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Persistent pain after surgery is surprisingly common, with 10-20% of patients reporting pain 6 or 12 months after surgery. After high risk operations such as hernia repair, mastectomy, and thoracotomy, the reported risk is up to 50%.
The risk of POCD increases with age, and the type of surgery is also important because there is a very low incidence associated with minor surgery. [4] POCD is common in adult patients of all ages at hospital discharge after major noncardiac surgery, but only the elderly (aged 60 years or older) are at significant risk for long-term cognitive ...
Of operative risk factors, surgical site is the most important predictor of risk for PPCs (aortic, thoracic, and upper abdominal surgeries being the highest-risk procedures, even in healthy patients. [16] The value of preoperative testing, such as spirometry, to estimate pulmonary risk is of controversial value and is debated in medical literature.
The Revised Cardiac Risk Index (RCRI) is a tool used to estimate a patient's risk of perioperative cardiac complications. The RCRI and similar clinical prediction tools are derived by looking for an association between preoperative variables (e.g., patient's age, type of surgery, comorbid diagnoses, or laboratory data) and the risk for cardiac complications in a cohort of surgical patients ...
In 1991 the National VA Surgical Risk Study (NVASRS) began in 44 Veteran's Administration Medical Centers. By 31 December 1993, there was information for 500,000 non-cardiac surgical procedures. In 1994 NVASRS was expanded to all 128 HVA hospitals that performed the surgery.
In 1977, Goldman created the "Goldman Index," which is used by cardiologists as a means of evaluating the cardiac risk of non-cardiac surgery. [7] He later developed the "Goldman Criteria," a set of guidelines that help healthcare workers determine which patients with chest pain require hospital admission.
Myocardial injury after non-cardiac surgery, also known as MINS, refers to at least one elevated post-operative troponin level presumed to be of an ischemic mechanism. [ 1 ] [ 2 ] There is an absence of any overt non-ischemic causes to explain this elevation.
The Surgical Care and Outcomes Assessment Program (SCOAP) is a clinician-led, performance benchmarking and quality improvement (QI) registry for surgical and interventional procedures. [ 1 ] SCOAP was established in 2005 through a grassroots effort of Washington State's surgical community led by David Flum, MD, MPH, and the state chapter of the ...
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