High-Risk Patients Avoid ‘Surgery Conveyor Belt’ in Taranaki

Press Release – ANZCA

How High-Risk Patients Avoid the “Surgery Conveyor Belt” in Taranaki

Half of all patients seen at high risk pre-operative clinics don’t go ahead with their surgery proving they can make informed decisions before they get on the “surgery conveyer belt,” according to new figures out of Taranaki Base Hospital.

The anaesthetist in charge of the high risk clinics, Dr Charlie Brown, is presenting findings from the clinics at the 2017 NZ Anaesthesia Annual Scientific Meeting being held in Rotorua (November 8-11, 2017).

Taranaki Base Hospital started the high risk clinics a few years ago, prompted initially by high numbers of patients needing joint replacements. The clinics allow for a deeper exploration with the patient about the possible outcomes from surgery.

“The key to this is not booking the patients to theatre but giving them a chance to explore the options. The patients get to spend a good period of time with an anaesthetist to look at their expectations and what might be the end result of surgery,” says Dr Brown.

He says patients are grateful to be given the time in the clinics to really talk about the risks and benefits of their surgery.

“Their lifestyle is looked at, the outcomes weighed up, and the decision is made whether to proceed after all the information is laid out on the table. When patients are looking at, say, a hernia repair or knee replacement and we talk about the risk of major complications following surgery, or even death, half the patients say no to surgery.”

From the half that decided not to be operated on in the data being looked at, 20 per cent died within the next six months. Dr Brown believes those people are potentially spared being put through stressful operations and complications in the last few months of their life. “So, the take-home message is there is a high mortality for these high risk patients and you need to invest time in them and not just put them on the surgery conveyer belt,” he says.

Meanwhile Auckland anaesthetist Dr Nicola Broadbent will also be speaking at the conference looking how to objectively assess frailty in the consultations before surgery. Dr Broadbent says there’s a buzz in the health industry around frailty but there needs to be much more work around how that is measured and used.
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NOTES

The NZ Anaesthesia Annual Scientific Meeting (ASM) is hosted jointly by the Australian and New Zealand College of Anaesthetists (ANZCA) and the New Zealand Society of Anaesthetists (NZSA).

One of Australasia’s largest specialist medical colleges, ANZCA is responsible for the training, examination and specialist accreditation of anaesthetists and pain medicine specialists, and for the standards of clinical practice, in Australia and New Zealand.

The New Zealand Society of Anaesthetists (NZSA) represents and champions the professional interests of anaesthetists and the optimal care of their patients through advocacy, promoting education and research, and supporting anaesthesia networks throughout the country.

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