Study: Patients want to be heard by physicians after adverse events occur
Findings from an article published online in the journal JAMA Internal Medicine suggest that patients and family members want attending physicians to listen to their feelings about adverse events and to explain what can be done to prevent recurrences. The authors conducted interviews with 40 participants (27 patients, 3 family members, and 10 staff members) at three U.S. hospitals that operate communication-and-resolution programs (CRPs). Overall, 18 of the 30 patients and family members considered the CRP experience to be positive. In addition, although patients and family members expressed interest in learning what the physician and hospital would do to prevent the error from happening again, 24 of them reported not receiving information about safety improvement efforts.
Study: Intra-articular physeal fracture often overlooked in pediatric athletes with acute knee injury
Data from a study published online in the Orthopaedic Journal of Sports Medicine suggest that clinicians who evaluate younger athletes with acute knee injury should be careful not to overlook possible intra-articular physeal fracture. The authors conducted a retrospective review of 49 patients aged 7 to 17 years who presented with intra-articular physeal fracture at one of three high-volume pediatric centers. They found that the initial diagnosis was missed in 39 percent of cases. The authors note that football was responsible for 50 percent of all injuries. Overall, 84 percent of fractures were Salter-Harris type III fractures, and of those, 88 percent involved the medial femoral condyle.
Study: Genetic changes linked with increased risk of lumbar spinal stenosis
A study published online in the Journal of Orthopaedic Research suggests that certain genetic changes may be associated with an increased risk of developing lumbar spinal stenosis. The researchers conducted a genome-wide association study of 469 patients aged 18 to 55 years. They found that low-density lipoprotein receptor-related protein 5 on chromosome 11 was an important functional gene in canal body development. “With better understanding of the DSS phenotype and genetic markers,” the researchers write, “the at-risk population can be identified early, preventative measures can be initiated, lifestyle/activity modification can be implemented, and more novel and precision-based therapeutics can be developed.”
Study: Patient frailty associated with increased perioperative morbidity
Data from a study published online in the journal JAMA Surgery suggest that frailty may be independently associated with perioperative morbidity in patients undergoing common ambulatory general surgery. The authors conducted a retrospective, cohort study of 140,828 patients aged older than 40 years, who underwent one of four ambulatory general surgeries. Of those, 2,457 (17 percent) experienced a perioperative complication and 971 (0.7 percent) experienced a serious perioperative complication. The authors note that an increasing modified frailty index was associated with a stepwise increase in the occurrence of complications.
Study: Surgical residents often overestimate risk of complication and death
A study published online in the journal JAMA Surgery suggests that many surgical residents may overestimate risk of postoperative complications and death in surgically complex patients. Members of the research team surveyed 152 general surgery (n = 76) and internal medicine (n = 76) residents regarding risk of morbidity, mortality, surgical site infection, pneumonia, and cardiac complications in seven real-life, complex clinical scenarios. For 91 percent of clinical estimates, researchers found that both groups overestimated every type of risk, based on National Surgical Quality Improvement Program estimates. The research team writes that the “near-universal overestimation of risk underscores the importance of developing risk-estimation resources for internists and surgeons.”
The Atlanta Business Chronicle reports that the Supreme Court of Georgia has upheld the state’s certificate of need (CON) law. A physician practice had filed suit after being denied a CON to add a second operating room to an ambulatory surgical center. The plaintiffs argued that the state’s CON statute runs counter to anti-monopoly provisions in the Georgia Constitution. However, the state supreme court determined that CON requirements do not encourage monopolies in the healthcare industry.