Surgical Outcomes Program News

Mayo researchers seek to manage pain while minimizing opioid prescriptions

Aug. 3, 2017

In the last 15 years, the number of Americans receiving an opioid prescription and the number of deaths involving overdoses have roughly quadrupled, according to the Centers for Disease Control and Prevention.

As the opioid epidemic continues, health care providers are hoping to do their parts in curbing it. For decades, the emphasis nationwide for treating patients after surgery was to prescribe enough opioid pain medication to ensure they didn't have any pain at all. But health care providers are realizing it's a balancing act between managing pain and ensuring patients aren't overprescribed.

To that end, Mayo Clinic researchers are studying the clinic's opioid prescribing practices after surgery, outlining areas for improvement based on evidence, and implementing change. The team includes scientists in the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, along with surgeons, pain medicine specialists, nurses and pharmacists. Their goal is to identify the ideal amount for each patient.

The full study was published online in the Annals of Surgery.

Underused cancer test could improve treatment for thousands, Mayo Clinic study finds

June 21, 2017

A simple blood test could improve treatment for more than 1 in 6 patients with stage II colon cancer, suggests new Mayo Clinic research. The researchers also discovered that many patients who could benefit from the test likely aren't receiving it.

Using data from the National Cancer Database for 40,844 patients, Mayo Clinic physicians and scientists teamed up to look at benefits of a blood test that measures the protein called carcinoembryonic antigen (CEA) in stage II colon cancer. Carcinoembryonic antigen can be found in higher levels in people with certain cancers, especially colon cancer.

The researchers found that knowing these blood test results prior to treatment could have changed the classification for 17 percent of patients with stage II colon cancer from average risk to high risk. That change could have altered treatment options, including whether to use chemotherapy.

The full study was published online in the Journal of Gastrointestinal Surgery.

Research looks to improve patient satisfaction, reduce costs by predicting surgery length

May 10, 2017

Accurately predicting the length of an operation has benefits beyond simply informing patients and their families. Doing so means improved patient satisfaction and has the potential to prevent over- or underutilization of operating rooms, which has significant implications on both resources and staff. Ultimately, that leads to improved quality of care for patients, improved well-being for surgical teams and reduced costs for hospitals.

With that in mind, Mayo Clinic researchers have shown that by looking at patients' specific traits they can more accurately predict the length of an operation.

"From an efficiency standpoint the current systems are often unreliable and contribute to costly overestimation and underestimation of surgery length," says Cornelius A. Thiels, D.O., a general surgery resident at Mayo Clinic and alumnus of the Surgical Outcomes Research Fellowship.

The researchers published a pair of studies, the first in The American Journal of Surgery, and the second in Surgical Endoscopy.

Ice fishing as extreme sport: Burns, broken bones, concussions among injuries chronicled

Feb. 14, 2017

Ice fishing might seem like a benign sport — for everyone except the fish. Sitting in a cozy shanty waiting for a bite, what could go wrong? A lot, Mayo Clinic surgeons have found. The ice fishing injuries they have chronicled seem more like a casualty list from an extreme sport: burns, broken bones, concussions and more.

The study team analyzed data on emergency department visits between 2009 and 2014 obtained from the National Electronic Injury Surveillance System All Injury Program and found 85 patients hurt while ice fishing. There may be more ice fishing cases than they could find; the database collects data on emergency room visits from a nationally representative sample of roughly 100 hospitals with six or more beds, and the researchers had to search case narratives to identify ice fishing injuries.

The full study was published online in the American Journal of Emergency Medicine.

Study of thousands of operations finds overlapping surgeries are safe for Mayo Clinic patients

Dec. 1, 2016

A common way of scheduling surgeries to expand patient access to care and improve hospital efficiency, known as "overlapping surgeries," is as safe and provides the same outcomes for patients as nonoverlapping surgeries, a Mayo Clinic study has found.

Spacing operations so a surgeon has two patients in operating rooms at the same time is a common practice in surgery at Mayo and other leading medical institutions. It gives patients greater access to qualified surgeons, allows more efficient use of operating rooms, and avoids unnecessary downtime for surgeons.

A Mayo Clinic study compared the outcomes of thousands of such overlapping surgeries with nonoverlapping operations at its Rochester campus and found no difference in the rates of postoperative complications or deaths within a month after surgery between the two groups.

The full study was published online in the Annals of Surgery.

Debunking the July phenomenon

July 5, 2016

"Never go to the hospital in July," a phrase often repeated by patients and perpetuated by myriad hospital employees, casts a worrisome tone over care received in July. Thus we hear of the so-called July phenomenon.

This is because each July 1 is the start of the medical residency year. A day full of mixed emotions — excitement, splendor, fear, stress and accomplishment — it is the very environment that many clinicians thrive in. It also starts the period that some people fear can be very distracting for new doctors, and possibly even dangerous for their patients.

Multiple studies have shown that the July phenomenon is not correlated with worse patient outcomes. Researchers from the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, who focus on rethinking how people understand and improve patient care, wanted to take those assurances one step further and ensure that patients' experiences and perspectives on their hospital care weren't suffering.

The research showed that patients treated in July or August were more likely to rate the hospital highly than were patients treated in the remaining months of the year.

The full study was published online in JAMA Surgery.

Frozen section analysis for breast cancer could save time, anxiety and more than $90 million

Feb. 23, 2016

When diagnosed with breast cancer, women may have thousands of questions running through their minds, but one they may not have immediately is: Will my choice of provider save me time and money?

Mayo Clinic researchers have answered this question with what they believe are compelling statistics that may encourage women and their doctors — and the health care system at large — to consider a different way of doing business, specifically with respect to lumpectomies as a treatment for early-stage breast cancer.

The full study was published online in the Journal of Oncology Practice.