Perioperative estimations of oxygen consumption from LiDCO™plus-derived cardiac output and Ca-cvO2 difference: Relationship with measurements by indirect calorimetry in elderly patients undergoing major abdominal surgery.

Background: Feasible estimations of perioperative changes in oxygen consumption (VO2) could enable larger studies of its role in postoperative outcomes. Current methods, either by reverse Fick calculations using pulmonary artery catheterisation or metabolic by breathing gas analysis, are often deemed too invasive or technically requiring. In addition, reverse Fick calculations report generally lower values of oxygen consumption.

Surgical Outcome Risk Tool (SORT) to predict 30-day postoperative mortality in a mixed surgical population in Swedish tertiary hospitals.

Background: The Surgical Outcome Risk Tool (SORT) was derived and validated in the UK to improve preoperative prediction of postoperative risk. The aim of this study was to validate the SORT in a European mixed-case surgical population outside of the UK.

Methods: The study included patients aged at least 18 years with ASA Physical Status (ASA-PS) grades I-V who underwent non-cardiac surgery at four tertiary hospitals in Sweden between November 2015 and February 2016.

Waiting more than 24 hours for hip fracture surgery is associated with increased risk of adverse outcomes for sicker patients: a nationwide cohort study of 63,998 patients using the Swedish Hip Fracture Register.

Background And Purpose: Waiting time to surgery is a modifiable risk factor in hip fracture surgery. However, there is no consensus regarding the acceptable duration of waiting time. We used the Swedish Hip Fracture Register RIKSHÖFT and 3 administrative registers to explore the association between time to surgery and adverse outcomes after discharge.

ASA classification and surgical severity grading used to identify a high-risk population, a multicenter prospective cohort study in Swedish tertiary hospitals.

Background: Identification of surgical populations at high risk for negative outcomes is needed for clinical and research purposes. We hypothesized that combining two classification systems, ASA (American Society of Anesthesiology physical status) and surgical severity, we could identify a high-risk population before surgery. We aimed to describe postoperative outcomes in a population selected by these two classifications system.

Peri-operative oxygen consumption revisited: An observational study in elderly patients undergoing major abdominal surgery.

Background: Monitoring oxygen consumption (VO2) is neither recommended nor included in peri-operative haemodynamic algorithms aiming at optimising oxygen delivery (DO2) in major abdominal surgery. Estimates of peri-operative VO2 changes are uncertain in earlier publications and have limited generalisability in the current high-risk surgical population. In a prospective non-interventional observational study in elderly patients undergoing major abdominal procedures, we investigated the change of VO2 after induction of anaesthesia and secondarily, the further changes during and after surgery in relation to DO2 and estimated oxygen extraction ratio (O2ER) by routine monitoring.

No association between waiting time to surgery and mortality for healthier patients with hip fracture: a nationwide Swedish cohort of 59,675 patients.

Background and purpose - Waiting time to surgery for patients with hip fractures and its potential association with mortality has been frequently studied with the hypothesis that longer waiting time is associated with adverse outcomes. However, despite numerous studies, there is no consensus regarding which time frames are appropriate, and whether some patients are more vulnerable to waiting than others. We explored the association between waiting time to surgery and short-term mortality and whether sex, age, surgical method, and comorbidity (ASA) modified this association.

A 1-year perspective on goal-directed therapy in elderly with hip fracture: Secondary outcomes.

Background: We have previously reported inconclusive results from a randomized controlled trial in elderly with hip-fracture comparing intra-operative goal-directed therapy with routine fluid treatment. Now we aimed to describe and compare secondary outcomes at 4 months and 1 year follow-up and to analyze the cost-effectiveness.

Methods: Patients with hip fracture (age ≥70) were randomized for GDT or routine fluid treatment (RFT).

The effects of general anaesthesia on oxygen consumption: A meta-analysis guiding future studies on perioperative oxygen transport.

Background: Increased oxygen extraction, the ratio of consumption to delivery, has been associated with poor outcome after surgery. Oxygen consumption (VO2) can change in several ways in the perioperative period, but is seldom monitored directly in routine care. This study investigates the effects of general anaesthesia on VO2.

Value of information: interim analysis of a randomized, controlled trial of goal-directed hemodynamic treatment for aged patients.

Background: A randomized, controlled trial, intended to include 460 patients, is currently studying peroperative goal-directed hemodynamic treatment (GDHT) of aged hip-fracture patients. Interim efficacy analysis performed on the first 100 patients was statistically uncertain; thus, the trial is continuing in accordance with the trial protocol. This raised the present investigation's main question: Is it reasonable to continue to fund the trial to decrease uncertainty? To answer this question, a previously developed probabilistic cost-effectiveness model was used.

Cost-effectiveness analysis of goal-directed hemodynamic treatment of elderly hip fracture patients: before clinical research starts.

Background: Health economic evaluations are increasingly used to make the decision to adopt new medical interventions. Before such decisions, various stakeholders have invested in clinical research. But health economic factors are seldom considered in research funding decisions.