How high-risk patients avoid the ‘surgery conveyor belt’ in Taranaki

Half of all patients seen at high risk pre-operative clinics don’t go ahead with their surgery proving they can make informed decisions before they get on the ‘surgery conveyer belt’, according to new figures out of Taranaki Base Hospital.
The anaesthetist in charge of the high risk clinics, Dr Charlie Brown, presented findings from the clinics at the 2017 NZ Anaesthesia Annual Scientific Meeting being held in Rotorua (November 8-11, 2017).
Taranaki Base Hospital started the high risk clinics a few years ago, prompted initially by high numbers of patients needing joint replacements. The clinics allow for a deeper exploration with the patient about the possible outcomes from surgery.
“The key to this is not booking the patients to theatre but giving them a chance to explore the options. The patients get to spend a good period of time with an anaesthetist to look at their expectations and what might be the end result of surgery,” says Dr Brown.
He says patients are grateful to be given the time in the clinics to really talk about the risks and benefits of their surgery.
“Their lifestyle is looked at, the outcomes weighed up, and the decision is made whether to proceed after all the information is laid out on the table. When patients are looking at, say, a hernia repair or knee replacement and we talk about the risk of major complications
following surgery, or even death, half the patients say no to surgery.”
From the half that decided not to be operated on in the
data being looked at, 20 percent died within the next six months. Dr Brown believes those people are potentially spared being put through stressful operations and complications in the last few months of their life. “So, the take-home message is there is a high mortality for these high risk patients and you need to invest time in them and not just put them on the surgery conveyer belt,” he says.