OR Manager - February 2020 - 32

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At a Glance
AI and surgical decision making
Integrating artificial intelligence (AI) with
surgical decision making could transform
care by augmenting the decision
to perform surgery,
informed consent
process, identification and mitigation
of modifiable risk factors, decisions
on postoperative management, and
shared decision for resource use, this
review finds.
Surgical decision making involves
hypothetical-deductive reasoning, individual
judgment, and heuristics-factors
that can lead to bias, error, and harm.
Predictive analytics and clinical decisionsupport
systems can be compromised
by time-consuming manual data management
and inaccuracies, whereas AI
models can be fed with livestreaming intraoperative
and electronic health record
data throughout each phase of care, the
researchers say.
-Loftus T J, Tighe P J, Filiberto A C, et
al. JAMA Surg. Published online
December 11, 2019.
Bariatric surgery improves the
heart
Bariatric surgery reverses subclinical
heart dysfunction in obese patients,
finds this study presented December 5
at EuroEcho 2019, a scientific congress
of the European Society of Cardiology in
Vienna, Austria.
The study included 38 obese patients
who had bariatric surgery and 19
who remained on the waiting list. At 6
months, surgery patients had lost 26%
of their total body weight, and patients
on the waiting list remained the same.
Rates of comorbidities were significantly
lower in the surgery group than the waiting
group: hypertension (30% vs 61%),
dyslipidemia (5% vs 42%), and type 2
diabetes (13% vs 40%).
A total of 22 (58%) patients in the
surgery group had subclinical heart disease
at the beginning of the study. At 6
months after surgery, subclinical heart
function had normalized in 82%, and
it worsened in 53% of patients on the
waiting list.
-https://www.escardio.org/The-ESC/
Press-Office/Press-releases/Obesitysurgery-improves-the-heart
Less
sleep before work days
affects nurses' performance
In this study from New York University
Rory Meyers College of Nursing, nurses
were found to sleep nearly an hour and
a half less before work days than before
days off, affecting patient care and
safety.
Using data from two surveys of
1,568 nurses collected in 2015 and
2016, nurses reported getting, on average,
just under 7 hours (414 minutes)
of sleep before a work day and more
than 8 hours (497 minutes) before a
nonwork day, for a difference in sleep
duration of 83 minutes.
Short sleep duration was statistically
significantly associated with
lower
ratings of patient safety and
quality of care. The researchers recommend
considering interventions to support
nurses' sleep.
-Witkoski Stimpfel A, Fatehi F, Kovner
C. Sleep Health. Published online
December 11, 2019.
MI after vascular surgery tied to
high mortality rates
Myocardial infarction (MI) after major
vascular surgery is associated with a
high mortality rate in the following year,
this study finds.
Of 26,231 vascular surgery patients
analyzed, factors linked to an increased
risk of postoperative MI included increased
age, diabetes, coronary artery
disease, congestive heart failure, cardiac
valvular disease, and preoperative
use of P2Y12 platelet inhibitors.
Patients who experienced a postoperative
MI within 1 year after surgery
had a 37% mortality rate. Those who
had a postoperative MI associated with
ECG changes or troponin elevation only
had an elevated risk of mortality as long
as 5 years after surgery.
-Beaulieu R J, Sutzko D C, Albright J, et
al. JAMA Surg. Published online
December 4, 2019.
32
OR Manager | February 2020
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OR Manager - February 2020

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