General Surgery

Multicenter MySurgeryRisk accurately predicts ICU admission, MV, AKI, and in-hospital mortality

In 508,097 major inpatient operations across 14 institutions, MySurgeryRisk achieved AUROCs of 0.93 for ICU admission and 0.95 for in-hospital mortality. Complication prevalences were 8% for ICU admission, 4% for mechanical ventilation, 7% for AKI, and 1% for in-hospital death. Primary procedure code and clinician-specific factors were the most influential model predictors. These results support using the model for perioperative risk stratification and resource planning after local calibration and validation. 1

Preoperative PCSK9 inhibitors linked to fewer 30‑day postoperative MACEs than statins

In a nationwide 1:1 propensity‑matched cohort of 35,923 pairs, PCSK9 inhibitor users had lower 30‑day MACEs (6.4% vs 9.6%, RR 0.67). PCSK9 use was also associated with lower all‑cause mortality (RR 0.45), AKI (RR 0.45), and fewer respiratory infections. Findings were consistent across time intervals and therapy durations in the database analysis. Because this is observational, residual confounding may exist; randomized trials are required before changing perioperative lipid therapy. 2

Task switching between organ types raises 1‑year post‑transplant mortality

Analysis of 316,742 US transplants using quasi-random organ arrivals found switching organ types increased 1‑year mortality by 0.66 percentage points. This change represented a 14.8% relative increase versus baseline mortality. Authors propose structured scheduling, longer intervals between procedures, and increased surgeon experience as mitigations. Apply these findings to transplant scheduling and team assignment, recognizing setting-specific factors. 3