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Perioperative, transfusion, mortality

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https://www.readbyqxmd.com/read/28101720/enhanced-recovery-after-surgery-programs-for-liver-resection-a-meta-analysis
#1
Cheng Wang, Guoqun Zheng, Wenlong Zhang, Fabiao Zhang, Shangdong Lv, Aidong Wang, Zheping Fang
BACKGROUND AND AIMS: Due to the limited number of high-quality randomized controlled trials on enhanced recovery after surgery for hepatectomy, previous reviews have not been sufficiently comprehensive. Our objectives were to evaluate and compare the safety and efficacy of enhanced recovery after surgery programs and traditional care in patients undergoing open or laparoscopic surgery and to assess the optimized items for hepatectomy. METHODS: We searched the PubMed, Embase, and the Cochrane Library databases for all the relevant studies regardless of study design...
January 18, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28096918/perioperative-outcomes-following-radical-prostatectomy-for-patients-with-disseminated-cancer-an-analysis-of-the-national-surgical-quality-improvement-program-database
#2
Raj Satkunasivam, Christopher J D Wallis, James Byrne, Azik Hoffman, Douglas C Cheung, Girish S Kulkarni, Avery B Nathens, Robert K Nam
INTRODUCTION: We sought to determine whether patients undergoing radical prostatectomy (RP) in the context of disseminated cancer have higher 30-day complications. METHODS: We conducted a retrospective cohort study of the National Surgical Quality Improvement Program (NSQIP) database. Men undergoing RP (from January 1, 2005 to December 31, 2014) for prostate cancer were identified and stratified by presence (n=97) or absence (n=27 868) of disseminated cancer. The primary outcome was major complications (death, re-operation, cardiac or neurologic events) within 30 days of surgery...
November 2016: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28089722/perioperative-allogenic-blood-transfusion-in-renal-cell-carcinoma-risk-factors-and-effect-on-long-term-outcomes
#3
Francesco Soria, Michela de Martino, Carmen V Leitner, Marco Moschini, Shahrokh F Shariat, Tobias Klatte
BACKGROUND: We sought to create a preoperative model to predict the risk of perioperative blood transfusion (PBT) in patients with renal cell carcinoma (RCC) undergoing nephrectomy and to evaluate the effect of PBT on long-term outcomes. PATIENTS AND METHODS: The present retrospective study included 648 consecutive patients who had undergone radical or partial nephrectomy for RCC at a single institution. The risk factors for PBT were analyzed using logistic regression analysis...
December 29, 2016: Clinical Genitourinary Cancer
https://www.readbyqxmd.com/read/28089474/what-happened-to-the-complication-the-importance-of-acs-nsqip-pediatric-in-optimizing-quality-improvement-initiatives-for-resident-education
#4
Bennett W Calder, Joseph V Sakran, Christian J Streck, Robert A Cina
OBJECTIVE: Morbidity and Mortality (M&M) conference is considered the golden hour of surgical education. Most training programs lack standardized methods to evaluate self-reported outcomes and contributions to resident education. The purpose of this study was to determine whether residents underreport pediatric postoperative complications thereby limiting a comprehensive educational opportunity and the ability to adequately perform quality improvement during M&M conference. DESIGN: A retrospective analysis of resident reports submitted to the M&M committee at an academic medical center was conducted over 1 year...
January 12, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28089470/conversion-hip-arthroplasty-in-failed-fixation-of-intertrochanteric-fracture-a-propensity-score-matching-study
#5
Young-Kyun Lee, Jung Taek Kim, Awad Abdalla Alkitaini, Ki-Choul Kim, Yong-Chan Ha, Kyung-Hoi Koo
BACKGROUND: Conversion hip arthroplasty is a salvage procedure for failed internal fixation of intertrochanteric fractures. However, the technical difficulties and perioperative morbidity of conversion arthroplasty are uncertain. METHODS: We compared the type of arthroplasty (total hip arthroplasty or hemiarthroplasty), operative parameters, perioperative morbidity, 1-year mortality, implant stability, and clinical results of 33 conversion hip arthroplasties due to a failed internal fixation of intertrochanteric fracture with those of a matched control group of 33 primary hip arthroplasties due to the same fracture...
December 22, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28086855/postoperative-fluid-overload-is-a-risk-factor-for-adverse-surgical-outcome-in-patients-undergoing-esophagectomy-for-esophageal-cancer-a-retrospective-study-in-335-patients
#6
Torben Glatz, Birte Kulemann, Goran Marjanovic, Svenja Bregenzer, Frank Makowiec, Jens Hoeppner
BACKGROUND: Restrictive intraoperative fluid management is increasingly recommended for patients undergoing esophagectomy. Controversy still exists about the impact of postoperative fluid management on perioperative outcome. METHODS: We retrospectively examined 335 patients who had undergone esophagectomy for esophageal cancer at the University Hospital Freiburg between 1996 and 2014 to investigate the relation between intra- and postoperative fluid management and postoperative morbidity after esophagectomy...
January 13, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28077819/association-between-blood-transfusions-and-12-month-mortality-after-transcatheter-aortic-valve-implantation
#7
Pawel Kleczynski, Artur Dziewierz, Maciej Bagienski, Lukasz Rzeszutko, Danuta Sorysz, Jaroslaw Trebacz, Robert Sobczynski, Marek Tomala, Maciej Stapor, Dariusz Dudek
Blood transfusions are considered as an important predictor of adverse outcome in patients with severe aortic (AS) undergoing transcatheter aortic valve implantation (TAVI). We sought to investigate the association between blood transfusions and mortality after TAVI. We enrolled 101 consecutive patients with severe AS undergoing TAVI. Patients who required transfusion were defined as patients in whom at least one unit of packed red blood cells (PRBCs) was transfused in the perioperative period. Twelve-month outcomes were assessed based on Valve Academic Research Consortium definitions...
January 11, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28072601/risk-factors-and-clinical-outcomes-associated-with-perioperative-transfusion-associated-circulatory-overload
#8
Leanne Clifford, Qing Jia, Arun Subramanian, Hemang Yadav, Darrell R Schroeder, Daryl J Kor
BACKGROUND: Transfusion-associated circulatory overload remains underappreciated in the perioperative environment. The authors aimed to characterize risk factors for perioperative transfusion-associated circulatory overload and better understand its impact on patient-important outcomes. METHODS: In this case-control study, 163 adults undergoing noncardiac surgery who developed perioperative transfusion-associated circulatory overload were matched with 726 transfused controls who did not develop respiratory complications...
January 10, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28059837/complications-risk-factors-and-staffing-patterns-for-noncardiac-surgery-in-patients-with-left-ventricular-assist-devices
#9
Michael R Mathis, Subramanian Sathishkumar, Sachin Kheterpal, Matthew D Caldwell, Francis D Pagani, Elizabeth S Jewell, Milo C Engoren
BACKGROUND: Patients with left ventricular assist devices presenting for noncardiac surgery are increasingly commonplace; however, little is known about their outcomes. Accordingly, the authors sought to determine the frequency of complications, risk factors, and staffing patterns. METHODS: The authors performed a retrospective study at their academic tertiary care center, investigating all adult left ventricular assist device patients undergoing noncardiac surgery from 2006 to 2015...
January 6, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28038967/pancreatoduodenectomy-with-venous-or-arterial-resection-a-nsqip-propensity-score-analysis
#10
Joal D Beane, Michael G House, Susan C Pitt, Ben Zarzaur, E Molly Kilbane, Bruce L Hall, Taylor S Riall, Henry A Pitt
INTRODUCTION: Vascular resection during pancreatoduodenectomy (PD) is being performed more frequently. Our aim was to analyze the outcomes of PD with and without vascular resection in a large, multicenter cohort. METHODS: Patient data were gathered from 43 institutions as part of the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) Pancreatectomy Demonstration Project. Over a 14-month period, 1414 patients underwent PD without (82...
December 27, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28017673/outcome-after-surgery-for-acute-aortic-dissection-influence-of-preoperative-antiplatelet-therapy-on-prognosis
#11
Raphaelle Avigael Chemtob, Hasse Moeller-Soerensen, Lene Holmvang, Peter Skov Olsen, Hanne Berg Ravn
OBJECTIVES: Outcome in patients with acute coronary syndrome (ACS) is improved with dual antiplatelet therapy (DAPT). Patients with acute aortic dissection type A (AAD) often present with similar symptoms and may therefore be prescribed DAPT before diagnosis. The aim of this study was to evaluate the use of antiplatelet therapy (APT) prior to AAD surgery and patient outcome, including indications according to the European Society of Cardiology's (ESC) recent guidelines. DESIGN: A retrospective, observational study...
October 11, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27999500/benefits-of-limited-use-of-a-tourniquet-combined-with-intravenous-tranexamic-acid-during-total-knee-arthroplasty
#12
Alexander D Rosenstein, Yehuda A Michelov, Stephanie Thompson, Alan D Kaye
BACKGROUND: Blood loss during total knee arthroplasty (TKA) may require blood transfusions that are associated with increased risk, morbidity, and cost. Multiple techniques exist to reduce blood loss in TKA, including the use of a tourniquet and tranexamic acid (TXA). While multiple studies suggest that TXA is effective in reducing blood loss, the use of a tourniquet is more controversial. We studied the combined effect of TXA with a limited-use tourniquet on blood loss and complications in the setting of primary TKA...
2016: Ochsner Journal
https://www.readbyqxmd.com/read/27995001/evaluation-of-the-patients-with-colorectal-cancer-undergoing-emergent-curative-surgery
#13
Fikri Kundes, Metin Kement, Kenan Cetin, Levent Kaptanoglu, Aytaç Kocaoglu, Mehmet Karahan, Serkan Fatih Yegen, Ali Emre Atici, Osman Civil, Mehmet Eser, Tebessum Cakir, Nejdet Bildik
BACKGROUND: The aim of our study is to evaluate perioperative and mid-term oncologic outcomes of the patients with colorectal cancer, who underwent emergent curative surgery. METHODS: The study included all patients with colorectal cancer, who underwent surgery for curative intent between 1 January 2012 and 31 December 2014 in General Surgery Department of Kartal Training and Research Hospital. The patients were divided into two groups according to the type of admission (emergent or elective)...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27993376/unplanned-readmission-after-lung-resection-complete-follow-up-in-a-1-year-cohort-with-identification-of-associated-risk-factors
#14
Karen J Dickinson, James B Taswell, Mark S Allen, Shanda H Blackmon, Francis C Nichols, Robert Shen, Dennis A Wigle, Stephen D Cassivi
BACKGROUND: Unplanned readmissions are adverse clinical events that negatively impact patients and affect the use of health care resources. Identifying risk factors that can predict readmissions might permit individualized patient management. We compiled a complete account of readmissions after all lung resections over a year to identify potentially modifiable risk factors. METHODS: All patients undergoing elective lung resection between August 1, 2013 and July 31, 2014 were contacted directly to determine whether they had been readmitted to any institution within 30 days of discharge from our service...
December 16, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27987016/factors-affecting-the-postoperative-morbidity-and-survival-of-patients-with-liver-cirrhosis-following-colorectal-cancer-surgery
#15
Jun Ho Lee, Chang Sik Yu, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Jin Cheon Kim
PURPOSE: Data are lacking on the appropriate risk stratification of patients undergoing surgery for colorectal cancer (CRC). This study aimed to evaluate the predictive factors for perioperative morbidity and oncological outcomes in CRC patients with liver cirrhosis (LC). METHODS: A retrospective analysis of prospectively collected data was conducted. A total of 161 LC patients who underwent surgery for CRC were identified between January 2001 and December 2010...
December 16, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27942394/current-outcomes-of-off-pump-versus-on-pump-coronary-artery-bypass-grafting-evidence-from-randomized-controlled-trials
#16
REVIEW
Daniel Fudulu, Umberto Benedetto, Gustavo Guida Pecchinenda, Pierpaolo Chivasso, Vito Domenico Bruno, Filippo Rapetto, Alan Bryan, Gianni Davide Angelini
Coronary artery bypass grafting remains the standard treatment for patients with extensive coronary artery disease. Coronary surgery without use of cardiopulmonary bypass avoids the deleterious systemic inflammatory effects of the extracorporeal circuit. However there is an ongoing debate surrounding the clinical outcomes after on-pump versus off-pump coronary artery bypass (ONCAB versus OPCAB) surgery. The current review is based on evidence from randomized controlled trials (RCTs) and meta-analyses of randomized studies...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27940453/perioperative-management-of-the-bleeding-patient
#17
K Ghadimi, J H Levy, I J Welsby
Perioperative bleeding remains a major complication during and after surgery, resulting in increased morbidity and mortality. The principal causes of non-vascular sources of haemostatic perioperative bleeding are a preexisting undetected bleeding disorder, the nature of the operation itself, or acquired coagulation abnormalities secondary to haemorrhage, haemodilution, or haemostatic factor consumption. In the bleeding patient, standard therapeutic approaches include allogeneic blood product administration, concomitant pharmacologic agents, and increasing application of purified and recombinant haemostatic factors...
December 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27916380/contemporary-outcomes-of-open-thoracoabdominal-aneurysm-repair-functional-status-is-the-strongest-predictor-of-perioperative-mortality
#18
Tammam Obeid, Caitlin W Hicks, Kanhua Yin, Isibor Arhuidese, Besma Nejim, Arman Kilic, James H Black, Mahmoud Malas
BACKGROUND: Open repair of thoracoabdominal and descending thoracic aneurysm (TAA) carries significant operative morbidity and mortality. Despite evolving operative techniques patient-level risk factors affecting mortality after open TAA repair, including patient functional status, remain to be fully understood. MATERIALS AND METHODS: We identified all open TAA repair cases in the National Surgical Quality Improvement Program database between 2005 and 2013. Multivariable logistic regression was used to evaluate the effect of patients' age, gender, race, body mass index (BMI), comorbid conditions, functional status, ASA class, smoking, rupture, descending thoracic aneurysm versus Crawford types, dissection, and preoperative: transfusion, creatinine levels, on perioperative (30-d) mortality after open TAA repair...
November 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27916348/blood-transfusion-is-an-independent-predictor-of-morbidity-and-mortality-after-hepatectomy
#19
Allison N Martin, Matthew J Kerwin, Florence E Turrentine, Todd W Bauer, Reid B Adams, George J Stukenborg, Victor M Zaydfudim
BACKGROUND: Previous studies have indicated that blood transfusion is associated with increased risk of worse outcomes among patients selected for hepatectomy. However, the independent effect of transfusion has not been confirmed. We hypothesize that blood transfusion is an independent factor that affects outcomes in patients undergoing hepatectomy. MATERIALS AND METHODS: Patients at tertiary care center who underwent hepatectomy between 2006 and 2013 were identified and linked with the American College of Surgeons National Surgical Quality Improvement Program PUF data set...
November 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27909512/concomitant-left-atrial-appendage-clipping-during-minimally-invasive-mitral-valve-surgery-technically-feasible-and-safe
#20
Ashraf Alqaqa Md, Shabiah Martin Md, Aiman Hamdan Md Facc, Fayez Shamoon Md Facc, Kourosh T Asgarian DO
BACKGROUND: It is believed that most of thrombi form in the left atrial appendage (LAA)before they emboli. Different surgical and percutaneouse approaches were suggested to manage the LAA. In this study we are evaluating the safety of clipping the LAA via minithoractotomy approach. METHOD: All consecutive patients who had minimally invasive mitral valve surgery with concomitant LAA clipping between December 2012 and February 2014 were included in the study. LAA exclusion was performed using AtriClip® LAA Exclusion System (Cincinnati, Ohio, AtriCure®)...
June 2016: Journal of Atrial Fibrillation
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