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Perioperative, transfusion, mortality

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https://www.readbyqxmd.com/read/28822658/preoperative-anemia-is-associated-with-mortality-after-carotid-endarterectomy-in-symptomatic-patients
#1
Alexander B Pothof, Thomas C F Bodewes, Thomas F X O'Donnell, Sarah E Deery, Katie Shean, Peter A Soden, Gert J de Borst, Marc L Schermerhorn
OBJECTIVE: Preoperative anemia and blood transfusions are associated with worse outcomes after surgery. However, the impact of preoperative anemia and transfusions on outcomes after carotid endarterectomy (CEA) is unknown. METHODS: CEA patients from 2011 to 2015 in the American College of Surgeons National Surgical Quality Improvement Program Targeted Vascular module were compared by the presence of preoperative anemia (hematocrit <36%) after stratification by symptom status...
August 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28777814/prevalence-of-preoperative-anemia-abnormal-mean-corpuscular-volume-and-red-cell-distribution-width-among-surgical-patients-in-singapore-and-their-influence-on-one-year-mortality
#2
Yilin Eileen Sim, Hide Elfrida Wee, Ai Leen Ang, Niresh Ranjakunalan, Biauw Chi Ong, Hairil Rizal Abdullah
INTRODUCTION: Preoperative anemia and high red cell distribution width (RDW) are associated with higher perioperative mortality. Conditions with high RDW levels can be categorized by mean corpuscular volume (MCV). The relationship between RDW, anemia and MCV may explain causality between high RDW levels and outcomes. We aim to establish the prevalence of preoperative anemia and distribution of RDW and MCV among pre-surgical patients in Singapore. In addition, we aim to investigate the association between preoperative anemia, RDW and MCV levels with one-year mortality after surgery...
2017: PloS One
https://www.readbyqxmd.com/read/28777390/thrombosis-in-left-ventricular-assistance-device-with-centrifugal-technology-is-early-thrombolysis-a-better-solution
#3
Paolo Centofanti, Andrea Baronetto, Matteo Attisani, Davide Ricci, Erika Simonato, Michele W La Torre, Massimo Boffini, Mauro Rinaldi
BACKGROUND: Continuous flow left ventricular assistance devices (CF-LVADs) have revolutionized the treatment of advanced heart failure. Pump replacement for thrombosis is a high-risk procedure with a high perioperative mortality rate with possible recurrence. We aim to summarize our experience using a conservative approach with medical therapy. METHODS: We retrospectively reviewed records of patients who experienced pump thrombosis after LVAD implantation with HeartWare HVAD at our institution, from November 2010 to March 2016...
July 27, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28755257/two-way-interaction-effects-of-perioperative-complications-on-30-day-mortality-in-general-surgery
#4
Minjae Kim, Guohua Li
BACKGROUND: Multiple perioperative complications increase mortality risk, and certain complications synergistically increase this risk to a greater degree than might be expected if the complications were independent, but these effects are not well established. METHODS: This is a retrospective cohort study of 422,827 intraabdominal general surgery patients (American College of Surgeons National Surgical Quality Improvement Program 2005-2011). Eight complications were evaluated: acute respiratory failure (ARF), acute kidney injury (AKI), sepsis/septic shock, stroke, cardiac arrest (CA), myocardial infarction (MI), deep vein thrombosis/pulmonary embolus, and transfusion...
July 28, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28739093/individual-surgeon-is-an-independent-risk-factor-for-leak-after-double-stapled-colorectal-anastomosis-an-institutional-analysis-of-800-patients
#5
Eduardo García-Granero, Francisco Navarro, Carlos Cerdán Santacruz, Matteo Frasson, Alvaro García-Granero, Franco Marinello, Blas Flor-Lorente, Alejandro Espí
BACKGROUND: Our aim was to assess whether the individual surgeon is an independent risk factor for anastomotic leak in double-stapled colorectal anastomosis after left colon and rectal cancer resection. METHODS: This retrospective analysis of a prospectively collected database consists of a consecutive series of 800 patients who underwent an elective left colon and rectal resection with a colorectal, double-stapled anastomosis between 1993 and 2009 in a specialized colorectal unit of a tertiary hospital with 7 participating surgeons...
July 21, 2017: Surgery
https://www.readbyqxmd.com/read/28728715/robotic-lobectomy-and-segmentectomy-technical-details-and-results
#6
REVIEW
Benjamin Wei, Robert J Cerfolio
Robotic-assisted pulmonary lobectomy can be considered for patients fit for conventional lobectomy. Contraindications include prohibitive lung function or medical comorbidities, multistation N2, gross N2 disease, or evidence of N3 disease. Team training, familiarity with equipment, troubleshooting, and preparation are critical for successful robotic lobectomy. Similar to video-assisted thoracoscopic surgery (VATS) lobectomy, robotic lobectomy is associated with decreased blood loss, blood transfusion, air leak, chest tube duration, duration of stay, and mortality compared with thoracotomy...
August 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28714229/implementing-a-protocol-to-optimize-blood-use-in-a-cardiac-surgery-service-results-of-a-pre-post-analysis-and-the-impact-of-high-volume-blood-users
#7
Juan B Grau, Jacqueline H Fortier, Cyrus Kuschner, Giovanni Ferrari, Mariano E Brizzio, Alex Zapolanski, Richard E Shaw
BACKGROUND: Blood transfusions are a common and costly intervention for cardiac surgery patients. Evidence suggests that a more restrictive transfusion strategy may reduce costs and transfusion-related complications without increasing perioperative morbidity and mortality. STUDY DESIGN AND METHODS: A transfusion-limiting protocol was developed and implemented in a cardiovascular surgery unit. Over a 5-year period, data were collected on patient characteristics, procedures, utilization of blood products, morbidity, and mortality, and these were compared before and after the protocol was implemented...
July 16, 2017: Transfusion
https://www.readbyqxmd.com/read/28695560/minimally-invasive-extracorporeal-circulation-excellent-outcome-and-life-expectancy-after-coronary-artery-bypass-grafting-surgery
#8
Bernhard Winkler, Paul Philipp Heinisch, Grzegorz Zuk, Katarzyna Zuk, Brigitta Gahl, Hans-Jörg Jenni, Alexander Kadner, Christoph Huber, Thierry Carrel
OBJECTIVE: Coronary artery bypass grafting (CABG) remains the gold standard for complex revascularisation in multivessel disease. The concept of the minimally invasive extracorporeal circulation circuit (MiECC) was introduced to minimise pathophysiological side effects of conventional extracorporeal circulation. This study presents early and long-term outcomes after CABG with use of MiECC in a single-centre consecutive patient cohort. METHODS: From 1 January 2005 to 31 December 2010, 2130 patients underwent isolated CABG with MiECC at our centre...
July 11, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28692337/a-multidisciplinary-perioperative-strategy-for-attaining-more-physiologic-cardiac-surgery
#9
Kyriakos Anastasiadis, Polychronis Antonitsis, Apostolos Deliopoulos, Helena Argiriadou
BACKGROUND: Cardiac surgery is, by definition, a "non-physiologic" intervention associated with systemic adverse effects. Despite advances in surgical technique, cardiopulmonary bypass (CPB) technology as well as anaesthesia management and patient care, there is still significant morbidity and subsequent mortality. AIM: We consider that the contemporary demand for further improving patient outcome mandates the upgrade from optimal perfusion during the procedure as the gold standard to the concept of a "more physiologic" cardiac surgery...
March 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28691229/desmopressin-use-for-minimising-perioperative-blood-transfusion
#10
REVIEW
Michael J Desborough, Kathryn Oakland, Charlotte Brierley, Sean Bennett, Carolyn Doree, Marialena Trivella, Sally Hopewell, Simon J Stanworth, Lise J Estcourt
BACKGROUND: Blood transfusion is administered during many types of surgery, but its efficacy and safety are increasingly questioned. Evaluation of the efficacy of agents, such as desmopressin (DDAVP; 1-deamino-8-D-arginine-vasopressin), that may reduce perioperative blood loss is needed. OBJECTIVES: To examine the evidence for the efficacy of DDAVP in reducing perioperative blood loss and the need for red cell transfusion in people who do not have inherited bleeding disorders...
July 10, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28680726/predominantly-negative-impact-of-diabetes-on-spinal-surgery-a-review-and-recommendation-for-better-preoperative-screening
#11
REVIEW
Nancy E Epstein
BACKGROUND: For patients undergoing spine surgery, the literature attributes significant increased perioperative risks/adverse events (AE) complications, longer length of stay (LOS), and higher 30-day readmission/reoperation rates to those with diabetes. Diabetics are often divided into those with insulin dependent diabetes (IDDM), and non-insulin dependent diabetes (NIDD). However, other series also compare those with uncontrolled diabetes (UCDM) vs. those with controlled DM (CDM). METHODS: We found a marked variation in the size and quality of studies identified in PubMed regarding the impact of diabetes on spinal surgery (e...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28673707/predictors-of-survival-functional-survival-and-hospital-readmission-in-octogenarians-after-surgical-aortic-valve-replacement
#12
Kendra Kuo, Pallav Shah, Brett Hiebert, Karin Love, Alan H Menkis, Rizwan A Manji, Rakesh C Arora
OBJECTIVE: To analyze outcomes and predictors of functional survival (personal care home admission and mortality) and hospital readmission in patients aged ≥80 years who underwent surgical aortic valve replacement (SAVR) in a Manitoba hospital. METHODS: This was a retrospective cohort study of patients aged ≥80 years who underwent SAVR with or without coronary artery bypass grafting in Manitoba between 1995 and 2014. Data from the Manitoba Adult Cardiac Surgery database and the Manitoba Centre for Health Policy were used...
May 23, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28673383/preoperative-embolization-in-surgical-treatment-of-metastatic-spinal-cord-compression
#13
Caroline Clausen
An increasing number of patients develop symptomatic spinal metastasis and increasing evidence supports the benefit of surgical decompression and spinal stabilization combined with radiation therapy. However, surgery for metastatic spinal disease is known to be associated with a risk of substantial intraoperative blood loss and perioperative allogenic blood transfusion. Anemia is known to increase morbidity and mortality in patients undergoing surgery, but studies also indicate that transfusion with allogenic red blood cells (RBC) may lead to worse outcomes...
July 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28633147/tranexamic-acid-safely-reduced-blood-loss-in-hemi-and-total-hip-arthroplasty-for-acute-femoral-neck-fracture-a-randomized-clinical-trial
#14
Chad D Watts, Matthew T Houdek, S Andrew Sems, William W Cross, Mark W Pagnano
OBJECTIVES: We aimed to determine whether (1) tranexamic acid (TXA) reduces the incidence of transfusion (2) TXA reduces the calculated blood loss, and (3) there are any observable differences in 30- and 90-day complications with TXA administration during arthroplasty for femoral neck fracture (FNF). DESIGN: Prospective, double-blinded, randomized controlled trial. SETTING: Level 1 Academic Trauma Center. PATIENTS/PARTICIPANTS: One hundred thirty-eight patients who presented with a low-energy, isolated, FNF (AO 31B) treated with either hemi- or total hip arthroplasty within 72 hours of injury were randomized to either the TXA group (69 patients) or placebo group (69 patients)...
July 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28625825/red-blood-cell-transfusion-in-surgical-cancer-patients-targets-risks-mechanistic-understanding-and-further-therapeutic-opportunities
#15
REVIEW
Vassilis L Tzounakas, Jerard Seghatchian, Elissavet Grouzi, Styliani Kokoris, Marianna H Antonelou
Anemia is present in more than half of cancer patients and appears to be an independent prognostic factor of short- and long-term adverse outcomes. It increases in the advanced period of cancer and perioperatively, in patients with solid tumors who undergo surgery. As a result, allogeneic red blood cell (RBC) transfusion is an indispensable treatment in cancer. However, its safety remains controversial, based on several laboratory and clinical data reporting a linkage with increased risk for cancer recurrence, infection and cancer-related mortality...
May 26, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28625450/vasoplegic-syndrome-an-update-on-perioperative-considerations
#16
REVIEW
Henry Liu, Ling Yu, Longqiu Yang, Michael S Green
Vasoplegic syndrome (VS) is increasingly recognized as an important clinical entity in perioperative medicine. VS is characterized by significant arterial hypotension, normal or high cardiac output, low systemic vascular resistance, and increased requirements for intravenous volume and vasopressors. Tremendous variations exist regarding incidence reported in the literature and management at different institutions; and the incidence of VS is likely significantly higher than many anesthesiologists believe. Thus the aims of this article are to review the pertinent aspects related to VS and alert clinical anesthesiologists to this under-recognized yet very challenging clinical condition...
August 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28606725/do-packed-red-blood-cell-transfusions-really-worsen-oncologic-outcomes-in-colon-cancer
#17
Ramzi Amri, Anne M Dinaux, Lieve G J Leijssen, Hiroko Kunitake, Liliana G Bordeianou, David L Berger
BACKGROUND: Data from small retrospective studies have argued that perioperative packed red blood cell transfusions may increase the risk of developing metastatic recurrence in cancer patients. This study tests this assumption in a large cohort spanning a decade of operatively treated colon cancer patients. METHODS: All patients undergoing primary resection of a colon cancer at a tertiary care center between 2004-2014 (n = 1,423) were included in a retrospective review of a prospectively maintained data repository...
September 2017: Surgery
https://www.readbyqxmd.com/read/28601313/a-propensity-score-analysis-of-two-methods-of%C3%A2-hepatic-vascular-occlusion-in-hepatectomy
#18
Xin Luo, Lin Chen, Wenhua Liu, Shuilin Dong, Hongping Luo, Bixiang Zhang, Xiaoping Chen
BACKGROUND: The key points in hepatectomy are reducing blood loss and preservation of hepatic function. The aim of this study was to compare the perioperative outcomes of partial hepatectomy using two techniques of hepatic vascular inflow occlusion. MATERIALS AND METHODS: A total of 1817 patients were selected from our multi-institutional hepatectomy database in China and classified into two groups: the hemihepatic inflow occlusion (HIO) group (n = 1693) and the ipsilateral portal vein branch occlusion (IPVBO) group (n = 124)...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28591336/prognostic-factors-affecting-outcomes-in-multivisceral-en-bloc-resection-for-colorectal-cancer
#19
Caio Sergio Rizkallah Nahas, Sergio Carlos Nahas, Ulysses Ribeiro-Junior, Leonardo Bustamante-Lopez, Carlos Frederico Sparapan Marques, Rodrigo Ambar Pinto, Antonio Rocco Imperiale, Guilherme Cutait Cotti, William Carlos Nahas, Daher Cezar Chade, Dariane Sampaio Piato, Fabio Busnardo, Ivan Cecconello
OBJECTIVES: This study sought to determine the clinical and pathological factors associated with perioperative morbidity, mortality and oncological outcomes after multivisceral en bloc resection in patients with colorectal cancer. METHODS: Between January 2009 and February 2014, 105 patients with primary colorectal cancer selected for multivisceral resection were identified from a prospective database. Clinical and pathological factors, perioperative morbidity and mortality and outcomes were obtained from medical records...
May 2017: Clinics
https://www.readbyqxmd.com/read/28585138/assessment-of-complications-after-liver-surgery-two-novel-grading-systems-applied-to-patients-undergoing-hepatectomy
#20
Li-Ning Xu, Bo Yang, Gui-Ping Li, De-Wei Gao
Although quality assessment is gaining increasing attention, there is still no consensus on how to define and grade postoperative complications. The absence of a definition and a widely accepted ranking system to classify surgical complications has hampered proper interpretation of the surgical outcome. This study aimed to define and search the simple and reproducible classification of complications following hepatectomy based on two therapy-oriented severity grading system: Clavien-Dindo classification of surgical complications and Accordion severity grading of postoperative complications...
June 2017: Journal of Huazhong University of Science and Technology. Medical Sciences
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