elective surgery is more effective
in patients ages 80 and older.
Jennifer Dwyer, MD, Nebraska
Medical Center, Omaha,
reported on a study designed
to determine whether the risk
analysis index score—a measure
of frailty—correlates with
complications after urologic
operations. The study indicated
that frailty affects both primary
(mortality and pulmonary,
cardiac, and infectious
complications) and secondary
(length of stay, readmission,
return to the OR, discharge
Luis A. de la Cruz, MD, MBA,
Baptist Hospital of Miami,
described how a strategy
combining risk stratification,
interventions, and postoperative
renal function monitoring
significantly reduced the
incidence of acute renal failure
in noncardiac surgery patients.
Beth Turrentine, PhD, RN,
trauma care coordinator,
acute care nurse practitioner
instructor, University of
Virginia, Charlottesville, offered
insights into a study that tested
the hypothesis that sarcopenia,
as measured by preoperative
computed tomography scans,
predicts morbidity and mortality
in emergent laparotomy.
Jonathan S. Abelson, MD, a
general surgery resident at New
York Presbyterian Hospital,
New York, described a study of
his institution’s use of the ACS
NSQIP Surgical Risk Calculator
in weekly morbidity and
mortality conferences. The study
showed that the risk calculator
can be particularly effective in
predicting patients with “above
average” risk of complications.
Julia Berian, MD, an ACS
Clinical Scholar in Residence
who has played a significant
role in the ACS and the John A.
for Quality in Geriatric Surgery,
also spoke, offering insights
into future directions in this
growing surgical arena.
ACS Strong for Surgery
To ensure that all patients
are in optimal condition for
operative care, the College
will be leading a national ACS
Strong for Surgery initiative.
Each year, approximately 210,000
preventable deaths occur in U.S.
hospitals—half during some
phase of surgical care, according
to Thomas K. Varghese, Jr., MD,
MS, FACS, head, general thoracic
surgery, University of Utah;
associate professor, department
of surgery, University of Utah
School of Medicine; and co-
director, Huntsman Cancer
Institute’s thoracic oncology
program, Salt Lake City.
According to Dr. Varghese, under
the ACS Strong for Surgery
model, health care providers
use a series of checklists and
tools first developed at the
University of Washington,
Seattle, in four modifiable areas
to ensure the patient’s optimal
readiness for operative care:
nutrition, blood sugar, smoking
status, and medication use.
Peter Angelos, MD, PhD, FACS,
Linda Kohler Anderson Professor
of Surgery, chief, endocrine
surgery, and associate director,
MacLean Center for Clinical
Medical Ethics, University of
Chicago Medicine, explored
the concept of professionalism.
Surgical professional ethics
centers on three factors: the
surgeon-patient relationship, the
invasive nature of surgery, and
informed consent for surgery.
“What makes surgery unique
is that it requires harm in order
to heal,” Dr. Angelos said.
“Healing cannot occur without
actions that would be illegal
in any other context. It is an
intensely physical relationship.”
V101 No 10 BULLETIN American College of Surgeons