European Perioperative Diabetes Care: Significant Practice Variation Impacts 30-Day Recovery Outcomes

The MOPED study of over 6,000 European patients reveals significant international variations in perioperative diabetes management. Findings demonstrate that higher preoperative HbA1c levels and practice inconsistencies are linked to fewer days at home within 30 days of surgery, highlighting an urgent need for clinical harmonization.
Home-Based Prehabilitation Did Not Reduce Disability or Complications in Older Adults with Frailty: Results of a Pragmatic Multicenter RCT

Home-Based Prehabilitation Did Not Reduce Disability or Complications in Older Adults with Frailty: Results of a Pragmatic Multicenter RCT

A pragmatic multicenter randomized trial found that coach-supported, home-based multimodal prehabilitation before elective noncardiac surgery did not reduce 30-day postoperative disability or in-hospital complications in older adults with frailty; higher adherence signaled possible benefit for disability outcomes.
Metformin Exposure Associated with Up to 81% Lower 30‑Day Mortality After Cardiac Surgery in T2DM: A Critical Appraisal of AHA 2025 MIMIC‑IV Cohort Findings

Metformin Exposure Associated with Up to 81% Lower 30‑Day Mortality After Cardiac Surgery in T2DM: A Critical Appraisal of AHA 2025 MIMIC‑IV Cohort Findings

A retrospective MIMIC‑IV cohort presented at AHA 2025 found perioperative metformin exposure in T2DM patients undergoing cardiac surgery associated with markedly lower 30‑, 90‑ and 360‑day mortality. Results are compelling but observational—randomized trials are needed to confirm causality and define perioperative use.
Liberal vs Restrictive Postoperative Transfusion in High-Cardiac-Risk Surgery: TOP Trial Shows No Mortality or Major Ischemic Benefit

Liberal vs Restrictive Postoperative Transfusion in High-Cardiac-Risk Surgery: TOP Trial Shows No Mortality or Major Ischemic Benefit

In high–cardiac-risk veterans after major vascular or general surgery, a liberal postoperative transfusion threshold (Hb <10 g/dL) did not reduce 90‑day death or major ischemic events compared with a restrictive threshold (Hb <7 g/dL); some non‑MI cardiac complications were less frequent with liberal transfusion.