30-Second Takeaway
- Preoperative PCSK9 inhibitors were associated with fewer 30-day MACEs versus statins (**NNT 31**) in a large matched cohort.
- MySurgeryRisk models reliably predict ICU admission, mechanical ventilation, AKI, and in-hospital mortality across centers (AUROCs ≥ **0.92**).
- Dexmedetomidine monotherapy reduces postoperative delirium risk in elderly spinal surgery patients and has moderate-certainty evidence.
Latest - Week ending May 2, 2026
Perioperative interventions and prediction: PCSK9 inhibitors, yoga during thoracic RT, MySurgeryRisk predictions, HF drug sex effects, and delirium prevention
Preoperative PCSK9 inhibitors linked to lower 30-day MACEs versus statins in surgical patients with hyperlipidemia
In a nationwide 1:1 propensity-matched cohort of 35,923 pairs, preoperative PCSK9 inhibitor use was associated with lower 30-day MACEs (6.4% vs 9.6%; RR 0.67). PCSK9 inhibitor exposure was also associated with lower all-cause mortality, AKI, respiratory infections, delirium, and elevated liver enzymes. This is an observational, active-comparator study using EHR data, so residual confounding may explain some associations. Randomized trials are required before routinely replacing perioperative statins with PCSK9 inhibitors.
Dyadic yoga during thoracic radiotherapy improves functional capacity and physical quality of life
In a randomized trial of 222 patient-caregiver dyads, a 15-session yoga program improved 6MWT distance versus education/support (LSM 469 m vs 441 m; P = .03). Patients in the yoga arm reported better physical QOL across end of RT to three months follow-up (P = .03). Exploratory benefits included improved sleep and coping, but mental QOL did not improve. Including caregivers may increase adherence; consider dyadic programs where feasible.
MySurgeryRisk multicenter models accurately predict key postoperative complications
Across 508,097 encounters from 366,875 adults at 14 centers, MySurgeryRisk achieved AUROCs of 0.93 for ICU admission, 0.94 for mechanical ventilation, 0.92 for AKI, and 0.95 for in-hospital mortality. Models used routinely collected variables and maintained performance comparable to prior single-center results. Primary procedure codes and clinician-specific factors were the most influential predictors. Apply these models to aid risk stratification and perioperative planning, but verify local performance before clinical deployment.
References
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Additional Reads
Optional additional studies from this edition.