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Perioperative, transfusion, mortality

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https://www.readbyqxmd.com/read/29230573/incidence-of-perioperative-stroke-in-clampless-aortic-anastomosis-during-off-pump-coronary-artery-bypass-grafting
#1
Francesco Formica, Giuseppe Tata, Gurmeet Singh, Serena Mariani, Stefano D'Alessandro, Luigi Amerigo Messina, Fabio Sangalli, Giovanni Paolini
This study aimed to assess if clampless off-pump coronary artery bypass grafting (OPCAB) decreases the incidence of perioperative stroke (POS) rate and in-hospital mortality. The secondary aim was to evaluate 12-year rates of overall mortality. Between January 2003 to December 2015, data of 645 consecutive patients undergoing isolated CABG were retrospectively collected. 363 underwent aortic no-touch OPCAB (No-touch group) and 282 underwent OPCAB with the Heartstring device (HS group). In-hospital mortality and perioperative stroke rate as primary endpoint, as well as long-term follow-up outcome were analysed...
December 12, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/29229350/predictors-of-readmissions-and-reoperations-related-to-venous-thromboembolic-events-after-spine-surgery-a-single-institution-experience-with-6-869-patients
#2
Michael Cloney, Ekamjeet S Dhillon, Helena Roberts, Zachary A Smith, Tyler R Koski, Nader S Dahdaleh
BACKGROUND: Readmission and reoperation are used as hospital and surgeon quality metrics. Venous thromboembolic events (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), are a major cause of readmission, morbidity, mortality, after spine surgery. Specific procedural, perioperative, and patient characteristics may be associated with these outcomes. METHODS: We retrospectively examined records from 6869 consecutive spine surgeries at our institution...
December 8, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29229261/preliminary-experience-in-combined-somatic-and-cerebral-oximetry-monitoring-in-liver-transplantation
#3
Tina Hu, Yves Collin, Réal Lapointe, François Martin Carrier, Luc Massicotte, Annik Fortier, Jean Lambert, Franck Vandenbroucke-Menu, André Y Denault
OBJECTIVE: The use of cerebral near-infrared spectroscopy (NIRS) has become widespread in cardiac surgery after research demonstrated an association between perioperative cerebral desaturations and postoperative complications. Somatic NIRS desaturation also is associated with an increased risk of postoperative complications and mortality. The objective of this study was to explore the trends of both somatic and cerebral NIRS during liver transplantation. DESIGN: A prospective, single-site, observational case series...
July 20, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29218666/transition-from-laparoscopic-to-retroperitoneoscopic-approach-for-live-donor-nephrectomy
#4
Zi Qin Ng, Gabrielle Musk, Alethea Rea, Bulang He
BACKGROUND: Laparoscopic donor nephrectomy has become the standard of care due to multiple benefits. Currently, there are various techniques employed with two different approaches: transperitoneal (TLDN) or retroperitoneoscopic (RLDN) approach. There is a lack of data to determine which technique is superior, although the RLDN offers an anatomical advantage by avoidance of manipulation of the intraperitoneal organs. The aims of this study were to explore the merits of RLDN to TLDN and assess the learning curve of transition from TLDN to RLDN...
December 7, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29212084/perioperative-outcomes-and-early-survival-in-octogenarians-who-underwent-radical-cystectomy-for-bladder-cancer
#5
Fabio Zattoni, Vito Palumbo, Gianluca Giannarini, Alessandro Crestani, Afrovita Kungulli, Giacomo Novara, Filiberto Zattoni, Vincenzo Ficarra
OBJECTIVE: To evaluate perioperative outcomes and early survival in a series of octogenarians who underwent radical cystectomy (RC) and urinary diversion for bladder cancer. PATIENTS AND METHODS: We retrospectively evaluated the clinical records of 44 patients aged ≥80 years who underwent open RC and urinary diversion at 2 high-volume centers between July 2013 and December 2015. Estimated blood loss (EBL), transfusion rate, and length of hospital stay (LOS) were evaluated...
December 7, 2017: Urologia Internationalis
https://www.readbyqxmd.com/read/29211220/blood-transfusion-and-increased-perioperative-risk-in-coronary-artery-bypass-grafts
#6
Igor C Campos, Valessa Tanganelli, Hugo P Maues, Marcio C M Coelho, Fernanda A Martins, Giovana Munhoz, Julyana G T Egito, Hayala C C Souza, Cássio M C Giannini, Pedro S Farsky
OBJECTIVE: To correlate blood transfusions and clinical outcomes during hospitalization in coronary artery bypass grafting surgery (CABG). METHODS: Transfusion, clinical and hematological data were collected for 1,378 patients undergoing isolated or combined CABG between January 2011 and December 2012. The effect of blood transfusions was evaluated through multivariate analysis to predict three co-primary outcomes: composite ischemic events, composite infectious complications and hospital mortality...
September 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29210786/selective-serotonin-reuptake-inhibitors-and-serotonin-norepinephrine-reuptake-inhibitors-are-not-associated-with-bleeding-or-transfusion-in-cardiac-surgical-patients
#7
Mark M Smith, Bradford B Smith, Brian D Lahr, Gregory A Nuttall, William J Mauermann, Timothy J Weister, Joseph A Dearani, David W Barbara
BACKGROUND: Selective serotonin reuptake inhibitor (SSRI) and serotonin-norepinephrine reuptake inhibitor (SNRI) use is known to alter platelet activation and aggregation leading to impairment in hemostasis. Previous studies are ambiguous with regard to bleeding, transfusion, and perioperative complications in patients undergoing cardiac surgery. The purpose of this study was to evaluate the risk of perioperative bleeding, transfusion, morbidity, and mortality in cardiac surgical patients taking SSRI/SNRIs compared with propensity-matched controls...
November 22, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29205497/the-use-of-preoperative-aspirin-in-cardiac-surgery-a-systematic-review-and-meta-analysis
#8
REVIEW
Sleiman Sebastian Aboul-Hassan, Tomasz Stankowski, Jakub Marczak, Maciej Peksa, Marcin Nawotka, Ryszard Stanislawski, Bartosz Kryszkowski, Romuald Cichon
BACKGROUND: Despite the fact that aspirin is of benefit to patients following coronary artery bypass grafting (CABG), continuation or administration of preoperative aspirin before CABG or any cardiac surgical procedure remains controversial. Therefore, we performed a systematic review and meta-analysis to assess the influence of preoperative aspirin administration on patients undergoing cardiac surgery. MATERIALS AND METHODS: Medline database was searched using OVID SP interface...
December 3, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29192952/thromboelastography-for-predicting-bleeding-in-patients-with-aortic-stenosis-treated-with-tavi
#9
Bartosz Rymuza, Karol Zbroński, Piotr Scisło, Kajetan Grodecki, Janusz Kochman, Krzysztof Jerzy Filipiak, Grzegorz Opolski, Zenon Huczek
BACKGROUND AND AIMS: Bleeding complications are frequent and independently impact mortality after TAVI. Thromboelastography (TEG) measures viscoelastic properties of clot formation and is currently best known for perioperative management to reduce blood transfusion in cardiac surgery. We sought to determine whether TEG may be predictive of bleeding in patients treated with TAVI. METHODS AND RESULTS: Overall, 54 consecutive patients with severe aortic stenosis treated with TAVI were prospectively included...
December 1, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/29191690/the-extent-of-vascular-resection-is-associated-with-perioperative-outcome-in-patients-undergoing-pancreaticoduodenectomy
#10
Olga Kantor, Mark S Talamonti, Chi-Hsiung Wang, Kevin K Roggin, David J Bentrem, David J Winchester, Richard A Prinz, Marshall S Baker
BACKGROUND: Few studies have examined the relation between extent of vascular resection and morbidity following pancreaticoduodenectomy (PD) with vein resection (PDVR). METHODS: Patients undergoing PD for malignancy were identified using the American College of Surgeons National Surgical Quality Improvement Project from 2006 to 2013. Current procedural terminology codes were used to characterize PDVR. RESULTS: 9235 patients underwent PD, 977 (10...
November 27, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/29189348/should-transfusion-trigger-thresholds-differ-for-critical-care-versus-perioperative-patients-a-meta-analysis-of-randomized-trials
#11
Matthew A Chong, Rohin Krishnan, Davy Cheng, Janet Martin
OBJECTIVE: To address the significant uncertainty as to whether transfusion thresholds for critical care versus surgical patients should differ. DESIGN: Meta-analysis of randomized controlled trials. SETTING: Medline, EMBASE, and Cochrane Library searches were performed up to 15 June 2016. PATIENTS: Trials had to enroll adult surgical or critically ill patients for inclusion. INTERVENTIONS: Studies had to compare a liberal versus restrictive threshold for the transfusion of allogeneic packed RBCs...
November 20, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29184910/adapting-the-surgical-apgar-score-for-perioperative-outcome-prediction-in-liver-transplantation-a-retrospective-study
#12
Amy C S Pearson, Arun Subramanian, Darrell R Schroeder, James Y Findlay
Background: The surgical Apgar score (SAS) is a 10-point scale using the lowest heart rate, lowest mean arterial pressure, and estimated blood loss (EBL) during surgery to predict postoperative outcomes. The SAS has not yet been validated in liver transplantation patients, because typical blood loss usually exceeds the highest EBL category. Our primary aim was to develop a modified SAS for liver transplant (SAS-LT) by replacing the EBL parameter with volume of red cells transfused. We hypothesized that the SAS-LT would predict death or severe complication within 30 days of transplant with similar accuracy to current scoring systems...
November 2017: Transplantation Direct
https://www.readbyqxmd.com/read/29183703/a-comparison-of-outcomes-between-open-laparoscopic-and-robotic-pancreaticoduodenectomy
#13
Asha M Zimmerman, Dean G Roye, Kevin P Charpentier
BACKGROUND: The advantages and comparison of minimally invasive techniques for pancreaticoduodenectomies have not been fully explored using large national multicenter data. STUDY DESIGN: A retrospective review of NSQIP targeted data from 2014 to 2015 was performed. Demographics and outcomes were compared between open (OPD), laparoscopic (LPD) and robotic pancreaticoduodenectomies (RPD). RESULTS: Of 6827 pancreaticoduodenectomies, 6336 (92...
November 25, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/29178096/-risk-factors-and-outcomes-of-postoperative-delirium-in-colorectal-cancer-patients-over-60-years
#14
Haitao Zhang, Yuanzhi Tang, Ying Qin
OBJECTIVE: To determine the incidence, risk factors and clinical outcomes of postoperative delirium in colorectal cancer patients over 60 years. METHODS: Consecutive 382 patients older than 60 years undergoing colorectal cancer surgery at Shenzhen Second People's Hospital from June 2013 to June 2016 were recruited prospectively in this study. These patients were evaluated daily after surgery for 7 days by confusion assessment method. Clinical outcomes were compared between patients with and without postoperative delirium, including postoperative complications, length of hospital stay, and mortality within 30 days...
November 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29171131/cpap-by-helmet-for-treatment-of-acute-respiratory-failure-after-pediatric-liver-transplantation
#15
F Chiusolo, V Fanelli, M L Ciofi Degli Atti, G Conti, F Tortora, R Pariante, L Ravà, C Grimaldi, J de Ville de Goyet, S Picardo
ARF after pediatric liver transplantation accounts for high rate of morbidity and mortality associated with this procedure. The role of CPAP in postoperative period is still unknown. The aim of the study was to describe current practice and risk factors associated with the application of helmet CPAP. In this retrospective observational cohort study, 119 recipients were divided into two groups based on indication to CPAP after extubation. Perioperative variables were studied, and determinants of CPAP application were analyzed in a multivariate logistic model...
November 24, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29169337/minimally-invasive-pancreaticoduodenectomy-for-periampullary-disease-a-comprehensive-review-of-literature-and-meta-analysis-of-outcomes-compared-with-open-surgery
#16
Ke Chen, Yu Pan, Xiao-Long Liu, Guang-Yi Jiang, Di Wu, Hendi Maher, Xiu-Jun Cai
BACKGROUND: Minimally invasive pancreatoduodenectomy (MIPD) has been gradually attempted. However, whether MIPD is superior, equal or inferior to its conventional open pancreatoduodenectomy (OPD) is not clear. METHODS: Studies published up to May 2017 were searched in PubMed, Embase, Cochrane Library, and Web of Science. Main outcomes were comprehensively reviewed and measured including conversion to open approach, operation time (OP), estimated blood loss (EBL), transfusion, length of hospital stay (LOS), overall complications, postoperative pancreatic fistula (POPF), delayed gastric emptying (DGE), post-pancreatectomy hemorrhage (PPH), readmission, reoperation and reasons of preoperative death, number of retrieved lymph nodes (RLN), surgical margins, recurrence, and survival...
November 23, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/29166543/transcatheter-or-surgical-aortic-valve-replacement-in-patients-with-advanced-kidney-disease-a-propensity-score-matched-analysis
#17
Rajkumar Doshi, Jay Shah, Vaibhav Patel, Varun Jauhar, Perwaiz Meraj
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is an alternative for surgically inoperable patients with severe aortic stenosis. Advanced kidney disease may significantly affect outcomes in patients treated with TAVR and surgical aortic valve replacement (SAVR). HYPOTHESIS: TAVR is associated with better in-hospital outcomes compared with SAVR in patients with advanced kidney disease. METHODS: We identified our sample from the National Inpatient Sample between 2012 and 2014, using International Classification of Diseases, Ninth Revision, Clinical Modification codes...
November 22, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/29157110/risk-factors-and-clinical-outcomes-of-delirium-in-osteoporotic-hip-fractures
#18
Joon Yub Kim, Jeong Hyun Yoo, Eugene Kim, Ki Bum Kwon, Byeong-Ryong Han, Yongun Cho, Jai Hyung Park
PURPOSE: This study is performed to identify risk factors for delirium in osteoporotic hip fractures and to evaluate the hospitalization cost and clinical outcomes of delirium in osteoporotic hip. METHODS: A total of 221 patients with osteoporotic hip fractures were assessed for eligibility between 2010 and 2014. Among them, 37 patients with delirium were allocated into the delirium group (group D) and 37 patients without delirium were allocated into the non-delirium group (group ND) by matching demographic factors...
September 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/29149189/perioperative-body-weight-change-is-associated-with-in-hospital-mortality-in-cardiac-surgical-patients-with-postoperative-acute-kidney-injury
#19
Chih-Chung Shiao, Ya-Ting Huang, Tai-Shuan Lai, Tao-Min Huang, Jian-Jhong Wang, Chun-Te Huang, Pei-Chen Wu, Che-Hsiung Wu, I-Jung Tsai, Li-Jung Tseng, Chih-Hsien Wang, Tzong-Shinn Chu, Kwan-Dun Wu, Vin-Cent Wu
BACKGROUND: Postoperative acute kidney injury (AKI) is common following cardiac surgery (CS). Body weight (BW) may be an amenable variable by representing the summation of the nutritional and the fluid status. However, the predictive role of perioperative BW changes in CS patients with severe postoperative AKI is never explored. This study aimed to evaluate this association. METHODS: This study was conducted using a prospectively collected multicenter cohort, NSARF (National Taiwan University Hospital Study Group on Acute Renal Failure) database...
2017: PloS One
https://www.readbyqxmd.com/read/29143088/the-association-of-preoperative-hematocrit-and-transfusion-with-mortality-in-patients-undergoing-elective-non-cardiac-surgery
#20
Rodney A Gabriel, Anthony I Clark, Albert P Nguyen, Ruth S Waterman, Ulrich H Schmidt
BACKGROUND: Patients with anemia frequently undergo surgery, as it is unclear at what threshold clinicians should consider delaying surgery for preoperative anemia optimization. The primary objective of this study was to determine whether there is an association of varying degrees of anemia and transfusion with 30-day mortality. METHODS: This is a retrospective cohort study using the American College of Surgeons National Surgical Quality Improvement Program database from 2011 to 2013...
November 15, 2017: World Journal of Surgery
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