(Reducing the risk of major elective surgery: randomised controlled trial of pre-operative optimisation of oxygen delivery)
Intensive care treatment of patients about to undergo major elective surgery can help to improve survival rates, say researchers in this week's BMJ. Major surgery in high risk people produces large numbers of critically ill patients, but appropriate pre-operative care may help to reduce mortality, morbidity and even reduce total stay in hospital, say Dr Jonathan Wilson and colleagues from York District Hospital.
They studied 138 patients undergoing major elective surgery, who were at risk of developing postoperative complications. In the UK, most patients are taken from a general ward directly to the operating theatre before such surgery and so the authors compared the outcome of patients who were treated in this normal way and of those who were given pre-operative treatment.
They found that those patients who had received treatment before their operation had a mortality rate of three per cent as opposed to 17 per cent in those patients who did not. Wilson et al conclude that even though a formal cost benefit analysis was not performed, the cost of pre-operative investment in high dependency care facilities could be offset by the reduction in complications and length of hospital stay.
Contact:
Dr Jonathan Wilson, Consultant, Department of Anaesthetics, York District Hospital, York jonathan@critbase.demon.co.uk