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the association of perioperative practice

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https://www.readbyqxmd.com/read/28507883/risk-factors-for-medical-and-surgical-complications-following-single-level-alif
#1
Winward Choy, Nikki Barrington, Roxanna M Garcia, Robert B Kim, Heron Rodriguez, Sandi Lam, Nader Dahdaleh, Zachary A Smith
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: The objective of the study was to determine rates of medical and surgical postoperative complications following anterior lumbar interbody fusion (ALIF) along with their associated predictors. METHODS: Using the American College of Surgeons National Surgical Quality Improvement database, patients who underwent single-level ALIF surgery from 2006 to 2013 were identified. The 30-day rate of postoperative medical and surgical complications along with associated risk factors were evaluated by multivariable logistic regression...
April 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28506488/perioperative-functional-neuroimaging-of-gliomas-in-eloquent-brain-areas
#2
C Mellerio, S Charron, S Lion, P Roca, G Kuchcinski, L Legrand, M Edjlali, O Naggara, J-F Meder, J Pallud, C Oppenheim
Surgical resection of gliomas involving eloquent brain areas must be maximal in order to improve patients' survival, and safe to prevent postoperative impairments. Therefore, the precise spatial relationship between the lesion and eloquent brain areas needs to be established. Functional magnetic resonance imaging and diffusion tensor imaging are robust methods with increasing indications in neurosurgery for past decade. The aim of this review article is not only to pinpoint the major limitations of these methods in order to avoid erroneous conclusions, but also to detail practical aspects associated with the main paradigms routinely used in functional magnetic resonance imaging, and to discuss recent validation of functional magnetic resonance imaging and diffusion tensor imaging results with direct electrical stimulation during awake surgery...
May 12, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28504992/trends-in-perioperative-practice-and-resource-utilization-in-patients-with-obstructive-sleep-apnea-undergoing-joint-arthroplasty
#3
Crispiana Cozowicz, Jashvant Poeran, Ashley Olson, Madhu Mazumdar, Eva E Mörwald, Stavros G Memtsoudis
BACKGROUND: Emerging evidence associating obstructive sleep apnea (OSA) with adverse perioperative outcomes has recently heightened the level of awareness among perioperative physicians. In particular, estimates projecting the high prevalence of this condition in the surgical population highlight the necessity of the development and adherence to "best clinical practices." In this context, a number of expert panels have generated recommendations in an effort to provide guidance for perioperative decision-making...
May 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28495063/topical-amiodarone-during-cardiac-surgery-does-epicardial-application-of-amiodarone-prevent-postoperative-atrial-fibrillation
#4
David Greenstein, Jordan Beau, Gary Gottlieb, Daniel Teller, Alexander Kulik
OBJECTIVES: Atrial fibrillation (AF) is a common complication after cardiac surgery. Topical amiodarone on the epicardium may help prevent postoperative AF while avoiding the side effects of its systemic administration. The purpose of this study was to evaluate the all-comer strategy of epicardial amiodarone application for the prevention of postoperative AF. METHODS: A retrospective observational study was performed that evaluated the incidence of new-onset AF in a consecutive series of cardiac surgery patients who were treated with either no amiodarone (historical control, n = 100), epicardial application of amiodarone mixed in a topical hydrogel (n = 50), or epicardial application of an amiodarone-soaked sealant patch (n = 50)...
April 13, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28493562/perioperative-practices-in-thyroid-surgery-an-international-survey
#5
Anastasios Maniakas, Apostolos Christopoulos, Eric Bissada, Louis Guertin, Marie-Jo Olivier, Jacques Malaise, Tareck Ayad
BACKGROUND: Perioperative practices in thyroid surgery vary from one specialty, institution, or country to the next. We evaluated the preoperative, intraoperative, and postoperative practices of thyroid surgeons focusing on preoperative ultrasound, vocal cord evaluation, wound drains, and hospitalization duration, among others. METHODS: A survey was sent to 7 different otolaryngology and endocrine/general surgery associations. RESULTS: There were 965 respondents from 52 countries...
May 11, 2017: Head & Neck
https://www.readbyqxmd.com/read/28493038/perioperative-implications-of-thoracic-decortications-a-retrospective-cohort-study
#6
Jay Gorman, Duane Funk, Sadeesh Srinathan, John Embil, Linda Girling, Stephen Kowalski
PURPOSE: An increasing number of thoracic decortications have been performed in Manitoba, from five in 2007 to 45 in 2014. The primary objective of this study was to define the epidemiology of decortications in Manitoba. The secondary objective was to compare patients who underwent decortication due to primary infectious vs non-infectious etiology with respect to their perioperative outcomes. METHODS: Data for this cohort study were extracted from consecutive charts of all adult patients who underwent a decortication in Manitoba from 2007-2014 inclusive...
May 10, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28492399/acute-kidney-injury-after-pediatric-cardiac-surgery-a-secondary-analysis-of-the-safe-pediatric-euglycemia-after-cardiac-surgery-trial
#7
Joshua J Blinder, Lisa A Asaro, David Wypij, David T Selewski, Michael S D Agus, Michael Gaies, Michael A Ferguson
OBJECTIVES: To understand the effect of tight glycemic control on cardiac surgery-associated acute kidney injury. DESIGN: Secondary analysis of data from the Safe Pediatric Euglycemia after Cardiac Surgery trial of tight glycemic control versus standard care. SETTING: Pediatric cardiac ICUs at University of Michigan, C.S. Mott Children's Hospital, and Boston Children's Hospital. PATIENTS: Children 0-36 months old undergoing congenital cardiac surgery...
May 10, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28489212/impact-of-using-a-local-protocol-in-preoperative-testing-blind-randomized-clinical-trial
#8
Mônica Loureiro Santos, Antônio Carlos Iglesias
Objective: to evaluate the impact of the use of a local protocol of preoperative test requests in reducing the number of exams requested and in the occurrence of changes in surgical anesthetic management and perioperative complications. Methods: we conducted a randomized, blinded clinical trial at the Gaffrée and Guinle University Hospital with 405 patients candidates for elective surgery randomly divided into two groups, according to the practice of requesting preoperative exams: a group with non-selectively requested exams and a protocol group with exams requested according to the study protocol...
January 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28486371/trends-in-mode-of-hysterectomy-after-the-u-s-food-and-drug-administration-power-morcellation-advisory
#9
Helga Ottarsdottir, Sarah L Cohen, Mary Cox, Allison Vitonis, Jon I Einarsson
OBJECTIVE: To evaluate the trends in mode of surgery for benign hysterectomy after the 2014 U.S. Food and Drug Administration (FDA) morcellation guidelines. METHODS: This is a retrospective review of all patients who underwent a hysterectomy for benign indications, specifically for leiomyomas, at Brigham and Women's Hospital from 2013 to 2015. The rates of abdominal, vaginal, laparoscopic, and robotic-assisted laparoscopic hysterectomy as well as the perioperative outcomes were compared over the study period...
May 5, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28482650/obesity-and-perioperative-noninvasive-ventilation-in-bariatric-surgery
#10
Michele Carron, Francesco Zarantonello, Giovanna Ieppariello, Carlo Ori
The incidence and prevalence of obesity continues to increase globally. Physicians will therefore provide care for an increasing number of obese patients in their clinical practice. Optimal management of these patients is required to minimize the risk of perioperative complications that increase morbidity and mortality. Obesity affects the respiratory function. It is generally associated with reduced lung volume with increased atelectasis, decreased lung and chest wall compliance, increased airway resistance, and moderate to severe hypoxemia...
June 2017: Minerva Chirurgica
https://www.readbyqxmd.com/read/28481995/influence-of-anaemia-and-red-blood-cell-transfusion-on-mortality-in-high-cardiac-risk-patients-undergoing-major-non-cardiac-surgery-a-retrospective-cohort-study
#11
S Feng, M Machina, W S Beattie
Background.: Perioperative anaemia is common. Physicians believe that patients at increased cardiac risk do not tolerate anaemia and, consequently, these patients receive transfusions earlier and more often. This practice runs counter to a growing body of evidence that perioperative red blood cell (RBC) transfusion is harmful The aims of this study were as follows: (i) to assess the effects of transfusion at moderate to severely low ranges of postoperative haemoglobin concentrations; and (ii) to assess whether transfusion was beneficial in patients at high cardiac risk within these haemoglobin ranges...
May 7, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28472245/beta-blocker-subtype-and-risks-of-perioperative-adverse-events-following-non-cardiac-surgery-a-nationwide-cohort-study
#12
Mads E Jørgensen, Robert D Sanders, Lars Køber, Kala Mehta, Christian Torp-Pedersen, Mark A Hlatky, Jannik L Pallisgaard, Richard E Shaw, Gunnar H Gislason, Per F Jensen, Charlotte Andersson
Aims: Beta-blockers vary in pharmacodynamics and pharmacokinetic properties. It is unknown whether specific types are associated with increased perioperative risks. We evaluated perioperative risks associated with beta-blocker subtypes, overall and in patient subgroups. Methods and results: We performed a Danish Nationwide cohort study, 2005-2011, of patients treated chronically with beta blocker (atenolol, bisoprolol, carvedilol, metoprolol, propranolol, or other) prior to non-cardiac surgery...
May 2, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28458067/effect-of-liberal-blood-transfusion-on-clinical-outcomes-and-cost-in-spine-surgery-patients
#13
Taylor E Purvis, C Rory Goodwin, Rafael De la Garza-Ramos, A Karim Ahmed, Virginie Lafage, Brian J Neuman, Peter G Passias, Khaled M Kebaish, Steven M Frank, Daniel M Sciubba
BACKGROUND CONTEXT: Blood transfusions in spine surgery are shown to be associated with increased patient morbidity. The association between transfusion performed using a liberal hemoglobin (Hb) trigger-defined as an intraoperative Hb level of ≥10 g/dL, a postoperative level of ≥8 g/dL, or a whole hospital nadir between 8 and 10 g/dL-and perioperative morbidity and cost in spine surgery patients is unknown and thus was investigated in this study. PURPOSE: This study aimed to describe the perioperative outcomes and economic cost associated with liberal Hb trigger transfusion among spine surgery patients...
April 27, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28454611/inadvertent-perioperative-hypothermia-current-nursing-knowledge
#14
Karen K Giuliano, Jane Hendricks
Inadvertent perioperative hypothermia is estimated to affect 70% of surgical patients and is associated with adverse clinical outcomes, lengthened hospital stays, and increased costs. To better understand the current level of nursing knowledge on this subject since the release of the "Guideline for prevention of unplanned patient hypothermia," we conducted an e-mail survey of AORN members. The overall response rate was 6.5% (N = 324), and most responding nurses overestimated or underestimated the lower and upper limits for normothermia...
May 2017: AORN Journal
https://www.readbyqxmd.com/read/28454610/indwelling-urinary-catheters-a%C3%A2-pathway-to-health-care-associated-infections
#15
Judith L Clayton
When a urinary catheter is not inserted using proper technique, becomes unclean, or remains in place for too long, microorganisms can travel through the catheter lumen or along the outside of the catheter and infect the bladder or kidneys, resulting in a catheter-associated urinary tract infection (CAUTI). Urinary tract infections resulting from catheter use are one of the most common health care-associated infections. The insertion of a urinary catheter is considered to be routine care. Improving practices of placement and removal of urinary catheters requires education aimed at changing the habits of nurses and physicians...
May 2017: AORN Journal
https://www.readbyqxmd.com/read/28437809/reactive-rather-than-proactive-diabetes-management-in-the-perioperative-period
#16
Inge Hommel, Petra J van Gurp, Alfons A den Broeder, Hub Wollersheim, Femke Atsma, Marlies E J L Hulscher, Cees J Tack
As perioperative hyperglycemia is associated with poor postoperative patient outcomes, clinical guidelines provide recommendations for optimal perioperative glucose control. It is unclear to what extent recommended glucose levels are met in daily practice, and little is known about factors that influence these levels. We describe blood glucose levels throughout the hospital care pathway in 375 non-critically ill patients with diabetes who underwent major surgery (abdominal, cardiac, or orthopedic) in 6 hospitals, examine determinants of these levels including adherence to 9 quality indicators for optimal perioperative diabetes care, and perform qualitative interviews to identify barriers for optimal care...
April 24, 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/28426464/comparative-effectiveness-in-urology-a-state-of-the-art-review-utilizing-a-systematic-approach
#17
Jathin Bandari, Charles B Wessel, Bruce L Jacobs
PURPOSE OF REVIEW: Comparative effectiveness research plays a vital role in healthcare delivery by guiding evidence-based practices. We performed a state-of-the-art review of comparative effectiveness research in the urology literature for 2016, utilizing a systematic approach. Seven high-impact papers are reviewed in detail. RECENT FINDINGS: Across the breadth of urology, there were several important studies in comparative effectiveness research, of which we will highlight two randomized controlled trials and five observational trials: radiotherapy, prostatectomy, and active monitoring have equivalent mortality outcomes in patients with localized prostate cancer; the ideal modality of patient education is yet to be determined, and written education has minimal effect on patient perception of prostate specific antigen screening; robotic prostatectomy is associated with higher perioperative complication rates on a population basis; racial disparities exist in incontinence rates after treatment for localized prostate cancer, but not in irritative, bowel, or sexual function; androgen deprivation therapy is associated with higher fracture, peripheral artery disease, and cardiac-related complications than bilateral orchiectomy; robotic and open cystectomy offer comparable cancer-specific mortality and perioperative outcomes; and bonuses for low-cost hospitals can inadvertently reward low-quality hospitals...
April 19, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28421343/antiplatelets-and-anticoagulants-in-vitreoretinal-surgery-with-a-special-emphasis-on-novel-anticoagulants-a-national-survey-and-review
#18
REVIEW
Rupa Patel, Stephen Charles, Assad Jalil
PURPOSE: To survey current practice and opinion regarding the cessation of antiplatelet and anticoagulant agents prior to vitreoretinal surgery, with special emphasis on novel anticoagulants, and to provide an overview of current literature. METHODS: An online survey was sent to 167 members of the British and Eire Association of Vitreoretinal Surgeons (BEAVRS). A literature search and analysis was conducted on studies that reviewed the bleeding risk of antiplatelet and anticoagulant agents...
April 18, 2017: Graefe's Archive for Clinical and Experimental Ophthalmology
https://www.readbyqxmd.com/read/28421314/the-impact-of-body-mass-index-on-the-risk-of-high-spinal-block-in-parturients-undergoing-cesarean-delivery-a-retrospective-cohort-study
#19
Agnes M Lamon, Lisa M Einhorn, Mary Cooter, Ashraf S Habib
PURPOSE: To investigate the hypothesis that the risk of high spinal block is not increased in obese parturients undergoing cesarean delivery compared to non-obese parturients. METHODS: This is a retrospective study at an academic center. We searched the perioperative database for women who underwent cesarean delivery under spinal or combined spinal epidural anesthesia with hyperbaric bupivacaine ≥10.5 mg. A body mass index (BMI) ≥30 kg/m(2) was defined as obese...
April 18, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28419035/clinical-practice-guidelines-decrease-unnecessary-echocardiograms-before-hip-fracture-surgery
#20
Chris Adair, Eric Swart, Rachel Seymour, Joshua Patt, Madhav A Karunakar
BACKGROUND: Preoperative assessment of geriatric patients with a hip fracture may include transthoracic echocardiography (TTE), which increases resource utilization and cost and may delay surgery. The purpose of this study was to evaluate preoperative TTE utilization at a single institution in order to determine (1) how often TTE is ordered in accordance with clinical practice guidelines (CPGs), (2) how frequently TTE reveals cardiac disease that may alter medical or anesthesia management, and (3) whether following CPGs reduces unnecessary TTE utilization without potentially missing important disease...
April 19, 2017: Journal of Bone and Joint Surgery. American Volume
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