 (95% confidence interval 1.26–1.78) at age 80 yr but 4.50 (2.84–7.13) at age 50 yr in female patients in VISION. This differed modestly (but not meaningfully) in men in VISION (<em>P</em><sub>interaction</sub>=0.02) but not in POISE-2 (<em>P</em><sub>interaction</sub>=0.79). eGFR contributed the most predictive information and mean net benefit of all predictors in both studies, most C-statistic in VISION, and third most C-statistic in POISE-2.</div></div><div><h3>Conclusions</h3><div>Continuous preoperative eGFR is among the best cardiac risk predictors in noncardiac surgery of the large set examined. Along with its interaction with age, preoperative eGFR would improve risk calculators.</div></div><div><h3>Clinical trial registration</h3><div>ClinicalTrials.gov <span><span>NCT00512109</span><svg><path></path></svg></span> (VISION) and <span><span>NCT01082874</span><svg><path></path></svg></span> (POISE-2).</div></div>","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"134 2","pages":"Pages 297-307"},"PeriodicalIF":9.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11775841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hypotension after general anaesthesia induction using remimazolam or propofol in geriatric patients undergoing sevoflurane anaesthesia with remifentanil. Comment on Br J Anaesth 2024;133:24–32","authors":"Ting Yan, Zhong-Meng Lai","doi":"10.1016/j.bja.2024.11.016","DOIUrl":"10.1016/j.bja.2024.11.016","url":null,"abstract":"","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"134 2","pages":"Pages 599-600"},"PeriodicalIF":9.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817344","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}
{"title":"Balanced crystalloids in kidney transplantation: the unknown benefits following donation after circulatory arrest","authors":"Stephen R. Knight , Colin C. Geddes","doi":"10.1016/j.bja.2024.10.038","DOIUrl":"10.1016/j.bja.2024.10.038","url":null,"abstract":"","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"134 2","pages":"Pages 590-591"},"PeriodicalIF":9.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142821909","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}
Daniel James Drayton , Jonathan Adam Batty , Simon James Howell , Marlous Hall
{"title":"Characterising multimorbidity in patients undergoing cardiac surgery: a study of 1.6 million patients in the USA","authors":"Daniel James Drayton , Jonathan Adam Batty , Simon James Howell , Marlous Hall","doi":"10.1016/j.bja.2024.11.010","DOIUrl":"10.1016/j.bja.2024.11.010","url":null,"abstract":"","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"134 2","pages":"Page 619"},"PeriodicalIF":9.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143139312","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}