On September 21-22 APSF convened a selective group of experts from multiple medical specialties-anesthesiology, surgery, cardiology and immunology - and others involved in government and health quality organizations whose activities and policies impact patient safety to discuss long-term outcomes (months to years) after anesthesia and surgery.
This collaborative conference provided the opportunity to examine a variety of issues. One had to do with surprising - but very preliminary - data regarding post-surgical survival that might affect the lives of tens of thousands of patients each year. These new data showed an unexpected correlation between the time a person spent at more profound levels of 'brain wave" changes during anesthesia and the likelihood of their dying within the first year after their surgery from causes totally unrelated to the surgery. These data also prompted speculation that some combination of anesthesia and surgery may trigger a cascade of inflammation in the body that enhances cardiovascular, respiratory, or even cancerous conditions. If such a correlation is confirmed, it prompts the question of how the short-lived event of surgery could result in long-term effects.
The workshop was intended to "connect the dots". Our deliberations allowed for the sharing of often-compartmentalized bodies of knowledge to forge a comprehensive understanding of the myriad factors that might be involved in this puzzle.
As in all scientific matters, there turned out to be more questions than answers regarding these issue.
The group arrived at a number of threads of agreement and observation, which will now serve as the basis for future analysis and action. These include:
This convergence of so many specialties focusing intensely on critical questions surrounding surgery, may, we hope, produce eventual revelations about how we care for a patient, before, during and long-after surgery. The new mass of insight we generated together could well affect how we practice and relate to each other in the future.
Jeffrey B. Cooper, PhD
David M. Gaba, MD
David M. Gaba, M.D.
Secretary, Anesthesia Patient Safety Foundation
Long Term Outcomes Workshop Principal Investigator