Browsing by Subject "Elective surgery"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Advance Care Planning in A Preoperative Clinic: A Retrospective Chart Review
    (Springer, 2019-01-02) Sinha, Shilpee; Gruber, Rachel N.; Cottingham, Ann H.; Nation, Barb; Lane, Kathleen A.; Bo, Na; Torke, Alexia; Medicine, School of Medicine
    Patients seen in preoperative testing clinics are at an increased risk of surgical complications and most are incapacitated for during anesthesia. Advance directives (ADs) are important to guide care in the event of emergencies when patients are unable to speak for themselves. The goal of this study was to determine the frequency with which ADs are completed for patients seen in preoperative clinics prior to elective surgery and identify demographic and clinical characteristics associated with having ADs available in the electronic medical record (EMR).
  • Thumbnail Image
    Item
    EAES and SAGES 2018 consensus conference on acute diverticulitis management: evidence-based recommendations for clinical practice
    (Springer Nature, 2019-09) Francis, Nader K.; Sylla, Patricia; Abou-Khalil, Maria; Arolfo, Simone; Berler, David; Curtis, Nathan J.; Dolejs, Scott C.; Garfinkle, Richard; Gorter-Stam, Marguerite; Hashimoto, Daniel A.; Hassinger, Taryn E.; Molenaar, Charlotte J. L.; Pucher, Philip H.; Schuermans, Valérie; Arezzo, Alberto; Agresta, Ferdinando; Antoniou, Stavros A.; Arulampalam, Tan; Boutros, Marylise; Bouvy, Nicole; Campbell, Kenneth; Francone, Todd; Haggerty, Stephen P.; Hedrick, Traci L.; Stefanidis, Dimitrios; Truitt, Mike S.; Kelly, Jillian; Ket, Hans; Dunkin, Brian J.; Pietrabissa, Andrea; Surgery, School of Medicine
    BACKGROUND: Acute diverticulitis (AD) presents a unique diagnostic and therapeutic challenge for general surgeons. This collaborative project between EAES and SAGES aimed to summarize recent evidence and draw statements of recommendation to guide our members on comprehensive AD management. METHODS: Systematic reviews of the literature were conducted across six AD topics by an international steering group including experts from both societies. Topics encompassed the epidemiology, diagnosis, management of non-complicated and complicated AD as well as emergency and elective operative AD management. Consensus statements and recommendations were generated, and the quality of the evidence and recommendation strength rated with the GRADE system. Modified Delphi methodology was used to reach consensus among experts prior to surveying the EAES and SAGES membership on the recommendations and likelihood to impact their practice. Results were presented at both EAES and SAGES annual meetings with live re-voting carried out for recommendations with < 70% agreement. RESULTS: A total of 51 consensus statements and 41 recommendations across all six topics were agreed upon by the experts and submitted for members' online voting. Based on 1004 complete surveys and over 300 live votes at the SAGES and EAES Diverticulitis Consensus Conference (DCC), consensus was achieved for 97.6% (40/41) of recommendations with 92% (38/41) agreement on the likelihood that these recommendations would change practice if not already applied. Areas of persistent disagreement included the selective use of imaging to guide AD diagnosis, recommendations against antibiotics in non-complicated AD, and routine colonic evaluation after resolution of non-complicated diverticulitis. CONCLUSION: This joint EAES and SAGES consensus conference updates clinicians on the current evidence and provides a set of recommendations that can guide clinical AD management practice.