Jul 31, 2026 · 19 min · 10 segments
In this episode of Scrubcast, host Rachel Baker sits down with Dr. Shipra Arya, a professor in the Division of Vascular Surgery at Stanford University, to discuss her journey into vascular surgery and…
Well, you are a past president of the Surgical Outcomes Club and a leader in the field of health services research, particularly on the subject of frailty.
And I feel like all of those interests really came together on your recent PAWS trial, which stands for Patient-Centered Multidisciplinary Care for Veterans Undergoing Surgery.
And the goals of this trial were that we knew for a long time that frailty is bad for our patients.
But where there's no consensus is once you know a patient is frail, what do you do about it? Especially in the preoperative setting, can you modify frailty or can you identified early enough to mitigate some of the effects of it on our patients.
We knew from like single center studies that if you identify frailty prior to surgery, it heightens the awareness and something changes.
And whether it's more multidisciplinary collaboration between surgery or anesthesia or getting palliative care involved, or, you know, maybe doing rehabilitation and all these things have been studied at individual studies.
So our goal was, can we combine all of this together to make like a multidisciplinary board where all these different stakeholders that are not involved in a patient's usual surgical pathway, like a patient does not see geriatrics or palliative care preoperatively, or does not see social work or case management, unless absolutely needed or does not see nutrition and PT unless the surgeon is really like trying to do the prehab.
So if we bring all of these different stakeholders together along with surgery and anesthesia and created a board to optimize these frail patients, then can we change their outcomes? So that was the main goal of the trial.
We are nearing the end of all the analyses and getting ready to submit our findings.
There's some interesting findings to come and hopefully we'll add to the literature of why we should be doing this.
Well, you are a past president of the Surgical Outcomes Club and a leader in the field of health services research, particularly on the subject of frailty.
And I feel like all of those interests really came together on your recent PAWS trial, which stands for Patient-Centered Multidisciplinary Care for Veterans Undergoing Surgery.
And the goals of this trial were that we knew for a long time that frailty is bad for our patients.
But where there's no consensus is once you know a patient is frail, what do you do about it? Especially in the preoperative setting, can you modify frailty or can you identified early enough to mitigate some of the effects of it on our patients.
We knew from like single center studies that if you identify frailty prior to surgery, it heightens the awareness and something changes.
And whether it's more multidisciplinary collaboration between surgery or anesthesia or getting palliative care involved, or, you know, maybe doing rehabilitation and all these things have been studied at individual studies.
So our goal was, can we combine all of this together to make like a multidisciplinary board where all these different stakeholders that are not involved in a patient's usual surgical pathway, like a patient does not see geriatrics or palliative care preoperatively, or does not see social work or case management, unless absolutely needed or does not see nutrition and PT unless the surgeon is really like trying to do the prehab.
So if we bring all of these different stakeholders together along with surgery and anesthesia and created a board to optimize these frail patients, then can we change their outcomes? So that was the main goal of the trial.
We are nearing the end of all the analyses and getting ready to submit our findings.
There's some interesting findings to come and hopefully we'll add to the literature of why we should be doing this.
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