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Canadian Journal of Anesthesia/Journal canadien d'anesthésie

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01-09-2017 | Editorials

Precise mathematics yet hazy predictions: Can validated risk indices help improve patient selection for major elective surgery?

Author: Duminda N. Wijeysundera, MD, PhD

Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Issue 9/2017

Excerpt

Not uncommonly, anesthesiologists face the scenario of a very high-risk patient being considered for major elective surgery. Many reasonable doctors speculate whether the likelihood of such a patient’s survival might be better served with a non-operative treatment option. Perhaps unsurprisingly, there are remarkably few data available to better our understanding of this important issue. In this issue of the Journal, McIsaac et al. present a population-based retrospective cohort study, by which they sought, in part, to quantify how patients’ observed survival after major elective noncardiac surgery compared with their expected survival based on their baseline preoperative health status.1 …

McIsaac D, Lavallee LT, van Walraven C. A retrospective assessment of prognostication in 456,685 patients undergoing elective major non-cardiac surgery. Can J Anesth 2017; 64: this issue. DOI: 10.1007/s12630-017-0909-x.

van Walraven C. The Hospital-patient One-year Mortality Risk score accurately predicted long-term death risk in hospitalized patients. J Clin Epidemiol 2014; 67: 1025-34.CrossRefPubMed

van Walraven C, McAlister FA, Bakal JA, Hawken S, Donze J. External validation of the Hospital-patient One-year Mortality Risk (HOMR) model for predicting death within 1 year after hospital admission. CMAJ 2015; 187: 725-33.CrossRefPubMedPubMedCentral

van Walraven C, Forster AJ. The HOMR-Now! model accurately predicts 1-year death risk for hospitalized patients on admission. Am J Med 2017. DOI:10.1016/j.amjmed.2017.03.008.PubMed

Wijeysundera DN. Predicting outcomes: is there utility in risk scores? Can J Anesth 2016; 63: 148-58.CrossRefPubMed

Savitz DA. Interpreting Epidemiologic Evidence: Strategies for Study Design and Analysis. New York, NY: Oxford University Press; 2001.

Leon MB, Smith CR, Mack M, et al. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med 2010; 363: 1597-607.CrossRefPubMed

EVAR trial participants. Endovascular aneurysm repair and outcome in patients unfit for open repair of abdominal aortic aneurysm (EVAR trial 2): randomised controlled trial. Lancet 2005; 365: 2187-92.CrossRef

Title: Precise mathematics yet hazy predictions: Can validated risk indices help improve patient selection for major elective surgery?
Author: Duminda N. Wijeysundera, MD, PhD
Publication date: 01-09-2017
Publisher: Springer US
Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Issue 9/2017
Print ISSN: 0832-610X
Electronic ISSN: 1496-8975
DOI: https://doi.org/10.1007/s12630-017-0910-4

At a glance: The STEP trials

Springer Medicine

Precise mathematics yet hazy predictions: Can validated risk indices help improve patient selection for major elective surgery?

Excerpt

At a glance: The STEP trials

Springer Medicine

Excerpt

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