High Risk Surgery

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Introduction
Each year, approximately 500,000 Americans age 65 and older will have a high risk operation, such as heart bypass or major cancer surgery. Although many patients benefit from high risk surgery, it carries real potential for mortality and serious complications, including stroke, kidney and respiratory failure, particularly for older patients with multiple comorbidities. High risk surgery can have other unintended consequences including postoperative suffering, conflict about additional aggressive treatments and receipt of unwanted postoperative interventions. Thus, there is much at stake for patients and families in the decision to proceed with surgery.
Surgeons play an important role in helping patients make preference sensitive …show more content…
Lists of questions “to ask your surgeon” exist, but the questions on those lists do not address specific surgical informational needs we have identified as important to the decision-making process. Furthermore, patients who are more activated receive more patient-centered care and take part in more collaborative decision making. This is especially critical for older patients, who are less likely to ask questions of physicians, and less effective in ensuring that physicians attend to their concerns, than their younger …show more content…
We aimed to develop a group with a range of positive and negative surgical experiences to help us further understand critical and potentially unaddressed decisional and informational needs of patients and their family members.
We recruited PFAC members through clinic nurses, surgeons who performed high risk operations, and hospital patient relations. We invited patients and family members of older patients who had experience with high risk surgery and purposely selected a small group with strong health literacy skills, so members could work with abstract study data. The senior author (MLS) briefed each member to clarify roles and expectations. Our group included 2 men and 2 women. Two of the members had had major surgery (cardiac, neurologic) and 2 members were primary care givers for patients who had vascular and oncologic surgery and subsequently died. We held monthly Patient and Family Advisory Council meetings at a public library. Each meeting was facilitated by a trained member of the research team (NMS) and a registrar (JLT). The Principle Investigator attended all but X number of meetings. We compensated each member $1000 total for their attendance of 10
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