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transfusion in surgical patients

Candice Ostrowka, Stéphanie Bonhomme, Pomme Jouffroy, Guillaume Riouallon
INTRODUCTION: Fractures of the pelvis (acetabulum and pelvic ring) are complex in both radiological diagnosis and therapeutic management. They show high risk of thrombosis, with variable rates of venous thromboembolic complications in the literature, ranging from 10% to 50%, with 0.5-10% risk of fatal pulmonary embolism. The objective of the present study was to determine the rate of venous thromboembolic events in a consecutive cohort of pelvic fracture and to attempt to identify thromboembolic risk factors in this population...
June 12, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Imre Janszky, Katalin Gémes, Staffan Ahnve, Hilmir Asgeirsson, Jette Möller
BACKGROUND: Various invasive medical procedures might induce bacteremia and, hence, act as triggers for infective endocarditis. However, empirical data in humans on the potential dangers of invasive medical procedures in this regard are very sparse. Due to lack of sufficient data, it is currently debated whether the risk for endocarditis with medical procedures is substantial or rather negligible. OBJECTIVES: The purpose of this nationwide case-crossover study was to quantify the excess risk for infective endocarditis in association with invasive medical and surgical procedures...
June 19, 2018: Journal of the American College of Cardiology
Abhiraj D Bhimani, Ankit Indravadan Mehta
BACKGROUND: Intradural extramedullary (IDEM) spinal cord tumors account for two thirds of all intraspinal neoplasms. Surgery for IDEM tumors carries risk for many different complications, which to date have been poorly described and quantified. OBJECTIVE: To better characterize risk factors and complications for IDEM tumors, stratifying by spinal cord level and malignancy. METHODS: The ACS-NSQIP database was queried to determine 30-day outcomes following surgery for IDEM tumors between 2005 and 2016...
June 11, 2018: World Neurosurgery
Majid Eshghpour, Sahand Samieirad, Alireza Sharifian Attar, Hamed Kermani, Sadaf Seddigh
PURPOSE: Propofol and remifentanil are 2 useful drugs used in induced hypotensive anesthesia. The purpose of this study was to compare the effects of these drugs on intraoperative blood loss, transfusion requirements, and hemodynamic status during standardized orthognathic surgical procedures. MATERIALS AND METHODS: In this double-blind randomized clinical trial, 50 consecutive healthy patients with Class III skeletal deformity were candidates for bimaxillary orthognathic surgery at Qaem Hospital, Mashhad University of Medical Sciences (Mashhad, Iran), from November 2016 until December 2017...
May 21, 2018: Journal of Oral and Maxillofacial Surgery
Aminu K Bello, Christine M Ribic, Serge H Cournoyer, Mercedeh Kiaii, Martine LeBlanc, Melanie Poulin-Costello, David N Churchill, Norman Muirhead
Background: Several studies have demonstrated harm associated with using erythropoiesis-stimulating agents (ESA) to achieve higher hemoglobin (Hb) levels. Subsequently, more conservative use of ESAs has changed anemia therapy in patients with chronic renal failure. Objective: The objectives were to identify transfusion rates in hemodialysis (HD) patients during the first year of therapy, to identify factors associated with the probability of transfusion, describe reasons for the transfusions, and identify the Hb values associated with each transfusion...
2018: Canadian Journal of Kidney Health and Disease
Wenbo Wei, Shajie Dang, Dapeng Duan, Ling Wei
BACKGROUND: To investigate the clinical effectiveness of intravenous (IV) and topical tranexamic acid (TXA) in patients undergoing total knee arthroplasty (TKA) by comparing safety, efficacy and patient-reported outcomes. METHODS: In this prospective single-blind clinical trial, 64 patients were randomized into two groups (n = 32 each). The Intravenous Group was administered TXA 10 mg/kg IV (Reyong, Shandong, China) 10 min prior to tourniquet deflation. In the Topical Group, 1...
June 13, 2018: BMC Musculoskeletal Disorders
Ruchika Goel, Eshan U Patel, Melissa M Cushing, Steven M Frank, Paul M Ness, Clifford M Takemoto, Ljiljana V Vasovic, Sujit Sheth, Marianne E Nellis, Beth Shaz, Aaron A R Tobian
Importance: Increasing evidence supports the role of red blood cells (RBCs) in physiological hemostasis and pathologic thrombosis. Red blood cells are commonly transfused in the perioperative period; however, their association with postoperative thrombotic events remains unclear. Objective: To examine the association between perioperative RBC transfusions and postoperative venous thromboembolism (VTE) within 30 days of surgery. Design, Setting, and Participants: This analysis used prospectively collected registry data from the American College of Surgery National Surgical Quality Improvement Program (ACS-NSQIP) database, a validated registry of 525 teaching and nonteaching hospitals in North America...
June 13, 2018: JAMA Surgery
Lauren E Stewart, Michelle A Eston, Rebecca G Symons, Michael F Fialkow, Anna C Kirby
OBJECTIVES: Mesh midurethral slings (MUSs) are safe, effective treatments for female stress urinary incontinence (SUI), but many companies have ceased production because of controversies surrounding transvaginal mesh. To determine if introduction of MUS has increased the complication rate associated with SUI surgery, we compared women undergoing SUI surgery in the MUS era to those who had surgery prior its introduction. METHODS: This was a retrospective cohort study of a statewide hospital discharge database...
June 12, 2018: Female Pelvic Medicine & Reconstructive Surgery
Fei Xu, Yangwu Song, Wei Feng, Xuan Li, Junzhe Du
BACKGROUND: This study was conducted to explore the impact of renal dysfunction on short-term and mid-term outcomes in elderly patients. METHODS: Patients over 65 years of age receiving surgical ventricular restoration (SVR) were included in the study. They were stratified through estimated glomerular filtration rate (eGFR), with a cutoff point of 60 mL/min/1.73m2. Risk-adjusted analysis, including propensity score matching, was carried out to compare short-term and mid-term outcomes between the two groups of patients...
May 24, 2018: Heart Surgery Forum
A F Saltzman, J C Warncke, A N Colvin, A Carrasco, J P Roach, J L Bruny, N G Cost
PURPOSE: To identify the factors associated with a shorter postoperative stay, as an initial step to develop a care pathway for children undergoing extirpative kidney surgery. STUDY DESIGN: This study retrospectively reviewed patients managed with upfront open radical nephrectomy for renal tumors between 2005 and 2016 at a pediatric tertiary care facility. Univariate and multivariate logistic regression were performed to identify factors associated with early discharge (by postoperative day 4)...
May 31, 2018: Journal of Pediatric Urology
Xuyin Zhang, Yan Ding, Keqin Hua, Songping Liu, Nan Jia
OBJECTIVE: To introduce a creation that combines laparoscopic and Wharton-Sheares-George cervicovaginal reconstruction using SIS graft in a patient with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome who had a rudimentary cavity (U5aC4V4). DESIGN: Video article introducing a new surgical technique. SETTING: University hospital. PATIENT(S): A 24-year-old patient had primary amenorrhea and irregular lower abdominal pain for 9 years...
June 8, 2018: Journal of Minimally Invasive Gynecology
Jason D Wright, Maria P Ruiz, Ling Chen, Lisa R Gabor, Ana I Tergas, Caryn M St Clair, June Y Hou, Cande V Ananth, Alfred I Neugut, Dawn L Hershman
OBJECTIVE: To examine changes over time in surgeon and hospital procedural volume for hysterectomy for endometrial cancer and explore the association between changes in volume and perioperative outcomes. METHODS: We used the Statewide Planning and Research Cooperative System database to analyze women who underwent abdominal or minimally invasive hysterectomy from 2000 to 2014. Annualized surgeon and hospital volume was estimated. The association between surgeon and hospital volume and perioperative morbidity, mortality, and resource utilization (transfusion, length of stay, hospital charges) was estimated by modeling procedural volume as a continuous and categorical variable...
June 6, 2018: Obstetrics and Gynecology
Ashutosh Gupta, Sourabh Nandi, Santanu Tiwari, Amit Choraria, Vivek Chaudhary
The aim of this paper is to study the outcome of single-layer end to side dunking pancreatojejunostomy technique in 32 patients of malignant pancreatic disease undergoing Whipple's surgery in a tertiary care oncology centre in India. From January 2013 to January 2016, 32 consecutive patients who underwent pancreatoduodenectomy for malignant diseases were analysed retrospectively. All the patients underwent standard Whipple's operation. Pancreatojejunostomy was established in a single-layer end to side dunking manner with PDS 4-0...
June 2018: Indian Journal of Surgical Oncology
Xi-Nuo Zhang, Xiang-Yao Sun, Yong Hai, Xiang-Long Meng, Yun-Sheng Wang
Adult degenerative scoliosis (ADS) surgery is known for its high incidence of complications. The propose of this study was to determine current complication rates and the predictors of medical complications in surgical ASD patients. A retrospective study of 153 ADS patients who underwent long level spinal fusion with 2-year follow-up between 2012 and 2017. The patient- and surgical-related risk factors for each individual medical complication were identified by using univariate testing. All patients were divided into groups with and without medical complication, infection, neurological complications, and cardiopulmonary complications, respectively...
June 7, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Burak Eren, Feyza Karagöz Güzey, Serkan Kitiş, Nezih Özkan, Cafer Korkut
OBJECTIVE: The aim of this study was to evaluate the efficacy of the local application of vancomycin hydrochloride (HCl)-ceftriaxone disodium hemiheptahydrate onto implants before using them to prevent postoperative infection. METHODS: The study included 239 patients (153 women and 86 men; mean age: 48.23 ± 16.77 years) who had thoracolumbar stabilization with transpedicular screws. All surgeries were performed by the same surgeon. Patients were divided into two groups...
June 7, 2018: Acta Orthopaedica et Traumatologica Turcica
Bridget Ollesch, Christopher Brazell, Patrick M Carry, Gaia Georgopoulos
STUDY DESIGN: Retrospective prognostic study. OBJECTIVE: The purpose of this study assess was to assess the results of spinal fusion and identify factors associated with the development of post-spinal fusion infections in patients with myelomeningocele. BACKGROUND: Surgical correction of neuromuscular scoliosis secondary to myelomeningocele is known to be associated with a high complication rate. METHODS: A retrospective cohort study design was used to collect data on patients with myelomeningocele who underwent spinal fusion between the years of 1997-2013...
July 2018: Spine Deformity
Timothy D Lyon, Matthew K Tollefson, Paras H Shah, Katherine Bews, Igor Frank, R Jeffrey Karnes, R Houston Thompson, Elizabeth B Habermann, Stephen A Boorjian
PURPOSE: To determine whether the rate of venous thromboembolism (VTE) following radical cystectomy (RC) is changing overtime. MATERIALS AND METHODS: The American College of Surgeons National Surgical Quality Improvement Program database was used to identify patients who underwent RC for bladder cancer from 2011 to 2016. VTE was defined as pulmonary embolism or deep vein thrombosis within 30 days of RC. VTE rate by year was assessed using the Cochran-Armitage test for trend...
June 6, 2018: Urologic Oncology
J Mason DePasse, Wesley Durand, Adam E M Eltorai, Mark A Palumbo, Alan H Daniels
Study design: Retrospective cohort study. Objective: To characterize the timing of complications after posterior cervical fusion. Summary of background data: Understanding the expected timing of postoperative complications facilitates early diagnosis of potential adverse events and is important for optimizing postoperative care. Though studies have examined the incidence of complications after posterior cervical fusion, no study has characterized the timing of these complications...
June 2018: Journal of Orthopaedics
Tomo Ando, Emmanuel Akintoye, Anthony A Holmes, Alexandros Briasoulis, Mohit Pahuja, Hisato Takagi, Theodore Schreiber, Cindy L Grines, Luis Afonso
It is unknown if transcatheter aortic valve implantation (TAVI) is a safe alternative to surgical aortic valve replacement (SAVR) in patients <65 years old. Data from the National Inpatient Sample database were utilized. Patients from 2011 to 2015, ages 18 to 64 years old (inclusive) who underwent TAVI and SAVR were included. Patients who underwent SAVR and who also received a concomitant nonaortic valve surgery were excluded. A propensity score analysis was used. A total of 18,970 (528 TAVI and 18,442 SAVR) patients were identified...
April 24, 2018: American Journal of Cardiology
Majid Rezvani, Reza Abbasi, Homayoon Tabesh, Leila Dehghani, Shahab Dolatkhah, Maryam Nasri, Mohsen Kolahdouzan, Rokhsareh Meamar
STUDY DESIGN: Randomized clinical trial. PURPOSE: In this study, we evaluated the effect of mechanical evacuation of the bowels prior to operation on intraoperative bleeding. OVERVIEW OF LITERATURE: Bleeding is the most significant complication in patients undergoing spinal surgery. METHODS: We randomly divided 108 individuals planned to undergo spinal surgery into two age-, sex-, and co-morbidity (especially preoperative hemoglobin [Hb])-matched groups of 54...
June 2018: Asian Spine Journal
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