Practice Changing Updates in Perioperative Medicine Literature 2020- 2021. A Systematic Review


      Recent literature published in a variety of multidisciplinary journals has significantly influenced perioperative patient care. Distilling and synthetizing the clinically important literature can be challenging. This review summarizes practice changing articles in perioperative medicine from the years 2020 and 2021. Embase, Ovid, and EBM reviews databases were queried from January 2020 to December 2021. Inclusion criteria were original research, systematic review, metaanalysis, and important guidelines. Exclusion criteria were conference abstracts, case reports, letters, protocols, pediatric and obstetric articles, and cardiac surgery literature. Two authors reviewed each reference using the Distiller SR systematic review software (Evidence Partners Inc., Ottawa, Ontario, Canada). A modified Delphi technique was used to identify nine practice changing articles. We identified another 13 articles for tabular summaries as they were relevant to an internist's perioperative evaluation of a patient. Articles were selected to highlight the clinical implications of new evidence in each field. We have also pointed out limitations of each study and clinical populations where they are not applicable.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to The American Journal of Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Roshanov PS
        • Sessler DI
        • Chow CK
        • et al.
        Predicting myocardial injury and other cardiac complications after elective noncardiac surgery with the Revised Cardiac Risk Index: the VISION study.
        Canadian Journal of Cardiology. 2021; 23: 23
        • Ruetzler K
        • Smilowitz NR
        • Berger JS
        • et al.
        Diagnosis and Management of Patients With Myocardial Injury After Noncardiac Surgery: A Scientific Statement From the American Heart Association.
        Circulation. 2021; 144: e287-e305
        • Devereaux P
        • Chan MT
        • Alonso-Coello P
        • et al.
        Association between postoperative troponin levels and 30-day mortality among patients undergoing noncardiac surgery.
        • Lee TH
        • Marcantonio ER
        • Mangione CM
        • et al.
        Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery.
        Circulation. 1999; 100: 1043-1049
        • Humeidan ML
        • Reyes J-PC
        • Mavarez-Martinez A
        • et al.
        Effect of cognitive prehabilitation on the incidence of postoperative delirium among older adults undergoing major noncardiac surgery: the neurobics randomized clinical trial.
        JAMA surgery. 2021; 156: 148-156
      1. Labs L. Lumosity. Published 2022. Accessed May 23, 2022.

        • Borges FK
        • Bhandari M
        • Guerra-Farfan E
        • et al.
        Accelerated surgery versus standard care in hip fracture (HIP ATTACK): an international, randomised, controlled trial.
        The Lancet. 2020; 395: 698-708
        • Nyholm AM
        • Gromov K
        • Palm H
        • et al.
        Time to surgery is associated with thirty-day and ninety-day mortality after proximal femoral fracture: a retrospective observational study on prospectively collected data from the Danish fracture database collaborators.
        JBJS. 2015; 97: 1333-1339
        • Simunovic N
        • Devereaux P
        • Sprague S
        • et al.
        Effect of early surgery after hip fracture on mortality and complications: systematic review and meta-analysis.
        Cmaj. 2010; 182: 1609-1616
        • Kohan L
        • Potru S
        • Barreveld AM
        • et al.
        Buprenorphine management in the perioperative period: educational review and recommendations from a multisociety expert panel.
        Regional Anesthesia & Pain Medicine. 2021; 46: 840-859
        • Mahmud N
        • Fricker Z
        • Lewis JD
        • Taddei TH
        • Goldberg DS
        • Kaplan DE.
        Risk Prediction Models for Postoperative Decompensation and Infection in Patients With Cirrhosis: A Veterans Affairs Cohort Study.
        Clinical Gastroenterology & Hepatology. 2021; 08: 08
        • Richards T
        • Baikady RR
        • Clevenger B
        • et al.
        Preoperative intravenous iron to treat anaemia before major abdominal surgery (PREVENTT): a randomised, double-blind, controlled trial.
        The Lancet. 2020; 396: 1353-1361
        • Mueller MM
        • Van Remoortel H
        • Meybohm P
        • et al.
        Patient blood management: recommendations from the 2018 Frankfurt Consensus Conference.
        Jama. 2019; 321: 983-997
        • Muñoz M
        • Acheson AG
        • Auerbach M
        • et al.
        International consensus statement on the peri-operative management of anaemia and iron deficiency.
        Anaesthesia. 2017; 72: 233-247
        • Elhenawy AM
        • Meyer SR
        • Bagshaw SM
        • MacArthur RG
        • Carroll LJ.
        Role of preoperative intravenous iron therapy to correct anemia before major surgery: a systematic review and meta-analysis.
        Systematic Reviews. 2021; 10: 36
        • Collaborative C
        • Collaborative G
        • Nepogodiev D
        • et al.
        Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study.
        Anaesthesia. 2021; 76: 748-758
        • Leone M
        • Einav S
        • Chiumello D
        • et al.
        Noninvasive respiratory support in the hypoxaemic peri-operative/periprocedural patient: a joint ESA/ESICM guideline.
        Intensive care medicine. 2020; 46: 697-713
        • Sun Z
        • Sessler DI
        • Dalton JE
        • et al.
        Postoperative hypoxemia is common and persistent: a prospective blinded observational study.
        Anesthesia and analgesia. 2015; 121: 709
        • Moller JT
        • Wittrup M
        • Johansen SH.
        Hypoxemia in the postanesthesia care unit: an observer study.
        The Journal of the American Society of Anesthesiologists. 1990; 73: 890-895
        • Zayed Y
        • Kheiri B
        • Barbarawi M
        • et al.
        Effect of oxygenation modalities among patients with postoperative respiratory failure: a pairwise and network meta-analysis of randomized controlled trials.
        Journal of Intensive Care. 2020; 8: 1-11
        • Pearse R
        • Ranieri M
        • Abbott T
        • et al.
        Postoperative continuous positive airway pressure to prevent pneumonia, re-intubation, and death after major abdominal surgery (PRISM): a multicentre, open-label, randomised, phase 3 trial.
        The Lancet Respiratory Medicine. 2021; 9: 1221-1230
        • Kovacs MJ
        • Wells PS
        • Anderson DR
        • et al.
        Postoperative low molecular weight heparin bridging treatment for patients at high risk of arterial thromboembolism (PERIOP2): double blind randomised controlled trial.
        bmj. 2021; : 373
        • Douketis JD
        • Spyropoulos AC
        • Kaatz S
        • et al.
        Perioperative bridging anticoagulation in patients with atrial fibrillation.
        New England Journal of Medicine. 2015; 373: 823-833
        • Deng JZ
        • Chan JS
        • Potter AL
        • et al.
        The Risk of Postoperative Complications After Major Elective Surgery in Active or Resolved COVID-19 in the United States.
        Annals of surgery. 2022; 275: 242-246
        • Rose PD
        • Au M
        • Woodman RJ
        • Tee D
        • Chinnaratha MA.
        Pre-procedural use of thrombopoietin-receptor agonists in cirrhosis and severe thrombocytopenia: A systematic review and meta-analysis.
        Digestive & Liver Disease. 2021; 53: 1396-1403
        • Benesch C
        • Glance LG
        • Derdeyn CP
        • et al.
        Perioperative Neurological Evaluation and Management to Lower the Risk of Acute Stroke in Patients Undergoing Noncardiac, Nonneurological Surgery: A Scientific Statement From the American Heart Association/American Stroke Association.
        Circulation. 2021; 143: e923-e946
        • Woo SH
        • Marhefka GD
        • Cowan SW
        • Ackermann L.
        Development and Validation of a Prediction Model for Stroke, Cardiac, and Mortality Risk After Non-Cardiac Surgery.
        Journal of the American Heart Association. 2021; 10e018013
        • Neuman MD
        • Feng R
        • Carson JL
        • et al.
        Spinal Anesthesia or General Anesthesia for Hip Surgery in Older Adults.
        New England Journal of Medicine. 2021; 385: 2025-2035
        • Xu Y
        • You D
        • Krzyzaniak H
        • et al.
        Effect of oral anticoagulants on hemostatic and thromboembolic complications in hip fracture: A systematic review and meta-analysis.
        Journal of Thrombosis and Haemostasis. 2020; 18: 2566-2581
        • O'Rourke MJ
        • Keshock MC
        • Boxhorn CE
        • et al.
        Preoperative Management of Opioid and Nonopioid Analgesics: Society for Perioperative Assessment and Quality Improvement (SPAQI) Consensus Statement.
        Mayo Clinic Proceedings. 2021; 96: 1325-1341
        • Cummings 3rd, KC
        • Keshock M
        • Ganesh R
        • et al.
        Preoperative Management of Surgical Patients Using Dietary Supplements: Society for Perioperative Assessment and Quality Improvement (SPAQI) Consensus Statement.
        Mayo Clinic Proceedings. 2021; 96: 1342-1355
        • Pfeifer KJ
        • Selzer A
        • Mendez CE
        • et al.
        Preoperative Management of Endocrine, Hormonal, and Urologic Medications: Society for Perioperative Assessment and Quality Improvement (SPAQI) Consensus Statement.
        Mayo Clinic Proceedings. 2021; 96: 1655-1669
        • Pfeifer KJ
        • Selzer A
        • Whinney CM
        • et al.
        Preoperative Management of Gastrointestinal and Pulmonary Medications: Society for Perioperative Assessment and Quality Improvement (SPAQI) Consensus Statement.
        Mayo Clinic Proceedings. 2021; 96: 3158-3177
        • Arias F
        • Wiggins M
        • Urman RD
        • et al.
        Rapid in-person cognitive screening in the preoperative setting: test considerations and recommendations from the Society for Perioperative Assessment and Quality Improvement (SPAQI).
        Perioperative care and operating room management. 2020; 19100089
        • Prowle JR
        • Forni LG
        • Bell M
        • et al.
        Postoperative acute kidney injury in adult non-cardiac surgery: joint consensus report of the Acute Disease Quality Initiative and PeriOperative Quality Initiative.
        Nature Reviews Nephrology. 2021; 11: 11