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American College of Surgeons, Oct. 19-22

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By Beth Gilbert HealthDay Reporter

The annual meeting of the American College of Surgeons was held this year from Oct. 19 to 22 in San Francisco and attracted participants from around the world, including surgeons, medical experts, allied health professionals, and administrators. The conference included hundreds of general and specialty sessions, postgraduate courses, scientific paper presentations, video-based education presentations, and posters focusing on the latest advances in surgical care.

In one study, Benjamin C. James, M.D., of the Beth Israel Deaconess Medical Center and Harvard Medical School in Boston, and colleagues found that patients with cancer continue to suffer from financial burden for many years after their cancer diagnosis, despite health care reform.

The authors analyzed objective data measures to evaluate financial burden among patients with cancer and found that patients with a cancer diagnosis suffer from financial burden as indicated by multiple measures, including medical debt, overall debt, and a decrease in credit score. The researchers note that what was particularly striking was not only the decrease in credit score after a diagnosis of cancer, but the credit score never rebounded even years after diagnosis.

“Clinicians should begin to have cost communications in their discussion of cancer treatment,” James said. “While we would not expect a change in clinical practice based on these findings, it’s important for both the patient and provider to be aware of the potential financial implications of treatment choices.”

Edward A. Joseph, M.B.B.S., of the University of Washington School of Medicine in St. Louis, and colleagues found that implementing a system-wide preoperative nutrition program would lead to a projected $7.8 million in annual savings through reduced hospital stays, fewer complications, and better resource utilization.

The authors conducted a comprehensive systematic review to assess the efficacy of preoperative immunonutrition for improving postoperative outcomes across nine surgical disciplines. The review focused on the impact of two specific nutritional interventions (Ensure Surgery Immunonutrition Drink and Ensure Pre-Surgery Clear Carbohydrate Drink) and their effects on reducing hospital length of stay and the incidence of postoperative complications. The researchers found that implementing a systemwide preoperative nutrition program resulted in an 18 percent reduction in hospitalization days and a 33 percent decrease in postoperative complications across multiple surgical specialties.

“Our study highlights the potential for enhanced surgical outcomes and health care cost efficiencies. Preoperative nutrition interventions are shown to reduce ‘outlier days’ — hospital days exceeding the expected number — which significantly contribute to overall cost savings,” Joseph said. “Adopting a systemwide preoperative nutrition program can enhance patient outcomes significantly while providing a substantial financial benefit to payers and providers.”

Eldo Frezza, M.D., of California Northstate University College of Medicine in Elk Grove, and colleagues found that music has a calming effect among patients following surgery, which leads to reductions in anxiety, perceived pain, and heart rate.

The authors reviewed 35 studies that focused on the role of music in assisting patients recovering from surgery and found that listening to music during recovery was associated with lower pain levels, reduced anxiety levels, less opioid use, and reduced heart rate. The investigators attributed this calming effect when listening to music to a reduction in cortisol levels.

“When patients wake up after surgery, sometimes they feel really scared and don’t know where they are,” Frezza said in a statement. “Music can help ease the transition from the waking-up stage to a return to normalcy and may help reduce stress around that transition.”

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