Abstract
BackgroundPost-operative complications are a significant source of morbidity and mortality for patients undergoing surgery. However, there is little research in the emerging field of perioperative medicine beyond cardiac risk stratification. We sought to determine the research priorities for perioperative medicine using a cross sectional survey of Canadian and American general internists.MethodsSurveys were electronically sent to 312 general internists from the Canadian Society of Internal Medicine and 130 internists from the perioperative medicine research interest group within the US based Society of General Internal Medicine. The questionnaire contained thirty research questions and respondents were asked to rate the priority of these questions for future study.ResultsThe research topics with the highest ratings included: the need for tight control of diabetes mellitus postoperatively and the value of starting aspirin on patients at increased risk for postoperative cardiac events. Research questions evaluating the efficacy and safety of perioperative interventions had higher ratings than questions relating to the prediction of postoperative risk. Questions relating to the yield of preoperative diagnostic tests had the lowest ratings (p < 0.001 for differences across these categories).ConclusionThe results of this survey suggest that practicing general internists believe that interventions studies are a priority within perioperative medicine. These findings should help prioritize research in this emerging field.
Highlights
Post-operative complications are a significant source of morbidity and mortality for patients undergoing surgery
The purpose of this study is to identify top perceived research priorities in this field using a survey of general internists practicing perioperative medicine
Participants To obtain the opinions of general internists who practice perioperative medicine, from the Canada and the United States, all general internists within the Canadian Society of Internal Medicine (n = 312) and all members of the perioperative medicine interest group of the American based Society of General Internal Medicine (n = 130), were surveyed
Summary
Post-operative complications are a significant source of morbidity and mortality for patients undergoing surgery. There is little research in the emerging field of perioperative medicine beyond cardiac risk stratification. Over 40 million people undergo non-cardiac surgery in the United States each year [1]. Postoperative cardiac complications affect 2–18% of patients alone, costing over 20 billion dollars annually in the United States [2]. Efforts to minimize these complications have resulted in the development of the field of perioperative medicine. Research in this emerging field has focused primarily on cardiac risk stratification [3]. Despite the significant medical and economic burden of perioperative complications, few studies evaluate diagnostic testing, risk stratification for non-cardiac complications, or interventions to prevent cardiac or non-cardiac complications. There is a growing need to expand the research base in this field
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