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In This Issue of JAMA Surgery
November 2018

Highlights

JAMA Surg. 2018;153(11):977. doi:10.1001/jamasurg.2017.3705

Postoperative delirium is the most common complication after major surgery in older patients. In this randomized clinical trial, Sieber and colleagues sought to determine whether sedation level reduces incident delirium in patients older than 65 years who were undergoing hip fracture repair with spinal anesthesia. Limiting the level of sedation provided no significant overall benefit in reducing incident delirium. However, in prespecified subgroup analyses, lighter sedation was found to reduce postoperative delirium in persons with low baseline comorbidity.

Invited Commentary

Continuing Medical Education

Surgical device manufacturers have a symbiotic relationship with clinicians, and a professional relationship between a clinician and a relevant manufacturer may increase the potential risk for bias in relevant studies. In a bibliometric analysis of the physicians who were most highly compensated by 10 large surgical device manufacturers, Ziai and colleagues found that a large discrepancy exists between self-declared conflicts of interest in articles and Open Payments data.

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