Do we know our patients’ goals? Evaluating preoperative discussions in emergency surgery

Hatchimonji, Justin S.; Huston-Paterson, Hattie; Dortche, Kristina; Orji, Whitney; Ganta, Niharika; O’Connor, Nina; Kaplan, Lewis J.; Martin, Niels D.

doi:10.1016/j.amjsurg.2020.05.028

Cited by 5 publications

(4 citation statements)

References 6 publications

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“…Several studies have explored the need for NTS improvement through the entire perioperative patient journey including assessments of preoperative communication, shared decision-making, and effective conversations on goals of care and palliation [ 103 ]. The role of NTS in simulated operating theatre crises management has been examined as well, documenting NTS as essential for crisis management [ 104 ].…”

Section: Non-technical Skills and Human Factor In Egsmentioning

confidence: 99%

European society for trauma and emergency surgery member-identified research priorities in emergency surgery: a roadmap for future clinical research opportunities

Bass,

Kaplan,

Gaarder

et al. 2024

Eur J Trauma Emerg Surg

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Background European Society for Trauma and Emergency Surgery (ESTES) is the European community of clinicians providing care to the injured and critically ill surgical patient. ESTES has several interlinked missions – (1) the promotion of optimal emergency surgical care through networked advocacy, (2) promulgation of relevant clinical cognitive and technical skills, and (3) the advancement of scientific inquiry that closes knowledge gaps, iteratively improves upon surgical and perioperative practice, and guides decision-making rooted in scientific evidence. Faced with multitudinous opportunities for clinical research, ESTES undertook an exercise to determine member priorities for surgical research in the short-to-medium term; these research priorities were presented to a panel of experts to inform a ‘road map’ narrative review which anchored these research priorities in the contemporary surgical literature. Methods Individual ESTES members in active emergency surgery practice were polled as a representative sample of end-users and were asked to rank potential areas of future research according to their personal perceptions of priority. Using the modified eDelphi method, an invited panel of ESTES-associated experts in academic emergency surgery then crafted a narrative review highlighting potential research priorities for the Society. Results Seventy-two responding ESTES members from 23 countries provided feedback to guide the modified eDelphi expert consensus narrative review. Experts then crafted evidence-based mini-reviews highlighting knowledge gaps and areas of interest for future clinical research in emergency surgery: timing of surgery, inter-hospital transfer, diagnostic imaging in emergency surgery, the role of minimally-invasive surgical techniques and Enhanced Recovery After Surgery (ERAS) protocols, patient-reported outcome measures, risk-stratification methods, disparities in access to care, geriatric outcomes, data registry and snapshot audit evaluations, emerging technologies interrogation, and the delivery and benchmarking of emergency surgical training. Conclusions This manuscript presents the priorities for future clinical research in academic emergency surgery as determined by a sample of the membership of ESTES. While the precise basis for prioritization was not evident, it may be anchored in disease prevalence, controversy around aspects of current patient care, or indeed the identification of a knowledge gap. These expert-crafted evidence-based mini-reviews provide useful insights that may guide the direction of future academic emergency surgery research efforts.

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Section: Non-technical Skills and Human Factor In Egsmentioning

confidence: 99%

European society for trauma and emergency surgery member-identified research priorities in emergency surgery: a roadmap for future clinical research opportunities

Bass,

Kaplan,

Gaarder

et al. 2024

Eur J Trauma Emerg Surg

View full text Add to dashboard Cite

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“…Hatchimonji et al rightfully asked the question ''Do we know our patients' goals?'' [37]. However, the concept of GOC is still evolving and encapsulates broadly the prognosis/diagnosis, illness/injury trajectory and goals/desired outcomes [38].…”

Section: Discussionmentioning

confidence: 99%

“…The stark one‐year range of mortality reported in this systematic review challenges the clinician to engage in a meaningful and truthful GOC discussion with a patient before obtaining consent for an EL. Hatchimonji et al rightfully asked the question “Do we know our patients’ goals?” [37]. However, the concept of GOC is still evolving and encapsulates broadly the prognosis/diagnosis, illness/injury trajectory and goals/desired outcomes [38].…”

Section: Discussionmentioning

confidence: 99%

One‐Year Outcomes Following Emergency Laparotomy: A Systematic Review

Weber

2021

World j. surg.

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Background Emergency laparotomies (EL) are associated with significant morbidity and mortality. To date, 30-day mortality has been predominately reported, and been the focus of various national emergency laparotomy audits. Only a few studies have reported on the long-term mortality associated with EL. The aim of this study was to review the one-year mortality following EL. Method A systematic review was conducted using PRISMA guidelines to identify studies published in the last 10 years reporting on long-term mortality associated with EL. The data abstracted included: patient demographics, pathology or type of operation performed for EL, post-operative mortality at 7-day, 30-day, 90-day, 1-year, beyond 1-year and inpatient, functional outcomes and risk factors associated with mortality. A quality assessment of included studies was performed.Results Fifteen studies reporting long-term outcomes associated with EL were identified, including the results of 48,023 patients. The indications and/or pathologies for ELs varied. The 30-day mortality after EL ranged from 5.3% to 21.8%, and the one-year mortality ranged from 15.1 to 47%. The mortality in the six studies focusing on elderly patients ranged from 30 to 47%. Conclusion The long-term mortality rate associated with EL is substantial. Further study is required to understand the 1-year mortality described in the studies and translate these findings for meaningful application into the clinical care of these patients.

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“…We are highlighting these eight thought-provoking editorials: COVID 19: Surgery & the question of race, 11 Reforming our general surgery residency program at an urban level 1 Trauma Center during the COVID-19 pandemic: Towards maintaining resident safety and wellbeing, 12 COVID-19 and surgical training in Italy: Residents and young consultants perspectives from the battlefield, 13 The volume of recyclable polyethylene terephthalate plastic in operating rooms, 14 Immersive Virtual Reality in surgery and medical education: diving into the future, 15 Educational benefits of an acute care surgery rotation during the medical student surgical clerkship, 16 Do We Know Our Patients' Goals? Evaluating Preoperative Discussions in Emergency Surgery 17 and General Surgery Trainee Perception of Early Specialization Programs. 18 …”

mentioning

confidence: 99%

Featured papers in the October Issue

Chen¹

2020

The American Journal of Surgery

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Delving Deeper into Disparity: The Impact of Health Literacy on the Surgical Care of Breast Cancer Patients. Portelli Tremont and colleagues summarize the current knowledge regarding health literacy in breast cancer. They identify future directions for research and potential intervention in breast surgical oncology 1 with an editorial from Lauren Theiss and Dan Chu. 2. Post-Thyroidectomy Emergency Room Visits and Readmissions: Assessment from the Collaborative Endocrine Surgery Quality Improvement Program (CESQIP). Taye and colleagues analyze independent factors associated with post-thyroidectomy emergency room visits and hospital readmissions. 3 There is an editorial from Toni Beninato and Amanda M. Laird. 4 Surgeon Experience and Opioid Prescribing. Santosa and colleagues evaluate the effects of surgeon characteristics such as surgeon experience on differences in opioid prescribing after surgery. 5 They demonstrate that surgeon characteristics such as cumulative years of practice contribute to differences in prescribing behavior, with an editorial from Willemijn Sch€ afer and Jonah Stulberg. 6 Significant Morbidity Is Associated With Proximal Fecal Diversion Among High-Risk Patients Who Undergo Colectomy: A NSQIP Analysis. Chang and colleagues perform a review of the NSQIP database to examine the impact of a diverting loop ileostomy (DLI) in high-risk patients. They found that significant thirty-day morbidity exists with a DLI among high-risk colectomy patients with minimal benefit in anastomotic leak rates. 7 There is an editorial from Drew Gunnells and Greg Kennedy 8 Robotic intraperitoneal onlay versus totally extraperitoneal (TEP) retromuscular mesh ventral hernia repair: A Propensity score matching analysis of short-term outcomes. Kudsi and colleagues present data suggesting that Robotic TEP-RM repair has better early postoperative outcomes for ventral hernias, suggesting that it may be preferable over robotic IPOM repair. 9 Ajita Prabhu provides an invited commentary. 10 Eight "My Thoughts/My Surgical Practice" Articles. We are highlighting these eight thought-provoking editorials: COVID 19: Surgery & the question of race, 11 Reforming our general surgery residency program at an urban level 1 Trauma Center during the COVID-19 pandemic: Towards maintaining resident safety and wellbeing, 12 COVID-19 and surgical training in Italy: Residents and young consultants perspectives from the battlefield, 13 The volume of recyclable polyethylene terephthalate plastic in operating rooms, 14 Immersive Virtual Reality in surgery and medical education: diving into the future, 15 Educational benefits of an acute care surgery rotation during the medical student surgical clerkship, 16 Do We Know Our Patients' Goals? Evaluating Preoperative Discussions in Emergency Surgery 17 and General Surgery Trainee Perception of Early Specialization Programs. 18

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Do we know our patients’ goals? Evaluating preoperative discussions in emergency surgery

Cited by 5 publications

References 6 publications

European society for trauma and emergency surgery member-identified research priorities in emergency surgery: a roadmap for future clinical research opportunities

European society for trauma and emergency surgery member-identified research priorities in emergency surgery: a roadmap for future clinical research opportunities

One‐Year Outcomes Following Emergency Laparotomy: A Systematic Review

Featured papers in the October Issue

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