Vascular Surgery

Nursing records show routine short peripheral IV use, early failure, and wide institutional variability

Multicentre nursing documentation captured >200,000 vascular access episodes, with ~85,000 complete for dwell and removal reason. Short peripheral IVs predominated, had the shortest dwell times, and the highest failure proportion compared with medium and long-duration devices. Device mix, dwell time, complication rates, and data completeness varied markedly across seven hospitals, limiting benchmarking. Authors conclude optimising device selection to anticipated treatment duration could reduce repeat insertions and nursing workload, but missing data constrain firm recommendations. 1

Long‑term preoperative beta‑blocker use linked to higher postoperative ischemic stroke in observational cohort

A large multicentre retrospective cohort (~290,000 patients) found long-term preoperative beta‑blocker prescription independently associated with increased ischemic stroke at 30 and 365 days. The stroke association was strongest in lower‑risk patients and absent in severe heart failure, suggesting effect modification by baseline cardiac risk. Authors note risk depends on timing, dose, and drug class and urge individualized perioperative decisions rather than blanket changes to guideline advice. 2

ERAS adherence >70% in open aortic surgery associates with shorter stay and fewer complications

Prospective cohort of 206 open aortic surgery patients managed with ERAS showed 112 (54.5%) achieved >70% adherence. Patients with adherence ≥70% had shorter time to discharge (mean 4–6 days in highest groups) and markedly fewer 30‑day complications (1.8% vs 19.1%). Four‑year overall survival was higher with ≥70% adherence (95% vs 89%), supporting substantial clinical benefit of protocol fidelity. 3