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Which surgical patients require shared care?

E Montero Ruiz1, D Rubal Bran2,

  • 1Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal, Madrid, España.

Revista Clinica Espanola
|June 15, 2020
PubMed
Summary
This summary is machine-generated.

Shared care (SC) for hospitalized surgical patients is crucial. This approach, involving shared responsibility for patient management, can reduce mortality by addressing complications and improving perioperative care.

Keywords:
Asistencia compartidaAtención perioperatoriaHospitalised patientsInternal medicineMedicina internaPacientes hospitalizadosPerioperative careReferral and consultationRemisión y consultaShared care

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Area of Science:

  • Medicine
  • Surgical Care
  • Internal Medicine

Background:

  • Hospitalized surgical patients often have complex medical comorbidities and polypharmacy.
  • Significant postoperative complications can lead to in-hospital mortality, a phenomenon known as failure to rescue.
  • Current patient selection criteria for shared care are often imprecise and may exclude suitable candidates.

Purpose of the Study:

  • To discuss the selection criteria for shared care in surgical wards.
  • To advocate for the universal application of shared care for all hospitalized surgical patients.

Main Methods:

  • Review of existing literature and clinical practices regarding shared care in surgery.
  • Analysis of factors contributing to failure to rescue and the role of internists in surgical wards.

Main Results:

  • Existing shared care selection criteria are not standardized and can be difficult to apply.
  • The presence of internists on surgical wards is a key factor in reducing failure to rescue.
  • Failure to rescue impacts surgical mortality across diverse patient populations.

Conclusions:

  • Shared care is essential for optimizing perioperative management and preventing postoperative mortality.
  • All patients admitted to surgical departments should benefit from shared care, irrespective of selection criteria.
  • Integrating internists into surgical wards enhances patient safety and reduces in-hospital mortality.