British journal of anaesthesia
-
Multicenter Study
Integration of the Duke Activity Status Index into preoperative risk evaluation: a multicentre prospective cohort study.
The Duke Activity Status Index (DASI) questionnaire might help incorporate self-reported functional capacity into preoperative risk assessment. Nonetheless, prognostically important thresholds in DASI scores remain unclear. We conducted a nested cohort analysis of the Measurement of Exercise Tolerance before Surgery (METS) study to characterise the association of preoperative DASI scores with postoperative death or complications. ⋯ A DASI score of 34 represents a threshold for identifying patients at risk for myocardial injury, myocardial infarction, moderate-to-severe complications, and new disability.
-
Despite an increase in the proportion of women anaesthesiologists over time, women remain under-represented in academic and leadership positions, honour awards, and academic promotion. Current literature has identified several reasons for the observed gender disparity in anaesthesiology leadership and faculty positions, including unsupportive work environments, lack of mentorship, personal choices, childcare responsibilities, and active discrimination against women. A scoping review design was selected to examine the nature and extent of available research. ⋯ Work-life demands may impose a challenge. Motivation and interest in career advancement of women anaesthesiologists have not been well studied. Several strategies have been proposed, ranging from an individual to administrative level, which may help anaesthesiologists achieve equal representation of women in the field.
-
Multicenter Study
Association between propofol dose and 1-year mortality in patients with and without a diagnosis of solid cancer.
Preclinical data suggest suppression of cancer proliferation by propofol, and retrospective studies suggest improved survival after cancer surgery with propofol-based anaesthesia. ⋯ Increasing propofol dose is associated with lower 1-yr mortality in patients without, but not in patients with, a diagnosis of solid cancer. We found evidence for competing effects, modifying the association between propofol dose and mortality.
-
The Women in Anaesthesia Research Symposium (Prato, Italy; 4 June, 2019), supported by the British Journal of Anaesthesia in collaboration with Monash University, was organised to discuss challenges facing women in anaesthesia clinical practice and research. We provide an overview of institutional or departmental measures that were proposed during the symposium that may empower women in anaesthesia today.
-
Review
Immune checkpoint inhibitors: a narrative review of considerations for the anaesthesiologist.
Immunotherapy has revolutionised the treatment of oncologic malignancies. Immune checkpoint inhibitors represent a new class of immunotherapy drugs. ⋯ An increasing number of patients who undergo surgery will have had treatment with immune checkpoint inhibitors. In this narrative review article, we discuss their mechanism of action, therapeutic effects, pertinent toxicities, and address specific perioperative considerations for patients treated with immune checkpoint inhibitors.