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the association of perioperative practice

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https://www.readbyqxmd.com/read/28222985/concurrent-renal-artery-stent-during-endovascular-infrarenal-aortic-aneurysm-repair-confers-higher-risk-for-30-day-acute-renal-failure
#1
Besma Nejim, Isibor Arhuidese, Muhammmad Rizwan, Lana Khalil, Satinderjit Locham, Devin Zarkowsky, Philip Goodney, Mahmoud B Malas
OBJECTIVE: Concurrent renal artery angioplasty and stenting (RAAS) during endovascular aneurysm repair (EVAR) of infrarenal abdominal aortic aneurysm (AAA) has been practiced in an attempt to maintain renal perfusion. The aim of this study was to identify the current practice of RAAS during EVAR and its effect on perioperative renal outcome. METHODS: Patients with infrarenal AAA were identified from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP, 2011-2014) database...
February 17, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28216362/endovascular-aneurysm-repair-patients-who-are-lost-to-follow-up-have-worse-outcomes
#2
Caitlin W Hicks, Devin S Zarkowsky, Ian C Bostock, David H Stone, James H Black, Jens Eldrup-Jorgensen, Philip P Goodney, Mahmoud B Malas
BACKGROUND: Society for Vascular Surgery practice guidelines recommend 1- and 12-month follow-up with computed tomography imaging for the year after endovascular aneurysm repair (EVAR). We describe the incidence, risk factors, and outcomes of EVAR patients who are lost to follow-up (LTF). METHODS: All patients undergoing elective EVAR in the Vascular Quality Initiative (VQI) data set (January 2003-December 2015) were stratified according to long-term follow-up method (in-person vs phone call vs LTF)...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28216361/the-effect-of-ambulatory-status-on-outcomes-of-percutaneous-vascular-interventions-and-lower-extremity-bypass-for-critical-limb-ischemia-in-the-vascular-quality-initiative
#3
Kimberly Lu, Alik Farber, Marc L Schermerhorn, Virendra I Patel, Jeffrey A Kalish, Denis Rybin, Gheorghe Doros, Jeffrey J Siracuse
OBJECTIVE: Ambulatory status has been shown to be an important predictor of postoperative morbidity and mortality for a variety of surgical procedures. We sought to assess contemporary practice patterns in treating critical limb ischemia (CLI) and outcomes based on ambulatory status. METHODS: The Vascular Quality Initiative (2010-2015) was queried for patients undergoing percutaneous vascular interventions (PVIs) or lower extremity bypass (LEB) for CLI. Ambulatory status was classified as ambulatory, ambulatory with assistance, and nonambulatory (composite of wheelchair bound and bedridden)...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28211002/factors-that-influence-effective-perioperative-temperature-management-by-anesthesiologists-a-qualitative-study-using-the-theoretical-domains-framework
#4
Sylvain Boet, Andrea M Patey, Justine S Baron, Karim Mohamed, Ashlee-Ann E Pigford, Gregory L Bryson, Jamie C Brehaut, Jeremy M Grimshaw
PURPOSE: Inadvertent perioperative hypothermia (IPH) is associated with a range of adverse outcomes. Safe and effective warming techniques exist to prevent IPH; however, IPH remains common. This study aimed to identify factors that anesthesiologists perceive may influence temperature management during the perioperative period. METHODS: After Research Ethics Board approval, semi-structured interviews were conducted with staff anesthesiologists at a Canadian academic hospital...
February 16, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28210405/titanium-clamps-for-a-simple-low-profile-autologous-osteosynthesis-in-the-reconstruction-of-posttraumatic-craniofacial-convexital-skeletal-disruption
#5
Amos Olufemi Adeleye, Toluyemi Adefolarin Malomo
Attempts at reconstruction of posttraumatic craniofacial defects (PTCDs) can be a challenge in low-resource practice areas of the world where the needed biomaterials are logistically beyond reach. A simple low-profile technique of autologous osteosynthesis for PTCD using the titanium clamps is presented in this report. In addition, a 6-year prospective database on a consecutive cohort of patients who underwent this procedure was analyzed for clinical, functional, and aesthetic outcomes, both in-hospital and at midterm follow-up...
March 2017: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/28193994/predictive-role-of-intraoperative-plasma-fibrinogen-for-postoperative-portal-venous-flow-in-living-donor-liver-transplantation
#6
Min Suk Chae, Chul Soo Park, Su A Oh, Sang Hyun Hong
BACKGROUND Previous studies have reported poor graft regeneration after living donor liver transplantation (LDLT) due to inappropriate portal venous flow (PVF). In this study, we investigated the perioperative factors affecting postoperative PVF after LDLT. MATERIAL AND METHODS The perioperative data of 366 LDLT patients were retrospectively reviewed. The average PVF on postoperative days 1, 3, and 5 was measured and dichotomized at a cut-off value for patient survival of 1,477 mL/min. Perioperative variables, including coagulation profiles, were compared between high and low postoperative PVF groups...
February 14, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28176903/analysis-of-perioperative-pain-management-in-vascular-surgery-indicates-that-practice-does-not-adhere-with-guidelines-a-retrospective-cross-sectional-study
#7
Krste Boric, Matija Boric, Teo Boric, Livia Puljak
BACKGROUND: Inadequate treatment of pain related to surgery may be associated with complications and prolonged recovery time and increased morbidity and mortality rates. We investigated perioperative pain management in vascular surgery and compared it with the relevant guidelines for the treatment of perioperative pain. METHODS: We conducted a retrospective study on 501 patients who underwent vascular surgery at the University Hospital Split, Croatia. We collected the following data from patients' charts: age, gender, premedication, preoperative patient's physical status, type of surgery, duration of surgery and anesthesia, type of anesthesia, postoperative analgesia, and need for intensive care...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28169116/utilization-and-effectiveness-of-desmopressin-acetate-after-cardiac-surgery-supplemented-with-point-of-care-hemostatic-testing-a-propensity-score-matched-analysis
#8
David Orlov, Stuart A McCluskey, Jeannie Callum, Vivek Rao, Jacobo Moreno, Keyvan Karkouti
OBJECTIVES: To explore the utilization pattern and hemostatic effectiveness of desmopressin acetate (DDAVP) supplemented with point-of-care (POC) hemostatic testing in contemporary cardiac surgery. DESIGN: Retrospective, observational study. SETTING: Single quaternary care university hospital. PARTICIPANTS: The study comprised 2,468 consecutive patients undergoing cardiac surgery-1,237 before and 1,231 after the introduction of POC testing...
November 17, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28167634/management-of-patients-on-non-vitamin-k-antagonist-oral-anticoagulants-in-the-acute-care-and-periprocedural-setting-a-scientific-statement-from-the-american-heart-association
#9
Amish N Raval, Joaquin E Cigarroa, Mina K Chung, Larry J Diaz-Sandoval, Deborah Diercks, Jonathan P Piccini, Hee Soo Jung, Jeffrey B Washam, Babu G Welch, Allyson R Zazulia, Sean P Collins
Non-vitamin K oral anticoagulants (NOACs) are now widely used as alternatives to warfarin for stroke prevention in atrial fibrillation and management of venous thromboembolism. In clinical practice, there is still widespread uncertainty on how to manage patients on NOACs who bleed or who are at risk for bleeding. Clinical trial data related to NOAC reversal for bleeding and perioperative management are sparse, and recommendations are largely derived from expert opinion. Knowledge of time of last ingestion of the NOAC and renal function is critical to managing these patients given that laboratory measurement is challenging because of the lack of commercially available assays in the United States...
February 6, 2017: Circulation
https://www.readbyqxmd.com/read/28145848/clinical-practice-guideline-improving-nasal-form-and-function-after-rhinoplasty-executive-summary
#10
Lisa E Ishii, Travis T Tollefson, Gregory J Basura, Richard M Rosenfeld, Peter J Abramson, Scott R Chaiet, Kara S Davis, Karl Doghramji, Edward H Farrior, Sandra A Finestone, Stacey L Ishman, Robert X Murphy, John G Park, Michael Setzen, Deborah J Strike, Sandra A Walsh, Jeremy P Warner, Lorraine C Nnacheta
Objective Rhinoplasty, a surgical procedure that alters the shape or appearance of the nose while preserving or enhancing the nasal airway, ranks among the most commonly performed cosmetic procedures in the United States, with >200,000 procedures reported in 2014. While it is difficult to calculate the exact economic burden incurred by rhinoplasty patients following surgery with or without complications, the average rhinoplasty procedure typically exceeds $4000. The costs incurred due to complications, infections, or revision surgery may include the cost of long-term antibiotics, hospitalization, or lost revenue from hours/days of missed work...
February 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28145823/clinical-practice-guideline-improving-nasal-form-and-function-after-rhinoplasty
#11
Lisa E Ishii, Travis T Tollefson, Gregory J Basura, Richard M Rosenfeld, Peter J Abramson, Scott R Chaiet, Kara S Davis, Karl Doghramji, Edward H Farrior, Sandra A Finestone, Stacey L Ishman, Robert X Murphy, John G Park, Michael Setzen, Deborah J Strike, Sandra A Walsh, Jeremy P Warner, Lorraine C Nnacheta
Objective Rhinoplasty, a surgical procedure that alters the shape or appearance of the nose while preserving or enhancing the nasal airway, ranks among the most commonly performed cosmetic procedures in the United States, with >200,000 procedures reported in 2014. While it is difficult to calculate the exact economic burden incurred by rhinoplasty patients following surgery with or without complications, the average rhinoplasty procedure typically exceeds $4000. The costs incurred due to complications, infections, or revision surgery may include the cost of long-term antibiotics, hospitalization, or lost revenue from hours/days of missed work...
February 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28131423/angiotensin-receptor-blockade-improves-cardiac-surgical-outcomes-in-patients-with-metabolic-syndrome
#12
Michael W Manning, Mary Cooter, Joseph Mathew, John Alexander, Eric Peterson, T Bruce Ferguson, Renato Lopes, Mihai Podgoreanu
BACKGROUND: Perioperative use of angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEis) in patients undergoing cardiac operations remains controversial. The current practice of discontinuing renin-angiotensin-system inhibitors preoperatively may negate their beneficial effects in vulnerable populations, including patients with metabolic syndrome, who exhibit elevated renin-angiotensin system activity. We hypothesized that preoperative ARB use is associated with reduced incidence of postoperative complications, compared with ACEi or no drug, in patients with metabolic syndrome undergoing coronary artery bypass grafting...
January 25, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28121034/alternatives-to-antibiotics-for-prevention-of-surgical-infection
#13
REVIEW
I B M Ploegmakers, S W M Olde Damink, S O Breukink
BACKGROUND: Surgical-site infection (SSI) is still the second most common healthcare-associated infection, after respiratory tract infection. SSIs are associated with higher morbidity and mortality rates, and result in enormous healthcare costs. In the past decade, several guidelines have been developed that aim to reduce the incidence of SSI. Unfortunately, there is no consensus amongst the guidelines, and some are already outdated. This review discusses the recent literature regarding alternatives to antibiotics for prevention of SSI...
January 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28109798/adverse-events-associated-with-surgical-antibiotic-prophylaxis-for-outpatient-circumcisions-at-us-children-s-hospitals
#14
Katherine H Chan, Benjamin M Whittam, Elizabeth A S Moser, Mark P Cain, William E Bennett
INTRODUCTION: Doctors often use surgical antibiotic prophylaxis (SAP) despite limited evidence to support its efficacy. We sought to determine the association between SAP in children undergoing circumcision and the rate of perioperative adverse events. MATERIAL AND METHODS: We performed a retrospective study of males >30 days old and <18 years old who underwent circumcision from 2004 to 2014 using the Pediatric Health Information System database. We excluded inpatients and those with any concomitant procedures...
November 22, 2016: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28105080/current-practice-of-antibiotic-prophylaxis-for-surgical-fixation-of-closed-long-bone-fractures-a-survey-of-297-members-of-the-orthopaedic-trauma-association
#15
Itai Gans, Amit Jain, Norachart Sirisreetreerux, Elliott R Haut, Erik A Hasenboehler
BACKGROUND: The risk of postoperative surgical site infection after long bone fracture fixation can be decreased with appropriate antibiotic use. However, there is no agreement on the superiority of a single- or multiple-dose perioperative regimen of antibiotic prophylaxis. The purpose of this study is to determine the following: 1) What are the current practice patterns of orthopaedic trauma surgeons in using perioperative antibiotics for closed long bone fractures? 2) What is the current knowledge of published antibiotic prophylaxis guidelines among orthopaedic trauma surgeons? 3) Are orthopaedic surgeons willing to change their current practices? METHODS: A questionnaire was distributed via email between September and December 2015 to 955 Orthopaedic Trauma Association members, of whom 297 (31%) responded...
2017: Patient Safety in Surgery
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
#16
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/28091694/-evidence-based-tep-technique
#17
F Köckerling
The guidelines of all international hernia societies recommend as procedures of choice the laparoendoscopic techniques total extraperitoneal patch plasty (TEP) and transabdominal preperitoneal patch plasty (TAPP) as well as the open Lichtenstein operation for elective inguinal hernia repair. The learning curve associated with the laparoendoscopic techniques, in particular TEP, is longer than that for the open Lichtenstein technique due to the complexity of the procedures. Accordingly, for laparoendoscopic techniques it is particularly important that the operations are conducted in a standardized manner in compliance with the evidence-based recommendations given for the technical details...
January 13, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28062326/the-impact-of-comorbidity-on-surgical-outcomes-in-older-adults-with-cancer
#18
REVIEW
Virginia Sun, Peggy S Burhenn, Lily Lai, Arti Hurria
OBJECTIVES: To provide an overview of the impact of comorbidity on surgical outcomes and postoperative geriatric events in older adults with cancer, and review key components of quality perioperative nursing care of older adults with cancer. DATA SOURCES: Journal articles, research reports, state of the science papers, position papers, and clinical guidelines from professional organizations. CONCLUSION: The high prevalence of multiple comorbidities and the associated burden of geriatric events in older adults after cancer surgery have a substantial impact on surgical outcomes, quality of life, and health care costs...
February 2017: Seminars in Oncology Nursing
https://www.readbyqxmd.com/read/28041996/utilization-of-perioperative-systemic-chemotherapy-in-upper-tract-urothelial-carcinoma
#19
Greg E Gin, Nora H Ruel, Steven V Kardos, John P Sfakianos, Edward Uchio, Clayton S Lau, Bertram E Yuh
INTRODUCTION: Evidence for the use of perioperative chemotherapy (PC) in upper tract urothelial carcinoma (UTUC) is largely derived from level I evidence for invasive urothelial carcinoma of the bladder (UCB). There has been an increase in PC for urothelial carcinoma of the bladder, as it has disseminated into clinical practice. Therefore, we sought to not only analyze trends in the utilization of PC in UTUC, but also assess factors associated with its use in a large cancer registry database...
December 29, 2016: Urologic Oncology
https://www.readbyqxmd.com/read/28027086/an-ambulatory-surgery-perioperative-surgical-home-in-kaiser-permanente-settings-practice-and-outcomes
#20
Chunyuan Qiu, Joseph Rinehart, Vu T Nguyen, Maxime Cannesson, Atef Morkos, Diana LaPlace, Narendra S Trivedi, Philip D Mercado, Zeev N Kain
BACKGROUND: The aim of this study is to describe the design, implementation, and associated outcome changes of a Perioperative Surgical Home (PSH) for patients undergoing ambulatory laparoscopic cholecystectomy in a Kaiser Permanente practice model. METHODS: A multidisciplinary planning committee of 15 individuals developed and implemented a new PSH program. A total of 878 subjects were included in the preimplementation period (T-fast), and 1082 patients were included in the postimplementation period (PSH) based on the date of their surgery...
March 2017: Anesthesia and Analgesia
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