Quantifying and communicating peri-operative risk

Irwin, Michael G.; Kong, V. K. F.

doi:10.1111/anae.12881

Cited by 18 publications

(11 citation statements)

References 44 publications

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“…The rate of~1% that is considered to reflect the incidence of anaesthesia-associated mortality in healthy horses is between a hundred-and a thousand-fold greater than the incidences of mortality associated with anaesthesia in humans (0.01-0.001%) (Lunn & Mushin 1982;Jones 2001;Irwin & Kong 2014), 20-fold greater than that in dogs (0.05%), 10-fold greater than that in cats (0.11%), and not dissimilar from that reported for rabbits (0.73%) (Brodbelt et al 2008). There is, therefore, much room for improvement.…”

Section: Comparative Mortalitymentioning

confidence: 99%

Equine anaesthesia-associated mortality: where are we now?

Dugdale

Taylor

2016

Veterinary Anaesthesia and Analgesia

116

112

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Section: Comparative Mortalitymentioning

confidence: 99%

Equine anaesthesia-associated mortality: where are we now?

Dugdale

Taylor

2016

Veterinary Anaesthesia and Analgesia

116

112

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“…People (including anaesthetists) have different attitudes to risk , and the ‘glass half‐full/half‐empty’ views of the airway in our survey may illustrate this. Furthermore, those who said they would wake the mother were more likely to mention medicolegal factors or the possibility of facing criticism for risk‐taking (see above), and ‘teaching’ or local policy that directed a specific action in this situation (“ Current guidelines used in my place of work are to wake the patient up unless the mother's life is in immediate danger ”).…”

mentioning

confidence: 85%

Obstetric difficult airway guidelines – decision‐making in critical situations

Rucklidge

Yentis

2015

Anaesthesia

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“…Furthermore, there may be a disparity between what doctors and patients view as ‘risk’ or ‘acceptable risk’. Therefore, the manner and circumstances in which risk is conveyed are important . High‐risk surgery should not be performed without a pre‐operative commitment to appropriate postoperative care.…”

Section: Pre‐operative Counselling and Shared Decision‐makingmentioning

confidence: 99%

Peri‐operative optimisation of elderly and frail patients: a narrative review

Chan

Irwin

2019

Anaesthesia

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With increasing life expectancy and technological advancement, provision of anaesthesia for elderly patients has become a significant part of the overall case-load. These patients are unique, not only because they are older with more propensity for comorbidity but a decline in physiological reserve and cognitive function invariably accompanies ageing; this can substantially impact peri-operative outcome and quality of recovery. Furthermore, it is not only morbidity and mortality that matters; quality of life is also especially relevant in this vulnerable population. Comprehensive geriatric assessment is a patient-centred and multidisciplinary approach to peri-operative care. The assessment of frailty has a central role in the pre-operative evaluation of the elderly. Other essential domains include optimisation of nutritional status, assessment of baseline cognitive function and proper approach to patient counselling and the decision-making process. Anaesthetists should be proactive in multidisciplinary care to achieve better outcomes; they are integral to the process. Twitter: @mgirwin advanced age [2]. Although chronological age itself predicts surgical outcome poorly, age-related decline in physiological reserve and functional capacity are inevitable, and affect all organ systems. When people live longer, more comorbidities appear; this will result in higher rates of peri-operative morbidity and mortality. This is already imposing a significant burden on healthcare systems, by increasing both the utilisation of intensive care facilities and length of hospital stay [3,4]. Therefore, it is imperative to deliver both high-quality and efficient peri-operative care for elderly patients.The 'elderly' represent a unique group of patients, with many challenges for the peri-operative care team. In this article, we review the following aspects of anaesthesia in the elderly: (1) the role of comprehensive geriatric assessment and innovative models of care; (2) the implications of frailty and its assessment; (3) the assessment and optimisation of nutritional status; (4) the assessment of neurocognitive dysfunction; and (5) patient counselling and approach to decision-making. 80

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Quantifying and communicating peri-operative risk

Abstract: EditorialQuantifying and communicating peri-operative risk Shallow men believe in luck. Strong men believe in cause and effect -Ralph Waldo Emerson

Cited by 18 publications

References 44 publications

Equine anaesthesia-associated mortality: where are we now?

Equine anaesthesia-associated mortality: where are we now?

Obstetric difficult airway guidelines – decision‐making in critical situations

Peri‐operative optimisation of elderly and frail patients: a narrative review

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