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A novel anesthesiologist‐led multidisciplinary model for evaluating high‐risk surgical patients at a comprehensive cancer center
Author(s) -
Sroka Raymond,
Gabriel Emmanuel M.,
AlHadidi Danna,
Nurkin Steven J.,
Urman Richard D.,
Quinn Timothy D.
Publication year - 2018
Publication title -
journal of healthcare risk management
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.221
H-Index - 16
eISSN - 2040-0861
pISSN - 1074-4797
DOI - 10.1002/jhrm.21326
Subject(s) - medicine , perioperative , cancer , surgery , multidisciplinary approach , general surgery , retrospective cohort study , diabetes mellitus , vascular surgery , cardiac surgery , social science , sociology , endocrinology
The objective of this retrospective analysis was to describe the development and implementation of an anesthesiologist‐led multidisciplinary committee to evaluate high‐risk surgical patients in order to improve surgical appropriateness. The study was conducted in an anesthesia preoperative evaluation clinic at an academic comprehensive cancer center. One hundred sixty‐seven high‐risk surgical patients with cancer‐related diagnoses were evaluated and discussed at a High‐Risk Committee (HRC) meeting to determine surgical appropriateness and optimize perioperative care. The HRC is an anesthesiologist‐led model for multidisciplinary review of high‐risk patients developed at Roswell Park Comprehensive Cancer Center. The group of high‐risk patients in which surgery was not performed had, on average, a greater percentage of hypertension, smoking history, dyspnea, heart failure, chronic obstructive pulmonary disease, diabetes, renal failure, and sleep apnea than the group in whom surgery was performed. Only one of 107 high‐risk patients who had surgery died within the first 30 days after surgery. A smaller percentage of patients died in the group that had surgery versus the group in which surgery was canceled. For all patients discussed by the HRC, the mortality was less than 2% within the first 30 days after the HRC.