Optimizing health before elective thoracic surgery: Systematic review of modifiable risk factors and opportunities for health services research

Sean M. Stokes*, Elliot Wakeam, Mara B. Antonoff, Leah M. Backhus, Robert A. Meguid, David Odell, Thomas K. Varghese

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

5 Scopus citations

Abstract

Despite progress in many different domains of surgical care, we are still striving toward practices which will consistently lead to the best care for an increasingly complex surgical population. Thoracic surgical patients, as a group, have multiple medical co-morbidities and are at increased risk for developing complications after surgical intervention. Our healthcare systems have been focused on treating complications as they occur in the hopes of minimizing their impact, as well as aiding in recovery. In recent years there has emerged a body of evidence outlining opportunities to optimize patients and likely prevent or decrease the impact of many complications. The purpose of this review article is to summarize four major domains—optimal pain control, nutritional status, functional fitness, and smoking cessation—all of which can have a substantial impact on the thoracic surgical patient’s course in the hospital—as well as to describe opportunities for improvement, and areas for future research efforts.

Original languageEnglish (US)
Pages (from-to)S537-S554
JournalJournal of Thoracic Disease
Volume11
DOIs
StatePublished - 2019

Keywords

  • Exercise
  • Health services
  • Nutrition
  • Outcomes
  • Pain management
  • Prehabilitation
  • Preoperative risk
  • Quality improvement
  • Smoking cessation
  • Thoracic surgery

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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