Does a #preop #medicine consult lead to better outcomes?
Probably not in most cases
New in @JAMAInternalMed from @OttawaHospital @OttAnesthesia @aims_periop @OttawaIM @ICESOntario

bit.ly/3LZ3Vf4 1/
Among those who had a consult, baseline risk was higher (not surprising)

But, even with clustered adjustment and PS matching…

No signs of benefit:
-OR 1.19 (1.11-1.29) mortality
-LoS, costs and adverse events also significantly⬆️ with consult
-Consistent in sens analyses

Does labour epidural analgesia cause #autism? Probably not (but only an RCT can answer this question). A thread @CASUpdate @APSForg @OttawaHospital @OttAnesthesia @ASALifeline @SOAPHQ @glbryson @Ron_George @antonchau1 @DrLucieFilteau @Dolores_McKeen @EMARIANOMD @IARS_Journals 2/n A #bigdata study finds an association between labor epidurals and subsequent #autism in offspring.
Concerning? Yes.
Will lead to much concern for women, their partners and clinicians? Yes
Robust, clinically relevant findings? Probably not

Our new meta analysis led by @SylvieAucoin now out in @_Anesthesiology. Seems like a good time for a thread on choosing a frailty instrument for #periop care 1/ 2/ There are dozens of frailty instruments (big problem) but in reality 4 are commonly used: Frailty Index, Frailty Phenotype, Clinical Frailty Scale, Edmonton Frail Scale