Practice Of Surgery Research Articles

Improving Surgical Care and Outcomes in Older Cancer Patients Through Implementation of a Presurgical Toolkit (OPTI-Surg)-Final Results of a Phase III Cluster Randomized Trial (Alliance A231601CD).

To assess the effect of a practice-level preoperative frailty screening and optimization toolkit (OPTI-Surg) on postoperative functional recovery and complications in elderly cancer patients undergoing major surgery. Frailty is common in older adults. It increases the risk of poor postoperative functional recovery and complications. The potential for a practice-level screening/optimization intervention to improve outcomes is unknown. Thoracic, gastrointestinal, and urologic oncological surgery practices within the National Cancer Institute Community Oncology Research Program (NCORP) were randomized 1:1:1 to usual care (UC), OPTI-Surg, or OPTI-Surg with an implementation coach. OPTI-Surg consisted of the Edmonton Frail Scale and guided recommendations for referral interventions. Patients 70 years old or above undergoing curative intent surgery were eligible. The primary outcome was 8 weeks postoperative function (kcal/wk). The key secondary outcome was complications within 90 days. Mixed models were used to compare UC to the 2 OPTI-Surg arms combined. From July 2019 to September 2022, 325 patients were enrolled in 29 practices. One hundred ninety-nine (64 UC, 135 OPTI-Surg) and 279 (78 UC, 201 OPTI-Surg) were evaluable for primary and secondary analysis, respectively. UC and OPTI-Surg patients did not significantly differ in total caloric expenditure (2.2 UC, 2.0 OPTI-Surg) after adjusting for baseline function ( P =0.53). UC and OPTI-Surg patients did not significantly differ in postoperative complications (25.6% UC, 35.3% OPTI-Surg, P =0.5). Frailty assessment was successfully performed, but the OPTI-Surg intervention did not improve postoperative function nor reduce postoperative complications compared with UC. Future analysis will explore practice-level factors associated with toolkit implementation and the differences between the coaching and noncoaching arms.

Evaluating Resident Education Practices in Endoscopic Sinus Surgery.

Evaluating Resident Education Practices in Endoscopic Sinus Surgery.

Sushruta: The Father of Surgery and Ancient Medical Innovations.

Sushruta, known as the "Father of Surgery,"was a pioneering figure in ancient Indian medicine whose contributions have influenced the field of surgery, especially cosmetic surgery and medical practices within the global community. His systematized approach to surgery, with the use of herbal anaesthetics and postoperative care, laid the foundation for surgical practices. Sushruta's emphasis on practical experience, dissection of cadavers, and detailed documentation established standards that continue to underpin surgical education today. The influence of his detailing surgical techniques and surgical instruments extended beyond ancient India, spreading to other parts of the world and shaping the development of reconstructive surgery, orthopaedics, ophthalmology, and many more fields. Sushruta has a rich history of medicine that is imbued with his pioneering spirit, which carried enduring influence. His works have been relevant in fomenting generations of surgeons and medical practitioners into the annals of history and solidifying his place as a timeless figure in the evolution of medical science.

Pursuing beauty: socio-cultural and labor-economic determinants of cosmetic surgery consideration among female college students in China.

Cosmetic surgery has a profound impact on health and other aspects. As a means of enhancing physical attractiveness, it is increasingly being considered by female college students in China. However, current knowledge about the determinants of cosmetic surgery consideration among Chinese female college students still needs to be improved due to the lack of systematic perspectives and large-scale representative data sets. This study aimed to contribute to the literature in these two aspects. We framed cosmetic surgery consideration as a function of two broad sets of determinants: socio-cultural and labor-economic. We used data from a large, nationally representative sample of female college students in China (N = 6658, mean age = 20.3years). In terms of socio-cultural oriented factors, we found that family socioeconomic status, peers' cosmetic surgery practices, and media exposure were positively associated with the likelihood of considering cosmetic surgery. In terms of labor-economic oriented factors, we found that self-rated physical appearance, higher grades, and expected income after graduation were positively associated with a higher likelihood of considering cosmetic surgery. These findings suggest that the decision-making process for cosmetic surgery among Chinese female college students goes beyond personal factors and is significantly influenced by structural factors.

The waist-to-hip ratio is a superior predictor of complications in breast reconstruction: A prospective pilot study

IntroductionBreast reconstruction remains common. Identifying the key risk factors for preoperative counseling is key to improving surgical outcomes. The body mass index is a commonly used measure of preoperative risk but remains controversial. We propose that the waist-to-hip ratio, a measure of central adiposity, is superior to the body mass index in predicting complications. MethodsA single surgeon’s breast reconstruction patients were prospectively analyzed from 2022-2023. Demographic data, medical comorbidities, and surgical variables were recorded, as were complications including infection, wound breakdown, and loss of reconstruction. Height, weight, waist circumference, and hip circumference were collected to calculate the waist-to-hip ratio, waist-to-height ratio, and body surface area. Statistical analysis and multivariate analysis were performed. ResultsOne hundred patients were evaluated, 50 for alloplastic and 50 for autologous, abdominally based reconstruction. For alloplastic patients, 26% had complications, with a higher waist-to-hip ratio (0.96v 0.88). On multivariate regression, the waist-to-hip was the only significant independent predictor of complications. For autologous reconstruction, again 26% had complications, with a higher waist-to-hip ratio (0.96v 0.88). On multivariate regression, the waist-to-hip was the only significant predictor of complications. For both groups, waist-to-hip did not strongly correlate with other morphometric measures. Age and other morphometric measures were not predictive of complications for either set. ConclusionThe waist-to-hip ratio is a superior predictor of surgical risk to the body mass index in our cohort and could be integrated in plastic surgery practices to improve outcomes. Level of EvidenceIV

Understanding the Scope of Acute Care Vascular Surgery at a Tertiary Academic Medical System

The restructuring of nonelective general surgery and nationwide implementation of the acute care surgery paradigm has improved patient outcomes and healthcare resource utilization. Although vascular surgery maintains one of the highest acuity rates among surgical specialties, the acute care vascular surgery (ACVS) practice model has not been widely accepted. In the present study, we investigate the scope and burden of ACVS at a tertiary academic medical system. All vascular surgical procedures performed at three hospitals comprising a large tertiary academic medical system were retrospectively queried through electronic medical records. Data were collected on procedure, acuity, timing of intervention, primary service, admission type, and total costs and charges. Patients were stratified by acuity of surgical intervention, with ACVS being defined as urgent or emergent operation. A total of 12,689 vascular surgeries were performed from 2018 to 2022. ACVS procedures comprised 22.1% of this total (n=2,803; 12.5% urgent, 9.6% emergent), with an annual burden ranging from 19.1% to 28.3%. Vascular surgeons served as primary surgeon in 91.3% of ACVS and cosurgeon in 8.7%. Fourteen separate surgical specialties requested acute vascular assistance, with the most frequently consulting specialties, including trauma or acute care surgery (ACS) (n=109, 3.9%) and cardiac surgery (n=74, 2.6%). ACVS cases were more frequently performed during after-hours (30.7% vs 11.6%) and on weekends (27.1% vs 2.0%) compared with elective vascular procedures (P<0.0001 each). The majority of ACVS cases originated from inpatient (n=2,353, 85.0%) and emergency department (n=379, 13.5%) consultations. Overall, ACVS generated $37.5 million in charges, accounting for 14% of total procedure-related charges over the study period. ACVS comprises a substantial portion of modern vascular practice and is associated with significant human and healthcare resource expenditure. These data support the development of practice models dedicated to acute vascular surgical care.

Chronic Cough Related to Thyroid Cartilage Superior Cornu Abnormality.

Chronic cough is a common troublesome symptom in otolaryngology head and neck surgery practice. In rare cases, chronic cough may be related to anatomical abnormalities. In this article, we report the history of a 64-year-old female with a chronic course due to a curved superior cornu of the thyroid cartilage and related irritation of the laryngeal superior nerve. The cough was atypical and resolved after the surgical resection of the abnormal cornu. There was no recurrence at 9 months post-surgery. The findings of the present case report highlight the need to explore the laryngeal anatomy in patients with chronic cough to identify potential abnormalities, which may be treated surgically.

Antibiotic prophylaxis practice in gastrointestinal surgery in five hospitals in southern Benin

BackgroundBenin’s healthcare system is characterized by a lack of local guidelines for surgical antibiotic prophylaxis (SAP), which is essential to prevent surgical site infection. AimTo audit compliance for SAP practices in gastrointestinal surgery. MethodsData were prospectively collected from gastrointestinal surgery departments in five hospitals. Over a four month period, SAP was assessed using five conventional criteria (indication, choice of antibiotic, dosage, timing, and duration of administration) among patients admitted for Altemeier class 1 or 2 procedures. Three guidelines were used as reference: World Health Organization (WHO), American Society of Health-System Pharmacists (ASHP)and French Society of Anaesthesia and Intensive Care Medicine (SFAR). FindingsOf 68 surgical interventions, overall compliance with WHO, ASHP, and SFAR was observed in zero (0.0%), one case (1.5%) and two cases (2.9%), respectively. Compliance with indication varied according to the guidelines: 65 (95.6%) were compliant with WHO and ASHP and 47 cases (69.11%) with SFAR. Among compliant cases, the antibiotics administered were rarely selected according to guidelines: WHO, 2 (2.9%) and ASHP, 2 (2.9%), and SFAR, 3 (4.4%). Drug dosage compliance varied from 20 (29.4%) (SFAR) to 49 (72.0%) (ASHP). Timings were respected in 47 (69.1%; WHO), 45 (66.2%; ASHP) and 9 cases (13.2%; SFAR). The number of cases compliant with antibiotic prophylaxis duration were 13 (19.1%; WHO), 17 (25.0%; ASHP) and 16 (23.5%; SFAR). ConclusionThe SAP compliance rate in gastrointestinal surgery based on the five conventional criteria was very low. SAP guidelines must be implemented appropriately for local bacteriological epidemiology.

National introduction of one-anastomosis gastric bypass in the UK National Bariatric Surgery Registry – a cohort study

Aim: There is a paucity of evidence regarding the national introduction of newer bariatric metabolic surgery procedures. This study assessed the impact of introducing one-anastomosis gastric bypass (OAGB) in bariatric surgical practice in the UK on 30-day postoperative morbidity and early postoperative weight loss. Methods: Patients who underwent primary BMS in the UK National Bariatric Surgical Registry (2010-2019) were identified. Patient characteristics, 30-day postoperative morbidity, and 12-month total body weight loss (TBWL) were also assessed. Multivariate regression was performed for associations between 30-day postoperative morbidity and 12-month TBWL, with SG as a reference. Learning effects were assessed by factoring in the institutional OAGB caseload (0-24/25-49/50+ cases). Results: A total of 59,226 patients underwent primary BMS during the study period (RYGB, 38,434; SG, 24,702; AGB, 12,627; OAGB, 3,408; and Others, 276). The 30-day postoperative morbidity was lower for OAGB 1.8% (51/2,802) compared to RYGB 4.2% (1,391/32,853) and SG 3.4% (725/21,333) but higher than AGB 1.2% (123/9,915), while on multivariate regression, OAGB was associated with reduced morbidity once the institution caseload exceeded 50 operations (OR 0.35 (95% CI, 0.22-0.56; P&lt;0.001) and no statistical difference to SG at lesser caseloads. Overall, 12-month greater than 25% TBWL was seen in 69.4% (27736/39971) (RYGB: 82.9% (17617/21246)), SG: 65.4% (7383/11283)), AGB: 23.9% (1382/5572)) and OAGB: 82.9% (1328/1601)). On multivariate regression, OAGB was associated with the highest 12-month TBWL once the institution caseload exceeded 50 operations (OR 3.47 (95% CI 2.75-4.39; P&lt;0.001). Conclusion: OAGB has been safely implemented in UK national bariatric surgery practice. It has lower reported postoperative morbidity and comparable weight loss to RYGB or SG, despite being offered to patients with more severe and complex obesity.

Current Practices in Carotid Surgery.

We outline the indications and contraindications of carotid endarterectomy (CEA) and appraise four key areas still debated to this day; shunting versus non-shunting, patch angioplasty (PA) versus primary closure (PC) and local anaesthesia (LA) versus general anaesthesia (GA). Importantly, we compare CEA with Best Medical Therapy (BMT), which is an area that is still largely debated, principally because many of the studies conducted to date do not reflect the era of modern BMT practices, and these outcomes are eagerly awaited. Literature searches were conducted using Pubmed with the keywords 'carotid', and 'endarterectomy', which provided a wide variety of journals and articles. We further stratified our data by using only randomised control trials (RCTs), meta-analyses, and systematic reviews, and then excluded studies with asymptomatic disease, diabetes, and plaque-imaging studies, including studies that did not fit our four desired topics for discussion. For each of the different domain's, results demonstrated similar peri-operative outcomes when comparing shunting vs. non-shunting and modality of anaesthesia and therefore practice still remains dependent on operator experience and preference. Patch-angioplasty reduces the risk of subsequent stroke, transient ischaemic attack (TIA), and re-stenosis compared to PC. In carotid stenosis >50% BMT offers limited benefits without accompanying surgical intervention and BMT alone tends to be advantageous primarily for patients with <50% carotid stenosis. Where CEA is appraised in terms of superiority of the procedural components; the literature does not support wildly contrasting outcomes to change majority practice. However, the area of considerable interest is superiority of BMT to surgical intervention in terms of both carotid artery stenting (CAS) and CEA and more studies need to be conducted in this area.

Assessment of laparoscopic surgery practice, knowledge, and training goals in Liberia: A mixed-methods study among Liberian surgeons.

Laparoscopy training remains inaccessible in many low- and middle-income countries, including Liberia. We assessed the availability of laparoscopy and feasibility of implementing a laparoscopic program among Liberian surgeons and trainees. This mixed-methods study utilized a 32-item survey and semi-structured interviews on laparoscopic experience, knowledge, desires, barriers, patient perceptions, and training opportunities among surgeons and trainees at Liberia's two main teaching hospitals in March 2023. Data analysis utilized summed knowledge and desirability scores, descriptive statistics, and qualitative content analysis. 31 interns, residents, and consultants participated, comprising 60% of Liberia's surgeons. Laparoscopic training (32%) and experience (16%) was low, with exposure limited to those training outside Liberia (p=0.001). While laparoscopy knowledge varied (29% low, 55% medium, 16% high), participants expressed high interest in training (100%) and willingness to pay (52%). Interviews revealed four themes: desires for training, patient acceptability, feasibility of technology-based training, and barriers including limited equipment and expert trainers. At the time of survey, the only minimally invasive surgeries ever performed in Liberia were two diagnostic laparoscopies. This is the first mixed-methods study assessing laparoscopy in Liberia. Our sample, though small, comprised approximately 60% of Liberian surgeons in both rural and urban hospitals. Findings demonstrated limited experience, variable knowledge, and high desires for training, showing feasibility for laparoscopy implementation in Liberia.

Focusing on issues about phacoemulsification lens extraction combined with goniosynechialysis

Angle closure is a basic pathological process in primary angle-closure glaucoma. Unlike filtration anti-glaucoma surgery, goniosynechialysis is a treatment for the cause of primary angle-closure glaucoma by reconstructing the physiological aqueous outflow pathway. In the past 10 years, phacoemulsification lens extraction with posterior chamber intraocular lens implantation in combination with goniosynechialysis for the treatment of primary angle-closure glaucoma has become a hot topic of clinical research and discussion. This article points out the issues that need to be paid attention to in the clinical practice of the combined surgery, including the relationship between phacoemulsification surgery and goniosynechialysis, the effectiveness and influencing factors of the combined surgery, and how to avoid the postoperative re-adhesion of the angle, in order to provide reference and guidance for better goniosynechialysis.

Efficacy of perioperative pain management in paediatric cardiac surgery: a protocol for a network meta-analysis

IntroductionCongenital heart disease is a common birth defect, but advancements in diagnosis and treatment have improved survival rates. Enhanced recovery after surgery (ERAS) programmes have emerged in paediatric cardiac surgery....

Assessment of the carbon footprint of total hip arthroplasty and opportunities for emission reduction in a UK hospital setting.

This study aimed to assess the carbon footprint associated with total hip arthroplasty (THA) in a UK hospital setting, considering various components within the operating theatre. The primary objective was to identify actionable areas for reducing carbon emissions and promoting sustainable orthopaedic practices. Using a life-cycle assessment approach, we conducted a prospective study on ten cemented and ten hybrid THA cases, evaluating carbon emissions from anaesthetic room to recovery. Scope 1 and scope 2 emissions were considered, focusing on direct emissions and energy consumption. Data included detailed assessments of consumables, waste generation, and energy use during surgeries. The carbon footprint of an uncemented THA was estimated at 100.02 kg CO2e, with a marginal increase to 104.89 kg CO2e for hybrid THA. Key contributors were consumables in the operating theatre (21%), waste generation (22%), and scope 2 emissions (38%). The study identified opportunities for reducing emissions, including instrument rationalization, transitioning to LED lighting, and improving waste-recycling practices. This study sheds light on the substantial carbon footprint associated with THA. Actionable strategies for reducing emissions were identified, emphasizing the need for sustainable practices in orthopaedic surgery. The findings prompt a critical discussion on the environmental impact of single-use versus reusable items in the operating theatre, challenging traditional norms to make more environmentally responsible choices.

Malpractice rates are lower for women physicians compared to men physicians

Background Previous literature has shown that women physicians are less likely to be involved in medical malpractice litigation than male physicians. Methods This study sought to examine the differences in malpractice experience by provider gender by using closed medical malpractice claims from 2011 through 2020. Results We found that after adjusting for the number of claims and dollar losses per full time equivalents worked, female physicians experienced fewer and less costly claims than male physicians ( p &lt; .001). Specific specialties had a significant relationship between claim frequency and provider gender, which included general surgery ( p = .01), obstetrics ( p = .001), gynecology ( p = .04), internal medicine and family general practice ( p &lt; .001). Conclusion The results from this analysis support the prior findings that male physicians experience a higher rate of malpractice claims. Therefore, there is an opportunity to learn how women providers achieve lower malpractice risk to inform clinical practice recommendations.

WP8.11 - Perception of Patients, Physicians, and Chaperones Regarding the Use of Chaperones During Patient Examinations for Plastic Surgery: A Systemic Review

Abstract Aim There is a scarcity of information related to the use of chaperones during patient examinations of body areas where plastic and reconstructive surgery is performed. Methods In this systematic review, we searched electronic databases for literature addressing physician use of chaperones during examinations of patients undergoing plastic surgery from the perspective of the patient, physician, and chaperone from inception of the database until April 2023. We conducted an inductive thematic analysis of four domains (physician perspective, patient perspective, chaperone perspective, and chaperone documentation. Result The results of the analysis showed that surgeons who are experienced, are men, or have received education related to using chaperones are more likely to provide chaperones during patient examinations for medico-legal protection and patient comfort. A small percentage of surgeons have faced accusations from patients of inappropriate behavior. Most of these incidents have occurred without a chaperone present. Patients who have long associations with a particular plastic surgery practice are less likely to want a chaperone. When physicians examine nonsensitive areas, most patients prefer having no chaperone. However, young patients and patients undergoing reconstructive procedures are more likely to request chaperones. Patients prefer having family members or friends serve as chaperones. Notably, despite the presence of a chaperone, we found that documentation of the presence of a chaperone was inadequate. Conclusion Further research, including qualitative studies and multinational approaches, is warranted to gain deeper insights and develop comprehensive guidelines for chaperone use that empowers both patients and healthcare providers.

Biomechanical model of minimally invasive hallux valgus surgery

Hallux valgus is a common foot deformity characterized by outward tilting and twisting of the big toe, often accompanied by a medial prominence at the base. Minimally invasive surgical techniques are widely utilized for treating metatarsus adductus due to their advantages of smaller incisions, faster recovery, and early weight-bearing. However, due to individual variations and limited sample size, the biomechanical effects of different Kirschner wire fixation methods and the underlying mechanisms of postoperative metatarsalgia remain unclear. In this study, a finite element method was employed to develop a biomechanical model of metatarsus adductus. The influence of various Kirschner wire entry points and angles on foot loading characteristics was investigated. Six different Kirschner wire fixation models, including two entry methods (along the adjacent fracture line and proximal-biased entry at the midshaft of the metatarsal) with different entry angles, were analyzed. Mechanical parameters such as metatarsal stress distribution, plantar pressure distribution, and displacement of the first metatarsal osteotomy plane were assessed. This research aims to enhance understanding of minimally invasive surgery and its fixation methods for metatarsus adductus. By providing scientific support and reliable evidence, it seeks to contribute to the development of minimally invasive surgical techniques and the improvement of clinical practice in metatarsus adductus surgery. Ultimately, the goal is to reduce complications, increase surgical success rates, and enhance patient satisfaction.

The Impact of Standing Electric Scooters on Maxillofacial Fractures: An Italian Multi-Centric Epidemiological Study.

Objectives: This study aimed to determine the impact of standing electric scooters on maxillofacial on the Italian territory. Methods: The authors analyzed the epidemiology of the injuries to define electric mobility's impact on maxillofacial surgery practice. For this retrospective cohort study, data were collected by unifying the standing e-scooter-related fractures database from 10 Italian maxillofacial surgery departments. The reference period considered was from January 2020 to December 2023. The main data considered included age, gender, type of access, time slot of admission, type of admission, alcohol level, helmet use, dynamics of the accident, and area of the fracture. Results: A total of 79 patients were enrolled. The average age of the participants was approximately 31 years. The blood alcohol level was found to be above the Italian norm in 15 cases (19%). Only one patient wore a helmet. The most affected facial third was the middle one with 36 cases (45.5%), followed by the lower one (31, 39.3%). The most recurrent patterns were fractures of the orbito-malar-zygomatic complex (15, 19%), followed by multifocal (bifocal, trifocal) fractures of the mandible (14, 17.5%). Conclusions: This study demonstrated how maxillofacial fractures related to the use of electric scooters are associated with complex patterns, associated with a high rate of post-surgical aftermaths.

Predictive model for intraoperative decision-making in video-assisted thoracoscopic lobectomy: optimizing chest drain placement for high-risk patients.

For years, it has been the common and widely accepted practice in thoracic surgery to place apical and basal drains after a lobectomy to completely drain the pleural cavity. With the development of thoracoscopic technology, it became apparent that the use of a single chest tube provided the same clinical results. However, sometimes tension pneumothorax occurs with the need for additional pleural drainage. The aim of this study was to develop a prognostic model to identify high risk patients intraoperatively and to insert additional pleural drainage to prevent the development of pneumothorax after video-assisted thoracoscopic surgery (VATS) lobectomy. This was a retrospective multicenter study of patients (registry data was analyzed) who underwent VATS lobectomy via a standardized multiport approach between 2014 and 2022. In all cases, a single drain was used postoperatively. We used a machine learning algorithm and data synthesis to expand patient selection according to Riley's method. A total of 418 cases were analyzed in this study. After determining the prognostically significant factors, we performed a binary logistic regression analysis using reverse step-by-step inclusion of variables according to the Akaike information criterion. After validation of the model by bootstrap (400 iterations) and with the original dataset, a nomogram with a specific point distribution for each risk factor was created. The rate of tension pneumothorax was 4.53% (n=66). The most significant variables associated with the need for additional drainage were adhesions, intraoperative lung suturing, fused interlobar fissure, enlarged intrapulmonary lymph nodes, chronic obstructive pulmonary disease (P<0.001). The C-index of the model was 0.957, the mean absolute calibration error was 0.6%, and the slope of the calibration curve was 0.959. A score of 26 points indicated a 95% risk of postoperative tension pneumothorax. The nomogram achieved good predictive performance for tension pneumothorax after minimally invasive lobectomy. High-risk patients could be identified, and additional drainage may be placed intraoperatively to reduce the risk of lung collapse in the postoperative period.

A new simplified risk assessment model enhances postoperative prophylaxis of venous thromboembolism in Chinese adult patients with inguinal hernia (CHAT-3): a prospective, multicenter, randomized controlled trial.

Venous thromboembolism (VTE) significantly affects the prognosis of surgical patients with inguinal hernia. The complex Caprini score, commonly used for postoperative VTE risk assessment, poses practical challenges for surgeons in clinical settings. The CHAT-3 trial, a prospective, multicenter, randomized controlled trial, compared a simple three-factor model to assess VTE risk against routine practices in postinguinal hernia surgery (IHS) patients. The patients were randomly assigned (1:1) to the intervention or control arm. The intervention group used the three-factor model to identify patients at moderate or high risk of VTE for subsequent prophylaxis according to clinical guidelines. Both groups were followed for 4 weeks, with randomization implemented using computer-generated sequences. The primary outcome measured was the rate of VTE prophylaxis. Secondary outcomes included time spent on VTE risk assessment (surgeon self-reported), postoperative D-dimer trends, perioperative VTE occurrence, bleeding events, and the net clinical benefit. Of the 1109 participants, 508 in the experimental group and 601 in the control group completed follow-up. The three-factor model showed higher VTE prophylaxis rates in all patients (pharmacologic prophylaxis: 26.2 vs. 6.00%, P <0.001) and particularly in those at high risk (pharmacologic prophylaxis: 57.3 vs. 9.50%, P <0.001). The experimental group significantly reduced VTE risk assessment time compared to the Caprini score (1.39±0.55min vs. 5.73±1.35min, P <0.001). The experimental group had lower D-dimer levels (0.26±0.73mg/l vs. 0.35±0.55mg/l, P =0.028). In the experimental group, the patients did not experience an increased risk of VTE (0 vs. 1.66%, P =0.268) and bleeding (1.18 vs. 0.67%, P =0.558) compared to the controls. There was no significant difference in net clinical benefit, which combined VTE and bleeding events, between the experimental and control groups (1.18 vs. 0.83%, P =0.559). Applying the simple three-factor model in perioperative VTE management could quickly identify the patient with a high risk of VTE and improve the prophylaxis rate of perioperative VTE.