ArticleAnnals of surgery2020
Increased Healthcare Utilization for Medical Comorbidities Prior to Surgery Improves Postoperative Outcomes.
Article in Annals of surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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Who cites it
25 citing papers in PubMed.
- Screening and systematic follow-up for cardiopulmonary comorbidity in elective surgery for colorectal cancer: a randomised feasibility study.World journal of surgical oncology · 2019Trial
- Trend and clinical outcomes of transcatheter aortic valve replacement in connective tissue disease from the national inpatient sample database (2016-2022).Journal of cardiothoracic surgery · 2026Article
- The Impact of Multidisciplinary Preoperative Optimization Program on Postoperative Outcomes Among Surgical Oncology Patients.Journal of clinical medicine · 2025Article
- Patient-reported health-related social needs obtained at the bedside and outcomes after elective major surgery.Surgery · 2025Article
- Article
- Risk Model for Predicting Gaps in Surgical Oncology Care Among Patients With Stage I-III Rectal Cancer From KwaZulu-Natal, South Africa.JCO global oncology · 2025Article
- The Association of Established Primary Care with Postoperative Outcomes Among Medicare Patients with Digestive Tract Cancer.Annals of surgical oncology · 2024Article
- Preoperative Hepatology and Primary Care Visits Improve Postoperative Outcomes in Patients With Cirrhosis Undergoing Surgery.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2024Article
- Analysis of hospitalization costs in adult inguinal hernia: based on quantile regression model.Hernia : the journal of hernias and abdominal wall surgery · 2024Article
- Adapting Enhanced Recovery After Surgery (ERAS) Protocols to Promote Equity in Cancer Care and Outcomes.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2024Article
- High health care use prior to elective surgery for osteoarthritis is associated with poor postoperative outcomes: A Canadian population-based cohort study.Journal of health services research & policy · 2024Article
- Acetabular Fracture Outcomes and Complications: An International Comparison.Kansas journal of medicine · 2024Article
- Preoperative anemia is a risk factor for poor perioperative outcomes in ventral hernia repair.Hernia : the journal of hernias and abdominal wall surgery · 2022Article
- Factors associated with infrainguinal bypass graft patency at 1-year; a retrospective analysis of a single centre experience.Perfusion · 2022Article
- Medication Adherence and Blood Pressure Control: A Scientific Statement From the American Heart Association.Hypertension (Dallas, Tex. : 1979) · 2022Article
- The incidence and outcome of postoperative hepatic encephalopathy in patients with cirrhosis.United European gastroenterology journal · 2021Article
- On All Accounts: Cost-Effectiveness Analysis of Limited Preoperative Optimization Efforts Before Colon Cancer Surgery.Diseases of the colon and rectum · 2021Article
- Preoperative Medical Referral Prior to Hepatopancreatic Surgery-Is It Worth it?Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021Article
- Colectomy among Fee-for-Service Medicare Enrollees Coded as DRG 330: A Potential Platform to Allow Consumer Cost Transparency?Healthcare (Basel, Switzerland) · 2020Article
- Response to Comment on "Letter From Abeyesiri and Richards".Annals of surgery · 2019Article
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Funding
Abstract
objectiveThe purpose of this study was to evaluate the impact of optimization of preoperative comorbidities by nonsurgical clinicians on short-term postoperative outcomes. SUMMARY BACKGROUND DATA: Preoperative comorbidities can have substantial effects on operative risk and outcomes. The modifiability of these comorbidity-associated surgical risks remains poorly understood.
methodsWe identified patients with a major comorbidity (eg, diabetes, heart failure) undergoing an elective colectomy in a multipayer national administrative database (2010-2014). Patients were included if they could be matched to a preoperative surgical clinic visit within 90 days of an operative intervention by the same surgeon. The explanatory variable of interest ("preoperative optimization") was defined by whether the patient was seen by an appropriate nonsurgical clinician between surgical consultation and subsequent surgery. We assessed the impact of an optimization visit on postoperative complications with use of propensity score matching and multilevel, multivariable logistic regression.
resultsWe identified 4531 colectomy patients with a major potentially modifiable comorbidity (propensity weighted and matched effective sample size: 6037). After matching, the group without an optimization visit had a higher rate of complications (34.6% versus 29.7%, P = 0.001). An optimization visit conferred a 31% reduction in the odds of a complication (P < 0.001) in an adjusted analysis. Median preoperative costs increased by $684 (P < 0.001) in the optimized group, and a complication increased total costs of care by $14,724 (P < 0.001). CONCLUSIONS AND RELEVANCE: We demonstrated an association between use of nonsurgical clinician visits by comorbid patients prior to surgery and a significantly lower rate of complications. These findings support the prospective study of preoperative optimization as a potential mechanism for improving postoperative outcomes.
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