Researchers evaluate outcomes and costs in perioperative care

August 20, 2013

Differences in the utilization of intensive care services may be one potential explanation for improved outcomes after major surgery in the U.S. versus other nations, according to a commentary published in JAMA Surgery by researchers from the Perelman School of Medicine at the University of Pennsylvania.

The researchers comment on two recent studies from Europe that document international variations in surgical outcomes, along with suggestive evidence as to the causes of these variations.

The first study, published by researchers in the U.K., showed that of half the high-risk in the study who died never went to an (ICU). Instead of being admitted directly to the intensive care unit after surgery, they received treatment on a standard surgical ward. The second study, published in 2012 by a group of researchers from 28 European countries, found that among surgical patients who died during hospitalization, 75 percent were never treated in an ICU.

In their commentary, corresponding author Mark D. Neuman, MD, MSc, assistant professor of Anesthesiology and Critical Care and co-author Lee A. Fleisher, MD, chair of the Department of Anesthesiology and Critical Care, note past evidence indicating more aggressive use of critical care services in the U.S. compared to other nations. In one study of American and British patients who died after major surgical procedures, approximately 8.5 percent of the U.K. patients were admitted to an ICU at some point in their hospital stay, compared to 61 percent in the U.S.

"While it's too early to make definitive claims regarding the degree to which ICU care might produce survival benefits for surgical patients, the evidence we have to date clearly warrants further study," says Neuman.

The authors add that the national consensus to limit spending on while also preserving creates a need for a better understanding of how pre- and post-surgical care – as well as the care delivered during surgical procedures themselves – contributes to in the United States.

Explore further: Delayed transfer to the ICU increases risk of death in hospital patients

Related Stories

Delayed transfer to the ICU increases risk of death in hospital patients

May 21, 2013
Delayed transfer to the intensive care unit (ICU) in hospitalized patients significantly increases the risk of dying in the hospital, according to a new study from researchers in Chicago.

Mortality rates for emergency surgical admissions vary widely among hospitals in England

July 17, 2013
A new study reveals significant hospital-to-hospital variability in patient death rates following emergency surgical admissions in England. Published early online in the BJS (British Journal of Surgery), the study also found ...

Pre-op triage of total hip replacement patients improves outcomes

March 25, 2013
(Medical Xpress)—According to a new study by researchers from the Perelman School of Medicine at the University of Pennsylvania, pre-operatively identifying patients with certain comorbid risk factors that may increase ...

Europe-wide study finds death rates after surgery double that of recent estimates

September 20, 2012
National estimates of death following general surgery have been too optimistic, suggests the first large-scale study to explore surgical outcomes across Europe published in the first Article in a special Lancet theme issue ...

Study finds survival from cardiac arrest highest in the operating room or post-anesthesia care unit

May 1, 2013
A University of Michigan study from the "Online First" edition of Anesthesiology found cardiac arrest was associated with improved survival when it occurred in the operating room (O.R.) or post-anesthesia care unit (PACU) ...

Can supplementing vitamin D reduce infections in patients from neurosurgical ICU?

July 15, 2013
Vitamin D influences many other physiological processes, including muscle function, cardiovascular homeostasis, nerve function, and immune response. Furthermore, accumulated evidence suggests that vitamin D also mediates ...

Recommended for you

World's first child hand transplant a 'success'

July 19, 2017
The first child in the world to undergo a double hand transplant is now able to write, feed and dress himself, doctors said Tuesday, declaring the ground-breaking operation a success after 18 months.

Knee surgery—have we been doing it wrong?

July 18, 2017
A team of University at Buffalo medical doctors have published a study that challenges a surgical practice used for decades during arthroscopic knee surgery.

New tools help surgeons find liver tumors, not nick blood vessels

July 17, 2017
The liver is a particularly squishy, slippery organ, prone to shifting both deadly tumors and life-preserving blood vessels by inches between the time they're discovered on a CT scan and when the patient is lying on an operating ...

Researchers discover indicator of lung transplant rejection

July 13, 2017
Research by scientists at Dignity Health St. Joseph's Hospital and Medical Center's Norton Thoracic Institute was published in the July 12, 2017 issue of Science Translational Medicine titled "Zbtb7a induction in alveolar ...

New device could make closing surgical incisions a cinch

July 7, 2017
Like many surgeons, Dr. Jason Spector is often faced with the challenge of securely closing the abdominal wall without injuring the intestines. If the process goes awry, there can be serious consequences for patients, including ...

Success with first 20 patients undergoing minimally invasive pancreatic transplant surgery

June 29, 2017
Surgeons at Johns Hopkins Medicine report that their first series of a minimally invasive procedure to treat chronic pancreas disease, known as severe pancreatitis, resulted in shorter hospital stays, less need for opioids ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.