Surgery
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Preoperative frailty is associated with poor outcomes in major surgery. Postoperative delirium is common after neurosurgery. To date, the association of preoperative frailty with postoperative delirium after neurosurgery has not been established. We aimed to determine the association between preoperative frailty and postoperative delirium in patients undergoing elective brain tumor resection. ⋯ Preoperative frailty is associated with postoperative delirium, length of hospital stay, and total costs in patients undergoing elective brain tumor resection. Preoperative frailty assessment and appropriate management strategies should be involved in the perioperative management of postoperative delirium.
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New surgeons are faced with inadequate mentoring when first entering practice. Our study examined challenges faced by young surgeons during their transition in practice and their mentoring experience when entering practice. ⋯ Our survey highlights the importance of mentoring for young surgeons during their transition into practice. With many young surgeons being enthusiastic about mentoring by retired surgeons, specific programs are necessary to better use their expertise.
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This review describes the steps and conclusions from the development and validation of an artificial intelligence algorithm (the Hypotension Prediction Index), one of the first machine learning predictive algorithms used in the operating room environment. The algorithm has been demonstrated to reduce intraoperative hypotension in two randomized controlled trials via real-time prediction of upcoming hypotensive events prompting anesthesiologists to act earlier, more often, and differently in managing impending hypotension. ⋯ Clinical validation of such algorithms is relatively new and requires more standardization, as guidelines are lacking or only now start to be drafted. Before adaptation in clinical practice, impact of artificial intelligence algorithms on clinical behavior, outcomes and economic advantages should be studied too.
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The coronavirus disease 2019 (COVID-19) pandemic has seen transplant volume decrease nationwide, resulting in a 2.2-fold increase in waitlist mortality. In particular, solid organ transplant patients are subjected to increased morbidity and mortality from infection. In the face of these challenges, transplant centers need to develop innovative protocols to ensure high-quality care. ⋯ Orthotopic liver transplant can be accomplished safely and effectively in the COVID-19 era without compromising outcomes through increasing utilization of telehealth, rapid COVID-19 testing, and multidisciplinary protocols for managing immunosuppressed patients.
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Gender disparities still exist in the field of academic surgery. Women face additional obstacles obtaining high-ranking, surgical academia positions compared to men, and this may extend to the appointment of editorial board members. We aim to evaluate the gender distribution of editorial board members, associate editors, and editors-in-chief of top US surgical journals and to recommend interventions, which can promote equitable gender representation among editorial boards. ⋯ Gender disparities are evident in academic surgery, and women comprise a minority of US surgical editorial board members, associate editors, and editors-in-chief. The implementation of women mentorship from senior faculty on behalf of senior residents and junior faculty, as well as journal-facilitated pipeline programs, can diversify editorial board members by increasing women representation and reduce disparities in surgical journal editorial boards.