Preoperative internal medicine evaluation is associated with a reduction in 30-Day postoperative mortality risk in patients with cancer

Background: Patients commonly undergo evaluation by internists prior to surgery. However, the impact of preoperative internal medicine evaluations on the postoperative outcomes of patients with cancer is uncertain. Methods: We conducted a retrospective cohort study of patients who had been included in the National Surgery Quality Improvement Program from 2011 to 2014 from a single hospital specializing in cancer care to determine the effect of an Internal Medicine Perioperative Assessment Center (IMPAC) evaluation (IMPAC group) on the risk of 30-day mortality compared to that of patients who proceeded directly to surgery (control group). Results: Of the 11,577 participants, 3,589 underwent an IMPAC evaluation. The absolute 30-day mortality was 0.47% for the IMPAC group and 0.50% for the control group. After propensity matching, the odds ratio (OR) of 30-day mortality was 0.39 (95% CI=0.18-0.84) for the IMPAC group in comparison to the control group. Conclusions: Our findings demonstrate that a preoperative internal medicine evaluation was associated with lower 30-day mortality. Additional studies are needed to identify which patient populations are most likely to benefit and which attributes of the internal medicine evaluation are most beneficial.