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Perioperative, transfusion, mortality

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https://www.readbyqxmd.com/read/29451147/perioperative-single-donor-platelet-apheresis-and-red-blood-cell-transfusion-impact-on-90-day-and-overall-survival-in-living-donor-liver-transplantation
#1
Wei Zheng, Kang-Mei Zhao, Li-Hui Luo, Yang Yu, Sheng-Mei Zhu
Background: Although many previous studies have confirmed that perioperative blood transfusion is associated with poor outcomes after liver transplantation (LT), few studies described the influence of single-donor platelet apheresis transfusion in living donor LT (LDLT). This study aimed to assess the effect of blood products on outcomes for LDLT recipients, focusing on apheresis platelets. Methods: This retrospective study included 126 recipients who underwent their first adult-to-adult LDLT...
February 20, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29438158/intensive-care-unit-enhanced-recovery-pathway-for-patients-undergoing-orthotopic-liver-transplants-recipients-a-prospective-observational-study
#2
Adam B King, Clark D Kensinger, Yaping Shi, Matthew S Shotwell, Seth J Karp, Pratik P Pandharipande, J Kelly Wright, Liza M Weavind
BACKGROUND: Liver transplant recipients continue to have high perioperative resource utilization and prolonged length of stay despite improvements in perioperative care. Enhanced recovery pathways have been shown in other surgical populations to produce reductions in hospital resource utilization. METHODS: A prospective, observational study was performed to examine the effect of an enhanced recovery pathway for postoperative care after liver transplantation. Outcomes from patients undergoing liver transplantation from November 1, 2013, to October 31, 2014, managed by the pathway were compared to transplant recipients from the year before pathway implementation...
February 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29437055/aseptic-revision-total-hip-arthroplasty-in-the-elderly-quantifying-the-risks-for-patients-over-80-years-old
#3
P Bovonratwet, R Malpani, T D Ottesen, V Tyagi, N T Ondeck, L E Rubin, J N Grauer
AIMS: The aim of this study was to compare the rate of perioperative complications following aseptic revision total hip arthroplasty (THA) in patients aged ≥ 80 years with that in those aged < 80 years, and to identify risk factors for the incidence of serious adverse events in those aged ≥ 80 years using a large validated national database. PATIENTS AND METHODS: Patients who underwent aseptic revision THA were identified in the 2005 to 2015 National Surgical Quality Improvement Program (NSQIP) database and stratified into two age groups: those aged < 80 years and those aged ≥ 80 years...
February 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29424017/perioperative-blood-management-strategies-for-total-knee-arthroplasty
#4
REVIEW
Qiang Lu, Hao Peng, Guan-Jin Zhou, Dong Yin
Total knee arthroplasty (TKA) often causes a significant amount of blood loss with an accompanying decline in hemoglobin and may increase the frequency of allogeneic blood transfusion rates. Unfortunately, allogeneic blood transfusions have associated risks including postoperative confusion, infection, cardiac arrhythmia, fluid overload, increased length of hospital stay, and increased mortality. Other than reducing the need for blood transfusions, reducing perioperative blood loss in TKA may also minimize intra-articular hemorrhage, limb swelling, and postoperative pain, and increase the range of motion during the early postoperative period...
February 9, 2018: Orthopaedic Surgery
https://www.readbyqxmd.com/read/29402713/chronic-obstructive-pulmonary-disease-is-associated-with-short-term-complications-following-total-hip-arthroplasty
#5
George A Yakubek, Gannon L Curtis, Nipun Sodhi, Mhamad Faour, Alison K Klika, Michael A Mont, Wael K Barsoum, Carlos A Higuera
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality. Furthermore, COPD patients are at increased risk of complications following surgery. The purpose of this study was to evaluate the postoperative total hip arthroplasty (THA) outcomes of COPD patients. Specifically, we asked the following questions: (1) Is COPD associated with adverse perioperative outcomes and (2) Does COPD increase the risk of short-term complications following THA? METHODS: The American College of Surgeons National Surgical Quality Improvement Program database was used to identify 64,796 patients who underwent THA between 2008 and 2014...
January 9, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29400260/noteworthy-literature-published-in-2017-for-cardiothoracic-anesthesiologists
#6
Dirk J Varelmann, Jochen Daniel Muehlschlegel
The year 2017 was a year dominated by large-scale clinical studies reporting the outcome of various interventions in cardiac surgery and heart failure (HF) patients, relevant to all cardiothoracic anesthesiologists. Among them were studies investigating the addition of levosimendan, an alternative inotropic agent, to standard management of patients with HF undergoing cardiac surgery. Also, corticosteroids have been used for various purposes in cardiac patients. Here, a new study reports the effect of high-dose methylprednisolone on recovery and delirium...
March 2018: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29398999/the-fascia-iliaca-block-as-the-primary-intraoperative-anesthesia-for-hip-fracture-surgery-a-preliminary-study
#7
Joseph J Ruzbarsky, Elizabeth B Gausden, Elan M Goldwyn, Isaac P Lowenwirt, Vitaly Kotlyar
Background: Early surgical intervention for hip fractures in the elderly has proven efficacious. However, surgical delays commonly occur in this patient population due to comorbid conditions that put these patients at a high risk for hypotension-related complications of general or neuraxial anesthesia or anticoagulants that delay the safe use of neuraxial anesthesia. Questions/Purposes: The questions/purposes of this study are (1) to investigate if a fascia iliaca block in conjunction with light to moderate sedation could provide adequate analgesia throughout open surgery for intertrochanteric hip fractures (AO/OTA 31-1) without requiring conversion to general anesthesia with airway support and (2) to assess its perioperative complication profile...
February 2018: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/29398291/predictors-for-perioperative-blood-transfusion-in-elderly-patients-with-extra-capsular-hip-fractures-treated-with-cephalo-medullary-nailing
#8
M Ali Fazal, Caroline Bagley, Parag Garg
PURPOSE: The aim of our study was to determine predictive factors and requirement for perioperative blood transfusion in elderly patients with extra capsular hip fractures treated with cephalo-medullary device. METHODS: Seventy-nine patients with extra capsular hip fractures treated with cephalo-medullary nailing were included in the study. Age, sex, ASA grade, timing of surgery, preoperative and postoperative haemoglobin, length of hospital stay, fracture type, number of units transfused and 30-day mortality were recorded...
December 8, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/29396754/robotic-versus-laparoscopic-distal-pancreatectomy-a-french-prospective-single-center-experience-and-cost-effectiveness-analysis
#9
Regis Souche, Astrid Herrero, Guillaume Bourel, John Chauvat, Isabelle Pirlet, Françoise Guillon, David Nocca, Frederic Borie, Gregoire Mercier, Jean-Michel Fabre
BACKGROUND: Benefits and cost-effectiveness of robotic approach for distal pancreatectomy (DP) remain debated. In this prospective study, we aim to compare the short-term results and real costs of robotic (RDP) and laparoscopic distal pancreatectomy (LDP). METHODS: From 2011 until 2016, all consecutive patients underwent minimally invasive DP were included and data were prospectively collected. Patients were assigned in two groups, RDP and LDP, according to the availability of the Da Vinci® Surgical System for our Surgical Unit...
February 2, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29391760/clinical-advantages-of-single-port-laparoscopic-hepatectomy
#10
Jae Hyun Han, Young Kyoung You, Ho Joong Choi, Tae Ho Hong, Dong Goo Kim
AIM: To evaluate the clinical advantages of single-port laparoscopic hepatectomy (SPLH) compare to multi-port laparoscopic hepatectomy (MPLH). METHODS: We retrospectively reviewed the medical records of 246 patients who underwent laparoscopic liver resection between January 2008 and December 2015 at our hospital. We divided the surgical technique into two groups; SPLH and MPLH. We performed laparoscopic liver resection for both benign and malignant disease. Major hepatectomy such as right and left hepatectomy was also done with sufficient disease-free margin...
January 21, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29383871/preoperative-platelet-transfusions-to-reverse-antiplatelet-therapy-for-urgent-non-cardiac-surgery-an-observational-cohort-study
#11
Marcel Baschin, Sixten Selleng, Astrid Hummel, Stephan Diedrich, Henry W Schroeder, Thomas Kohlmann, Antje Westphal, Andreas Greinacher, Thomas Thiele
BACKGROUND: Patients receiving antiplatelet therapy (APT) have an increased risk of perioperative bleeding and cardiac adverse events (CAE). Preoperative platelet transfusions may reduce the bleeding risk but may also increase the risk of CAE, particularly coronary thrombosis in patients after recent stent implantation. OBJECTIVES: To analyse the incidence of perioperative CAE and bleeding in patients undergoing non-cardiac surgery using a standardized management of transfusing two platelet concentrates pre-operatively and restart of APT within 24-72 hours after surgery...
January 31, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29365358/perioperative-loss-of-psoas-muscle-is-associated-with-patient-survival-in-living-donor-liver-transplantation
#12
Min Suk Chae, Kwang Uck Moon, Joon-Yong Jung, Ho Joong Choi, Hyun Sik Jung, Chul Soo Park, Jaemin Lee, Jong Ho Choi, Sang Hyun Hong
BACKGROUND AND AIMS: Patients with end-stage liver disease show sarcopenia, and the preoperative sarcopenia is independently associated with patient mortality after liver transplantation. However, few studies have examined the relationship between perioperative loss of core muscle and patient mortality in living donor liver transplantation (LDLT). This study was performed to investigate the association between a perioperative decrease in the psoas muscle index (PMI) and patient mortality after LDLT...
January 24, 2018: Liver Transplantation
https://www.readbyqxmd.com/read/29354607/surgical-outcomes-and-risk-factors-in-patients-who-underwent-emergency-colorectal-surgery
#13
Dai Sik Jeong, Young Hun Kim, Kyung Jong Kim
Purpose: Emergency colorectal surgery has high rates of complications and mortality because of incomplete bowel preparation and bacterial contamination. The authors aimed to evaluate the surgical outcomes and the risk factors for the mortality and the complication rates of patients who underwent emergency surgery to treat colorectal diseases. Methods: This is a prospective study from January 2014 to April 2016, and the results are based on a retrospective analysis of the clinical results for patients who underwent emergency colorectal surgery at Chosun University Hospital...
December 2017: Annals of Coloproctology
https://www.readbyqxmd.com/read/29351695/reasons-for-failure-of-systemic-to-pulmonary-artery-shunts-in-neonates
#14
Keti Vitanova, Cornelius Leopold, Jelena Pabst von Ohain, Cordula Wolf, Elisabeth Beran, Rüdiger Lange, Julie Cleuziou
BACKGROUND:  Systemic-to-pulmonary artery shunt placement is an established palliative procedure for congenital heart disease. Although it is thought to be a simple operation, it is associated with significant morbidity and mortality. METHODS:  Data for all neonates who underwent surgery for a systemic-to-pulmonary artery shunt between 2000 and 2016 were reviewed. The study endpoints were shunt failure and shunt-related mortality. Shunt failure was defined as a shunt dysfunction because of thrombosis or stenosis requiring intervention or reoperation; shunt mortality was defined as death because of a shunt dysfunction...
January 19, 2018: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/29325846/hospital-outcome-and-risk-indices-of-mortality-in-potential-candidates-for-transcatheter-procedures-results-from-a-european-registry
#15
Francesco Onorati, Giovanni Mariscalco, Daniel Reichart, Andrea Perrotti, Giuseppe Gatti, Marisa De Feo, Antonio Rubino, Giuseppe Santarpino, Fausto Biancari, Christian Detter, Francesco Santini, Giuseppe Faggian
OBJECTIVE: Transcatheter mitral valve-in-valve/valve-in-ring procedures (TM-VIVoR) are increasing. The authors aimed to identify independent predictors for hospital mortality in redo mitral valve surgery as possible future selection criteria for TM-VIVoR. DESIGN: Retrospective multicenter registry. SETTING: Tertiary university and community hospitals. PARTICIPANTS: Two-hundred and sixty patients (out of 920 enrolled) who are potentially candidates for TM-VIVoR undergoing redo-surgery...
September 28, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29324598/adoption-of-minimally-invasive-surgery-and-decrease-in-surgical-morbidity-for-endometrial-cancer-treatment-in-the-united-states
#16
Jvan Casarin, Francesco Multinu, Daniel S Ubl, Sean C Dowdy, William A Cliby, Gretchen E Glaser, Kristina A Butler, Fabio Ghezzi, Elizabeth B Habermann, Andrea Mariani
OBJECTIVE: To assess how the widespread adoption of minimally invasive surgery in the United States is associated with changes in 30-day morbidity and mortality in endometrial cancer treatment. METHODS: In this retrospective cohort study, the American College of Surgeons' National Surgical Quality Improvement Project database for 2008-2014 was reviewed for patients who had undergone surgery for endometrial cancer according to their primary Current Procedural Terminology (CPT) codes...
January 9, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29324500/hydroxyethyl-starch-130-0-4-and-its-impact-on-perioperative-outcome-a-propensity-score-matched-controlled-observation-study
#17
Judith-Irina Pagel, Markus Rehm, Tobias Kammerer, Nikolai Hulde, Eike Speck, Josef Briegel, Falk Reinholz, Alexander Crispin, Klaus F Hofmann-Kiefer
BACKGROUND: Adverse effects of hydroxyethyl starches (HESs) have been verified in patients suffering from sepsis or kidney disease, but not in surgical patients at large. The investigation aimed to determine whether the use of HES 130/0.4 was associated with the incidence of acute postinterventional adverse events compared to Ringer's acetate alone in a perioperative setting. METHODS: This propensity score matched, controlled observational study was performed in a single-centre university hospital...
January 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29320978/two-vessel-branched-stent-graft-for-severely-angulated-aortic-arch-aneurysm-in-a-jehovah-s-witness
#18
Chung S Lim, A Dhutia, Celia Riga, A Dharmadasa, Richard G J Gibbs, Mohamad S Hamady
Aneurysmal disease involving the origins of supra aortic vessels often requires complex open and/or endovascular repair that is not only associated with significant risk of mortality and morbidity but also often with perioperative blood loss requiring transfusion. We report a successful repair of a large thoracic aortic aneurysm (TAA) involving the aortic arch with a custom-made Bolton Relay 2-vessel branched thoracic aortic endograft in a 42-year-old Jehovah's Witness who would otherwise be very unlikely to survive an open repair...
February 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29315474/regional-anesthesia-decreases-complications-and-resource-utilization-in-shoulder-arthroplasty-patients
#19
M D Herrick, H Liu, M Davis, J-E Bell, B D Sites
BACKGROUND: Regional anesthesia can be used as part of the anesthetic to optimize anesthesia and analgesia during shoulder arthroplasty, but little is known about the overall effect that regional anesthesia has on perioperative outcomes and resource utilization. We hypothesized that regional anesthesia may decrease complication rates and resource utilization in shoulder arthroplasty patients. METHODS: We examined administrative data from 588 US hospitals from 2010 to 2015...
January 7, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29306228/emergency-coronary-bypass-surgery-in-patients-under-the-influence-of-dualantiplatelet-therapy-effects-of-tranexamic-acid-and-desmopressin-acetate
#20
Gökalp Altun, Doğuş Hemşinli, Zerrin Pulathan, Ali Civelek
Background/aim: Bleeding in patients undergoing coronary artery bypass grafting (CABG) while using dual antiplatelet therapy (DAPT) is a cause of significant morbidity and mortality. The aim of this study is to examine the perioperative hemostatic effects of tranexamic acid (TnX-A) and desmopressin acetate (Des) in these patients. Materials and methods: This clinical study was planned in a prospective and randomized manner. Fifty-four patients were enrolled and classified into 4 different groups. They were compared in terms of various bleeding and transfusion parameters...
December 19, 2017: Turkish Journal of Medical Sciences
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