surgery

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Epidemiology

  • 1/3 of all surgeries performed in patients > 65 years of age

Indications

Contraindications

  • pregnancy not a contraindication
    • *general surgery as safe for pregnant women as it is for nonpregnant women[14]

Laboratory

Complications

Management

Notes

  • older surgeons may have a small advantage in operative mortality rates over younger colleagues[22]
  • female surgeons 50-59 years of age with lowest operative mortality rates[22]
    • no other differences in gender with operative mortality
  • internist involvement helps only as part of a multidisciplinary team[26]

More general terms

More specific terms

Additional terms

References

  1. Stedman's Medical Dictionary 27th ed, Williams & Wilkins, Baltimore, 1999.
  2. Jump up to: 2.0 2.1 Journal Watch 24(1):11, 2004 Birkmeyer JD et al, N Engl J Med 349:2117, 2003 PMID: https://www.ncbi.nlm.nih.gov/pubmed/14645640
  3. Surgical site infection National Institute for Cost Effectiveness (NICE) http://www.nice.org.uk/Guidance/CG74
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    Jacobs DO. Variation in hospital mortality associated with inpatient surgery - An S.O.S. N Engl J Med 2009 Oct 1; 361:1398. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/19797288 <Internet> http://content.nejm.org/cgi/content/full/361/14/1398?ijkey=4912dc43fd0dfc3fec779ce907adeb6d01438c1c&keytype2=tf_ipsecsha
  5. Jump up to: 5.0 5.1 5.2 Moore LJ et al Sepsis in General Surgery The 2005-2007 National Surgical Quality Improvement Program Perspective Arch Surg. 2010;145(7):695-700. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/20644134 <Internet> http://archsurg.ama-assn.org/cgi/content/abstract/145/7/695
  6. Jump up to: 6.0 6.1 Bradley KA et al. Alcohol screening and risk of postoperative complications in male VA patients undergoing major non-cardiac surgery. J Gen Intern Med 2011 Feb; 26:162. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20878363
    Harris AHS et al. Preoperative alcohol screening scores: Association with complications in men undergoing total joint arthroplasty. J Bone Joint Surg Am 2011 Feb; 93:321 PMID: https://www.ncbi.nlm.nih.gov/pubmed/21325583
  7. Jump up to: 7.0 7.1 Mills E et al. Smoking cessation reduces postoperative complications: A systematic review and meta-analysis. Am J Med 2011 Feb; 124:144. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21295194
  8. O'Leary JG, Yachimski PS, Friedman LS. Surgery in the patient with liver disease. Clin Liver Dis. 2009 May;13(2):211-31. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19442915
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    Schwarze ML et al. Surgeons expect patients to buy-in to postoperative life support preoperatively: Results of a national survey. Crit Care Med 2013 Jan; 41:1. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23222269
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    Devereaux PJ et al for the POISE-2 Investigators. Clonidine in patients undergoing noncardiac surgery. N Engl J Med 2014 Mar 31 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24679061 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1401106
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  15. Jump up to: 15.0 15.1 ProPublica. July 13, 2015 Making the Cut. Why choosing the right surgeon matters even more than you know. https://www.propublica.org/article/surgery-risks-patient-safety-surgeon-matters
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  20. Jump up to: 20.0 20.1 20.2 20.3 World Health Organization (WHO) WHO recommends 29 ways to stop surgical infections and avoid superbugs. WHO News Release, Nov 3, 2016 http://www.who.int/mediacentre/news/releases/2016/recommendations-surgical-infections/en/
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  25. NEJM Knowledge+ Question of the Week, June 30, 2020 https://knowledgeplus.nejm.org/question-of-week/635/
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