Area Deprivation and Postoperative Quality of Life After Major Operations for Cancer.

Introduction: Neighborhood deprivation, a measure of socioeconomic status, has been associated with worse postoperative outcomes. Its impact on postoperative quality of life (QOL) has not been concretely determined. We performed a secondary analysis of a randomized controlled trial to test the hypothesis that increased neighborhood deprivation is associated with worse postoperative QOL.

Perioperative Supportive Care Interventions to Enhance Surgical Outcomes for Older Adults With Cancer: A Systematic Review.

Purpose: Older adults with cancer have unique needs, which likely influence surgical outcomes in the geriatric oncology population. We conducted a systematic review to describe the literature focused on perioperative supportive care interventions for older adults with cancer undergoing surgery.

Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we performed a comprehensive search using the Ovid MEDLINE, CINAHL, and Embase databases for literature published from January 2010 to October 2023.

Patient Perceptions of Specialist Palliative Care Intervention in Surgical Oncology Care.

IntroductionSurgical oncology patients have a high symptom burden and increased risk of morbidity. The aim of palliative care is to evaluate and treat the patient in a holistic manner focusing on the unique attributes of each patient. This goal-concordant approach could help surgical patients cope with the stress and uncertainty that often accompany serious illness and surgery, improving overall outcomes.

Palliative Care Clinicians' Views on Metrics for Successful Specialist Palliative Care Delivery in the ICU.

Context: A quarter of palliative care (PC) clinicians' consultations are now requested from the intensive care unit (ICU). Despite this high usage, a standardized set of quality metrics for PC delivery in the ICU does not exist.

Objectives: To explore PC clinicians' views on how to best measure quality of care delivery in their role as a consultant in the ICU setting.

Palliative clinical trials in advanced chronic liver disease: Challenges and opportunities.

Patients with advanced chronic liver disease have a complex symptom burden and many are not candidates for curative therapy. Despite this, provision of palliative interventions remains woefully inadequate, with an insufficient evidence base being a contributory factor. Designing and conducting palliative interventional trials in advanced chronic liver disease remains challenging for a multitude of reasons.

Effects of Specialist Palliative Care for Patients Undergoing Major Abdominal Surgery for Cancer: A Randomized Clinical Trial.

Importance: Specialist palliative care benefits patients undergoing medical treatment of cancer; however, data are lacking on whether patients undergoing surgery for cancer similarly benefit from specialist palliative care.

Objective: To determine the effect of a specialist palliative care intervention on patients undergoing surgery for cure or durable control of cancer.

Design, Setting, And Participants: This was a single-center randomized clinical trial conducted from March 1, 2018, to October 28, 2021.

Interpreting the risk analysis index of frailty in the context of surgical oncology.

Background And Objectives: The Risk Analysis Index (RAI) accurately predicts adverse postoperative outcomes but the inclusion of cancer status in the RAI has raised two key concerns about its suitability for use in surgical oncology: (1) the potential over classification of cancer patients as frail, and (2) the potential overestimation of postoperative mortality for patients with surgically curable cancers.

Methods: We performed a retrospective cohort analysis to assess the RAI's power to appropriately identify frailty and predict postoperative mortality in cancer patients. We assessed discrimination for mortality and calibration across five RAI models-the complete RAI and four variants that removed different cancer-related variables.

Spirituality in Surgery-A Double-Edged Scalpel.

Investigating, respecting, and working with surgical patients' spiritualities is as critical a skill as the proficient technical performance of operations. When spirituality is ignored, sacred patient values remain undiscovered, authentic trust is hindered, and healthy shared decision-making processes suffer. These are instances when the other edge of the spiritual scalpel comes back to cut us as surgeons, but more importantly, upon withdrawal of spiritual understanding, it deeply injures our patients and their families.

Patient Perspectives on Perioperative Supportive Care Needs Surrounding Major Abdominal Operations for Cancer.

Purpose: The development of supportive care interventions delivered by surgeons for their patients is a major research priority. Designing such interventions requires understanding patients' supportive care needs for major operations. This qualitative analysis aimed to determine the supportive care needs of patients undergoing major abdominal operations for cancer.

Sex-Related Differences in Acuity and Postoperative Complications, Mortality and Failure to Rescue.

Introduction: Yentl syndrome describing sex-related disparities has been extensively studied in medical conditions but not after surgery. This retrospective cohort study assessed the association of sex, frailty, presenting with preoperative acute serious conditions (PASC), and the expanded Operative Stress Score (OSS) with postoperative complications, mortality, and failure-to-rescue.

Methods: The National Surgical Quality Improvement Program from 2015 to 2019 evaluating 30-d complications, mortality, and failure-to-rescue.

Top Ten Tips Palliative Care Clinicians Should Know About Solid Organ Transplantation.

Solid organ transplantation (SOT) is a life-saving procedure for people with end-stage organ failure. However, patients experience significant symptom burden, complex decision making, morbidity, and mortality during both pre- and post-transplant periods. Palliative care (PC) is well suited and historically underdelivered for the transplant population.

Comparing Veterans Affairs and Private Sector Perioperative Outcomes After Noncardiac Surgery.

Importance: Recent legislation facilitates veterans' ability to receive non-Veterans Affairs (VA) surgical care. However, contemporary data comparing the quality and safety of VA and non-VA surgical care are lacking.

Objective: To compare perioperative outcomes among veterans treated in VA hospitals with patients treated in private-sector hospitals.

"Aren't Surgery and Palliative Care Kind of Opposites?".

Surgery is often considered one of the most aggressive forms of medical care. Palliative care, on the other hand, usually focuses on eliminating aggressive forms of medical care in the name of patient comfort. This article explores the seeming incongruity between surgery and palliative care, conditions in which surgery and palliation coexist, and further integration of surgery and palliation.

Integrating Specialist Palliative Care in the Liver Transplantation Evaluation Process: A Qualitative Analysis of Hepatologist and Palliative Care Provider Views.

Patients undergoing evaluation for liver transplantation face heavy burdens of symptoms, health care use, and mortality. In other similarly ill populations, specialist palliative care has been shown to benefit patients, but specialist palliative care is infrequently used for liver transplantation patients. This project aims to describe the potential benefits of and barriers to specialist palliative care integration in the liver transplantation process.

The Correlation Between Case Total Work Relative Value Unit, Operative Stress, and Patient Frailty: Retrospective Cohort Study.

Objective: Assess the relationships between case total work relative value units (wRVU), patient frailty, and the physiologic stress of surgical interventions.

Summary Of Background Data: Surgeon reimbursement is frequently apportioned by wRVU. These subjective, procedure-specific valuations generated by physician survey estimate the intensity and time for typical patient care services.

Using the Unified Medical Language System to Expand the Operative Stress Score - First Use Case.

Background: The Unified Medical Language System (UMLS) maps relationships between and within >100 biomedical vocabularies, including Current Procedural Terminology (CPT) codes, creating a powerful knowledge resource which can accelerate clinical research.

Methods: We used synonymy and concepts relating hierarchical structure of CPT codes within the UMLS, (1) guiding surgical experts in expanding the Operative Stress Score (OSS) from 565 originally rated CPT codes to additional, 1,853 related procedures; (2) establishing validity of the association between the added OSS ratings and 30-day outcomes in VASQIP (2015-2018).

Results: The UMLS Metathesaurus and Semantic Network was converted into an interactive graph database (https://github.

Association of Frailty and the Expanded Operative Stress Score with Preoperative Acute Serious Conditions, Complications, and Mortality in Males Compared to Females: A Retrospective Observational Study.

Objective: The aim of this study was to expand Operative Stress Score (OSS) increasing procedural coverage and assessing OSS and frailty association with Preoperative Acute Serious Conditions (PASC), complications and mortality in females versus males.

Summary Background Data: Veterans Affairs male-dominated study showed high mortality in frail veterans even after very low stress surgeries (OSS1).

Methods: Retrospective cohort using NSQIP data (2013-2019) merged with 180-day postoperative mortality from multiple hospitals to evaluate PASC, 30-day complications and 30-, 90-, and 180-day mortality.

Statistical analysis plan for the Surgery for Cancer with Option of Palliative Care Expert (SCOPE) trial: a randomized controlled trial of a specialist palliative care intervention for patients undergoing surgery for cancer.

Background: The impact of specialist palliative care intervention in patients undergoing surgery for cancer has not been studied extensively. The SCOPE randomized controlled trial will investigate the effect of specialist palliative care intervention in cancer patients undergoing surgery for selected abdominal malignancies. The study protocol of the SCOPE Trial was published in December 2019.

Association Between Patient Frailty and Postoperative Mortality Across Multiple Noncardiac Surgical Specialties.

Importance: Frailty is an important risk factor for postoperative mortality. Whether the association between frailty and mortality is consistent across all surgical specialties, especially those predominantly performing lower stress procedures, remains unknown.

Objective: To examine the association between frailty and postoperative mortality across surgical specialties.

Association of Preoperative Frailty and Operative Stress With Mortality After Elective vs Emergency Surgery.

This cohort study investigates whether preoperative patient frailty and operative stress are associated with postoperative mortality for patients undergoing elective vs emergent surgical procedures.