title: Perioperative Management Center (PERIO) for Neurosurgical Patients.
abstract: Perioperative management is critical for positive neurosurgical outcomes. In order to maintain safe and authentic perioperative management, a perioperative management center (PERIO) was introduced to patients of our Neurosurgery Department beginning in June 2014. PERIO involves a multidisciplinary team consisting of anesthesiologists, dentists/dental hygienists/technicians, nurses, physical therapists, pharmacists, and nutritionists. After neurosurgeons decide on the course of surgery, a preoperative evaluation consisting of blood sampling, electrocardiogram, chest X-ray, and lung function test was performed. The patients then visited the PERIO clinic 7-14 days before surgery. One or two days before surgery, the patients without particular issues enter the hospital and receive a mouth cleaning one day before surgery. After surgery, postoperative support involving eating/swallowing evaluation, rehabilitation, and pain control is provided. The differences in duration from admission to surgery, cancellation of surgery, and postoperative complications between PERIO and non-PERIO groups were examined. Eighty-five patients were enrolled in the PERIO group and 131 patients in the non-PERIO group. The duration from admission to surgery was significantly decreased in the PERIO group (3.6 ± 0.3 days), compared to that in the non-PERIO group (4.7 ± 0.2 days). There was one cancelled surgery in the PERIO group and six in the non-PERIO group. Postoperative complications and the overall hospital stay did not differ between the two groups. The PERIO system decreased the duration from admission to surgery, and it is useful in providing high-quality medical service, although the system should be improved so as not to increase the burden on medical staff.
authors.affiliation: Department of Neurological Surgery, Okayama University Graduate School of Medicine.
authors.forename: Takao
authors.initials: T
authors.lastname: Yasuhara
authors.forename: Tomohito
authors.initials: T
authors.lastname: Hishikawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Agari
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Kurozumi
authors.forename: Tomotsugu
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authors.lastname: Ichikawa
authors.forename: Masahiro
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authors.lastname: Kameda
authors.forename: Aiko
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authors.lastname: Shinko
authors.forename: Joji
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authors.lastname: Ishida
authors.forename: Masafumi
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authors.lastname: Hiramatsu
authors.forename: Motomu
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authors.lastname: Kobayashi
authors.forename: Yoshikazu
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authors.lastname: Matsuoka
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Sasaki
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Soga
authors.forename: Reiko
authors.initials: R
authors.lastname: Yamanaka
authors.forename: Takako
authors.initials: T
authors.lastname: Ashiwa
authors.forename: Akemi
authors.initials: A
authors.lastname: Arioka
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Hashimoto
authors.forename: Ayasa
authors.initials: A
authors.lastname: Misaki
authors.forename: Yuriko
authors.initials: Y
authors.lastname: Ishihara
authors.forename: Machiko
authors.initials: M
authors.lastname: Sato
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Morimatsu
authors.forename: Isao
authors.initials: I
authors.lastname: Date
mesh_terms: D006748:Hospital Departments / Q000458:organization & administration; D006760:Hospitalization; D006801:Humans; D019635:Neurosurgical Procedures; D010348:Patient Care Team / Q000458:organization & administration*; D019990:Perioperative Care; D012189:Retrospective Studies