TopMedTalk Classic: Managing Perioperative Risk in Frail Patients
Release Date: 09/07/2026
Perioperative Profiles: Duminda Wijeysundera
TopMedTalk
This month’s Perioperative Profile features Duminda Wijeysundera, Professor in the Department of Anesthesiology and Pain Medicine and IHPME at the University of Toronto, and a Staff Physician at St. Michael's Hospital, who holds the Endowed Chair in Translational Anesthesiology Research, serves as Head of Science at SPHERE, acts as a Senior Adjunct Scientist at ICES, and is a Trustee for the International Anesthesia Research Society (IARS). He describes growing up across Sri Lanka, the US, Singapore, and Canada, and how adaptability and cultural sensitivity shaped him; he entered medicine...
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EBPOM London 2026: Enhanced Postoperative Care Units (EPOCs)
TopMedTalk
Recorded at the Evidence Based Perioperative Medicine (EPBOM) World Congress in London, this TopMedTalk episode, presented by Andy Cumpstey, features Guy Ludbrook, Professor of Anaesthesia and Head of Acute Care Medicine at the University of Adelaide and resident Georgia Cadzow, discussing the Perioperative Quality Initiative (POQI) POQI is a not-for-profit that uses a formal Delphi process to distill evidence and expert consensus into publishable clinical recommendations on topics such as perioperative hypotension, acute kidney injury, delirium, health economics, and fluid therapy. Georgia...
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Regulating AI in Perioperative Medicine: Data, Trust, and Evidence
TopMedTalk
Today’s TopMedTalk AI podcast was recorded at the Association of Anaesthetists of Great Britain and Ireland in London. It features Andy Cumpstey and Desiree Chappell and their guests, John Whittle, honorary associate professor of Perioperative medicine at University College London and Duncan McPherson, Head of the clinical team at QMD Services and Anesthesiologist and Honorary Professor at University College London. We discuss how early AI research shares core requirements with other research—especially data safety and governance—while medical device regulation applies the same legal...
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SOAP: Caesarean Pain, Patient Voice and System Change
TopMedTalk
At the 58th Society for Obstetric Anesthesia and Perinatology (SOAP) meeting in Montreal, TopMedTalk hosts Mike Grocott and Desiree Chappell interview Heather Nixon, SOAP immediate past president and Section Chief for Obstetric Anesthesiology; Section Chief for Simulation, Education, and Training Department of Anesthesiology University of Illinois, about SOAP’s educational mission, governance, outreach, and special interest groups. Nixon describes her focus on intraoperative pain during caesarean delivery after a sentinel event and how listening to patient narratives, including The...
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ANZCA ASM: Neuroscience, neuroimaging and practice in pain medicine
TopMedTalk
Recorded at ANZCA and the Faculty of Pain Medicine’s Annual Scientific Meeting in Auckland, TopMedTalk hosts Andy Cumstey and Kate Leslie interview visiting pain research leaders, Professor Irene Tracey, the Vice-Chancellor of the University of Oxford and Professor Lesley Colvin, the Chair of Pain Medicine at the University of Dundee and an Honorary Consultant in Anaesthesia and Pain Medicine at NHS Tayside. They discuss how thinking has shifted from chronic pain as a simple transition from acute pain, to a distinct disease with separate mechanisms and early “pre-vulnerability” factors...
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EBPOM London: The National Clinical Audit for Major Elective Surgery
TopMedTalk
At EBPOM 2026 live from the British Library in London, Joff Lacy and Imogen Fecher-Jones speak with Malcolm West and Tim Baker, clinical co-leads for the National Clinical Audit of Perioperative Care (NCAPC), an NHS England mandated and HQIP-funded initiative managed by the Royal College of Anaesthetists to audit major elective surgery in England and publicly funded Jersey. They outline the audit’s denominator (major surgery with anaesthetist involvement and >24-hour stay), year-one focus cohorts (thoracic, major gynaecology, major hip/knee orthopaedics, and lower GI/colorectal surgery),...
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TopMedTalk Classic: Managing Perioperative Risk in Frail Patients
TopMedTalk
This month’s TopMedTalk Classic has been digitally remastered for you and we’ve added the Q&A which wasn’t part of the original podcast. We’re featuring a talk first broadcast in 2018, featuring BobbieJean Sweitzer, Systems Director, Preoperative Medicine, Inova Health, Falls Church, Virginia, and Professor of Medical Education, University of Virginia. BobbieJean discusses whether perioperative risk in frail patients can be managed, emphasizing that current risk tools underweight frailty and functional outcomes. Using cases and data from U.S. nursing home residents, she highlights...
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SMART trial designs, perioperative data ecosystems, and collaboration
TopMedTalk
At the Collaborative Clinical Trials meeting in Prato, Italy, Mike Grocott and co-host Mark Priestley speak with Sachin Kheterpal, University of Michigan Medical School’s Associate Dean for Research Information Technology and the Robert B Sweet Professor and Kelley M. Kidwell, Chair of the Department of Anesthesiology and Professor of Biostatistics at the University of Michigan School of Public Health and Senior Associate Dean for Faculty Affairs . Kidwell explains sequential multiple assignment randomized trials (SMART) as multi-stage designs that randomize at key decision points to...
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Perioperative Profile: Dan Sessler
TopMedTalk
In this TopMedTalk perioperative profile, host Andy Cumpstey interviews Professor Dan Sessler, Vice President for Clinical and Outcomes Research and Professor of Anesthesiology and Biostatistics at UTHealth Houston (McGovern Medical School), about his career as a perioperative trialist with over 1,000 publications. Sessler describes his scientific family background, early inspiration from clinical trials through Henry Kaplan’s Hodgkin’s work, and a shift from planned pediatric oncology to anesthesiology. He recounts building a research career starting with perioperative thermoregulation at...
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IARS 2026: Foundation for Anesthesia Education and Research (FAER)
TopMedTalk
At The International Anesthesia Research Society (IARS) and Society of Critical Care Anesthesiologists (SOCCA) meeting in Montreal, TopMedTalk hosts Mike Grocott and former editor-in-chief Desiree Chappell speak with FAER board members Dr. Rebecca A. Aslakson, Chair and Professor with Tenure, Department of Anesthesiology, University of Vermont Health Network and Dr. Michael Gropper, Professor and Chair of the UCSF Department of Anesthesia and Perioperative Care, about the Foundation for Anesthesia Education and Research (FAER). We describe how FAER’s early-career support—especially the...
info_outlineThis month’s TopMedTalk Classic has been digitally remastered for you and we’ve added the Q&A which wasn’t part of the original podcast.
We’re featuring a talk first broadcast in 2018, featuring BobbieJean Sweitzer, Systems Director, Preoperative Medicine, Inova Health, Falls Church, Virginia, and Professor of Medical Education, University of Virginia.
BobbieJean discusses whether perioperative risk in frail patients can be managed, emphasizing that current risk tools underweight frailty and functional outcomes. Using cases and data from U.S. nursing home residents, she highlights high postoperative mortality and functional decline after procedures such as colectomy and breast surgery, arguing for multidisciplinary, patient-inclusive decision-making that considers nonoperative and palliative options.
Sweitzer describes Northwestern’s implementation of quick frailty and cognitive screening, plus interventions including anemia treatment, nutritional optimization, and elements of prehabilitation, noting evidence that screening can trigger goal clarification and more palliative care consults.
In the Q&A, speakers debate frailty-tool consensus, motivating patient engagement, funding prehab services, interpretation of mortality reductions after screening, and strategies to influence surgeons’ decision-making.
Original podcasts:
https://topmedtalk.libsyn.com/periop-medicine-sig18-can-perioperative-risk-in-the-frail-be-managed
TopMedTalk: Periop SIG18 | Perioperative frailty - panel discussion