Your doctor missed this? Millions of Americans die because they’re ill-prepared | Elisa Leigh Johns

Let’s call it the best-kept secret in healthcare. Today, the Centers for Disease Control and Prevention (CDC) announced that more than 28 million Americans (roughly 6% of the population) die each year because they’re…

Your doctor missed this? Millions of Americans die because they're ill-prepared | Elisa Leigh Johns

Let’s call it the best-kept secret in healthcare.

Today, the Centers for Disease Control and Prevention (CDC) announced that more than 28 million Americans (roughly 6% of the population) die each year because they’re underprepared for major surgery (including heart attacks, blood clots, and even deaths related to surgery). And one in five of those deaths are preventable.

“In a nutshell,” writes Elisa Leigh Johns for The New York Times, “as many as 33,000 deaths each year could be prevented by picking up a few extra medications during the initial recovery.”

These potentially lifesaving medications are called c.D.C. prevention drugs. While they don’t prevent acute or long-term surgical complications, c.D.C. prevention drugs also significantly decrease incidence of acute and long-term complications, since reducing surgical complications improves safety, lower hospital costs, and improves a patient’s quality of life, notes the CDC.

Currently, 56 million Americans (roughly 48% of the population) are at risk for pre-operative complications. The CDC estimates that half of the patient deaths related to c.D.C. prevention drugs could be prevented if patients had them during the pre-op routine.

The FDA, which first recommended c.D.C. prevention drugs for major surgeries in 1998, has since approved those drugs for 28 indications. And these medications are easy to administer and use, having been around since the early 80s. There are no additional costs to hospitals or insurance companies for administering these drugs, Johns adds.

A 2012 study by Johns and colleagues surveyed more than 46,000 admissions for patients in large US hospitals. It found that about 43% of hospital admissions due to various surgical complications resulted in the death of the patient. If all 28 million Americans (and their loved ones) had one of these potentially lifesaving medications during this pre-op routine, says Johns, then 16,000 deaths could be prevented each year. (Both Johns’s earlier article, reporting on her research, and the new paper were published in Annals of Surgery.)

As more people are dying due to a lack of pre-operative medication use, the price tag on those medications is soaring. Based on current trends, the same researchers found that ancillary costs to hospitals for medications prescribed in the pre-op routine are expected to rise to $1.6 billion by 2018.

Those costs are another sobering reminder that it’s time to pay attention to the kind of care you need before you go under the knife. Even with guidelines like the National Committee for Quality Assurance (NCQA) recommendations, health care professionals still sometimes leave patients on the operating table with the wrong medications or may not prescribe the medications as soon as they think they should be.

Now that the CDC has elevated pre-operative medication use to one of its top priorities, this could be the moment when patients and caregivers rise up in opposition and demand better care.

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