Preoperative internal medicine evaluation is associated with a reduction in 30-Day postoperative mortality risk in patients with cancer

Abstract

Background

Patients commonly undergo evaluation by internists prior to surgery. However, the impact of preoperative internal medicine evaluations on the postoperative outcomes of patients with cancer is uncertain.

Methods

We conducted a retrospective cohort study of patients who had been included in the National Surgery Quality Improvement Program from 2011 to 2014 from a single hospital specializing in cancer care to determine the effect of an Internal Medicine Perioperative Assessment Center (IMPAC) evaluation (IMPAC group) on the risk of 30-day mortality compared to that of patients who proceeded directly to surgery (control group).

Results

Of the 11,577 participants, 3,589 underwent an IMPAC evaluation. The absolute 30-day mortality was 0.47% for the IMPAC group and 0.50% for the control group. After propensity matching, the odds ratio (OR) of 30-day mortality was 0.39 (95% CI=0.18–0.84) for the IMPAC group in comparison to the control group.

Conclusions

Our findings demonstrate that a preoperative internal medicine evaluation was associated with lower 30-day mortality. Additional studies are needed to identify which patient populations are most likely to benefit and which attributes of the internal medicine evaluation are most beneficial.