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Anesthesia risk score

Chang-Hua Li, Wen-Liang Chen, Guang-Mao Lin
OBJECTIVE: To study the risk factors of perioperative heart failure in the elderly patients with femoral shaft fracture by the regression analysis, so as to provide relevant clinical reference. METHODS: From July 2012 to April 2017, 143 elderly patients with femoral shaft fracture who underwent surgical treatment in our hospital were retrospectively studied. Among them, 25 patients with perioperative heart failure included 10 males and 15 females with a mean age of (77...
February 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Joshua I Rosenbloom, Methodius G Tuuli, Molly J Stout, Omar M Young, Candice L Woolfolk, Julia D López, George A Macones, Alison G Cahill
OBJECTIVE:  To determine the factors associated with severe maternal morbidity in a modern cohort of women laboring at term and to create a prediction model. STUDY DESIGN:  This is a retrospective cohort study of all term, laboring patients with live births at a single tertiary care center from 2004 to 2014. The primary outcome was composite maternal morbidity including organ failure, amniotic fluid embolism, anesthesia complications, sepsis, shock, thrombotic events, transfusion, or hysterectomy...
February 8, 2018: American Journal of Perinatology
Laurent G Glance, Richard P Dutton, Changyong Feng, Yue Li, Stewart J Lustik, Andrew W Dick
BACKGROUND: Under the Merit-based Incentive Payment System, physician payment will be adjusted using a composite performance score that has 4 components, one of which is resource use. The objective of this exploratory study is to quantify the facility-level variation in surgical case duration for common surgeries to examine the feasibility of using surgical case duration as a performance metric. METHODS: We used data from the National Anesthesia Clinical Outcomes Registry on 404,987 adult patients undergoing one of 6 general surgical or orthopedic procedures: laparoscopic appendectomy, laparoscopic cholecystectomy, laparoscopic cholecystectomy with intraoperative cholangiogram, knee arthroscopy, laminectomy, and total hip replacement...
March 6, 2018: Anesthesia and Analgesia
Jenny Ringblom, Ingrid Wåhlin, Marie Proczkowska
BACKGROUND: Emergence delirium and emergence agitation have been a subject of interest since the early 1960s. This behavior has been associated with increased risk of injury in children and dissatisfaction with anesthesia care in their parents. The Pediatric Anesthesia Emergence Delirium Scale is a commonly used instrument for codifying and recording this behavior. AIMS: The aim of this study was to psychometrically evaluate the Pediatric Anesthesia Emergence Delirium scale, focusing on the factor structure, in a sample of children recovering from anesthesia after surgery or diagnostic procedures...
March 6, 2018: Paediatric Anaesthesia
Etienne St-Louis, Nadia Safa, Elena Guadagno, Robert Baird
BACKGROUND: Gastrostomy tubes are a common adjunct to the care of vulnerable pediatric patients. This study systematically evaluates the epidemiology and risk-factors for gastrocutaneous fistulae (GCF) after gastrostomy removal in children and reviews treatment options focusing on nonoperative management (NOM). METHODS: After protocol registration (CRD-42017059565), multiple databases were searched. Studies describing epidemiology in children and GCF treatment at any age were included...
February 8, 2018: Journal of Pediatric Surgery
Khaled Dajani, Mohammed Almualim, Akshay Menon, Jacqueline Volpi-Abadie, Kierstin Lund
OBJECTIVES: Management of pediatric patients with neurological diagnoses can be challenging for anesthesiologists. We sought to determine whether preexisting neurologic disease could serve as an intrinsic risk factor for prolonged emergence. METHODS: Following institutional review board approval, we conducted a database search from 2012 to 2015. Included were patients aged 0 to 18 years undergoing ambulatory procedures, and carrying neurological diagnoses that profoundly affected their development...
March 2018: Southern Medical Journal
Karina Woodling, Juan Fiorda-Diaz, Bradley A Otto, Christie A Barnes, Alberto A Uribe, Sergio D Bergese, Vedat Yildiz, Nicoleta Stoicea, Michael G Guertin
Background: Obstructive sleep apnea (OSA) may be related to episodes of oxygen de-saturation, hypercapnia, cardiovascular dysfunction, cor-pulmonale, and pulmonary hypertension. STOP-BANG is an acronym for eight specific questions used to assess the likelihood of OSA. If the individual exhibits three or more of these indicators, he/she should be considered to be at high risk for OSA complications. Therefore, the decision of proceeding with inpatient versus outpatient ENT surgery still remains controversial...
February 2018: Laryngoscope Investigative Otolaryngology
Albert Castellheim, Sebastian Lundström, Mattias Molin, Ralf Kuja-Halkola, Carina Gillberg, Christopher Gillberg
BACKGROUND: The role of general anesthetics as a risk factor for possible neurodevelopmental disorders (NDDs) in humans is unresolved. The investigation of the role of anesthetics in the development of postgeneral anesthesia (anesthesia onward) NDDs has proven to be complicated, partly because of the inherent confounding in clinical cohort studies, and partly by the fact that anesthetics are only one part in the complex process of anesthesia-surgery. METHODS: Utilizing the Swedish databases Child and Adolescent Twins Study in Sweden (CATSS) and National Patient Register (NPR), we investigated twins discordant for anesthesia, born between 1997 and 2004 for traits of NDDs...
February 21, 2018: Journal of Child Psychology and Psychiatry, and Allied Disciplines
N Patrick Mayr, Gunther Wiesner, Pieter van der Starre, Alexander Hapfelmeier, Gertrud Goppel, Albert Markus Kasel, Christian Hengstenberg, Oliver Husser, Heribert Schunkert, Peter Tassani-Prell
PURPOSE: Different sedation regimens have been described for use during transfemoral transcatheter aortic valve implantation (tf-TAVI) for treatment in patients with severe aortic stenosis. The purpose of this study was to compare dexmedetomidine (DEX) with a combination of propofol-opioid (PO) with respect to periprocedural gas exchange and hemodynamic support. METHODS: Data from a cohort of patients sedated with either DEX or PO for tf-TAVI were retrospectively analyzed from a prospectively maintained TAVI registry...
February 20, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Canser Yilmaz Demir, Nureddin Yuzkat
BACKGROUND: Emergence agitation (EA), defined as restlessness, disorientation, excitation, and/or inconsolable crying, is a common phenomenon during early recovery from general anesthesia. In this study, we aimed to determine the (1) EA incidence after rhinoplasty operations in adults; (2) the effects of ketamine administered at sub-anesthetic doses just 20 min before the end of the surgery in rhinoplasty operations on agitation level, postoperative pain, side effects, and complications; and (3) to determine the risk factors for EA in adults after rhinoplasty...
February 20, 2018: Aesthetic Plastic Surgery
Joerg Schnoor, Thilo Busch, Nazar Turemuratov, Andreas Merkenschlager
BACKGROUND: Children with obstructive sleep apnea are at high risk for perioperative airway obstruction. Many "at risk" children may remain unrecognized. The aim of this study is to find a clinically practicable test to identify obstructive sleep apnea in childhood. METHODS: In this pilot study, we prospectively compared four parental questionnaires with the respective findings of subsequent sleep laboratory testing in children. Right before sleep laboratory testing, children's parents answered both the Pediatric Sleep Questionnaire, a subscale of the Sleep Related Breathing Disorder questionnaire (PSQ-SRBD-Subscale), and an eight-item questionnaire derived from it...
February 20, 2018: BMC Anesthesiology
Ju-Lei Ma, Yun-Qin Xu, Tu-Gang Shen, Qiang Li
OBJECTIVE: To analyze the risk factor of infection for complex tibial plateau fractures after operation. METHODS: Totally clinical data of 293 patients with complex tibial plateau fractures underwent open reduction and internal fixation were retrospectively analyzed from September 2010 to March 2015, including 199 males and 94 females, ranging in age from 17 to 80 years old with an average of 47.3 years old. The possible risk factors such as gender, age, smoking, diabetes, type of fracture(open/closed), classification of open fracture(Gustilo-Anderson classification), classification of soft tissue injury in closed fracture (Tscherne-Gotzen classification), fracture classification(Schatzker V/VI), osteofascial compartment syndrome, ASA score, anesthesia, timing of surgery, operative time(<=150 min/>150 min), surgical approach, combined approach or not, internal fixation site were studied...
October 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Christopher J Pannucci, Kory I Fleming
OBJECTIVE: Perioperative venous thromboembolism (VTE) risk can be quantified with the 2005 Caprini score. The Caprini score has previously been validated by review of the electronic medical record (EMR) in >3000 plastic surgery patients. However, the accuracy of Caprini-based risk stratification using the EMR, as opposed to face-to-face contact with the patient, remains unknown. METHODS: Plastic and reconstructive surgery patients who had surgery under general anesthesia, required postoperative admission, and were started on enoxaparin prophylaxis were identified...
February 13, 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Jonathon P Fanning, Allan J Wesley, Darren L Walters, Andrew A Wong, Adrian G Barnett, Wendy E Strugnell, David G Platts, John F Fraser
BACKGROUND: Transcatheter aortic valve implantation (TAVI) is associated with a high incidence of cerebrovascular injury. As these injuries are thought to be primarily embolic, neuroprotection strategies have focused on embolic protection devices. However, the topographical distribution of cerebral emboli and how this impacts on the effectiveness of these devices have not been thoroughly assessed. Here, we evaluated the anatomical characteristics of magnetic resonance imaging (MRI)-defined cerebral ischemic lesions occurring secondary to TAVI to enhance our understanding of the distribution of cardioembolic phenomena...
March 2018: American Heart Journal
Mariela M Lopez, Derrick Zech, Judith L Linton, Steven J Blackwell
OBJECTIVE: Dexmedetomidine is a parenteral agent that combines the benefits of cooperative sedation, anxiolysis, and analgesia without the risks of respiratory depression. Off-label use has been reported in children. We have introduced dexmedetomidine for use in patients having undergone alveolar bone graft (ABG). The objective is to demonstrate the value and safety of postoperative dexmedetomidine infusion in a non-ICU setting following ABG. DESIGN: A retrospective review was performed on patients who underwent ABG by the senior author...
January 1, 2018: Cleft Palate-craniofacial Journal
Kristine E Day, Andrew C Prince, Chee Paul Lin, Benjamin J Greene, William R Carroll
Objective The Surgical Apgar Score (SAS) is a validated postoperative complication prediction model. The purpose of this study was to investigate the utility of the SAS in a diverse head and neck cancer population and to compare it with a recently developed modified SAS (mSAS) that accounts for intraoperative transfusion. Study Design Case series with chart review. Setting Academic tertiary care medical center. Subjects and Methods This study comprised 713 patients undergoing surgery for head and neck cancer from April 2012 to March 2015...
February 1, 2018: Otolaryngology—Head and Neck Surgery
Change Zhu, Saiji Zhang, Zhiqing Gu, Yiru Tong, Rong Wei
BACKGROUND: Dexamethasone has become a popular additive for regional anesthesia. The aim of this meta-analysis was to assess the effectiveness of this additive on the duration of postoperative analgesia, postoperative vomiting, and possible adverse events in pediatrics. METHODS: We searched databases, conference records, and registered trials for randomized controlled trials. The databases included the Cochrane Library, JBI Database of Systematic Reviews, PubMed, ISI Web of Knowledge, Science-Direct, and Embase...
March 2018: Paediatric Anaesthesia
Nicholas M Hernandez, Joshua A Parry, Tad M Mabry, Michael J Taunton
BACKGROUND: The purpose of this study was to evaluate the effect of preoperative opioid use on opioid prescriptions, refills, and clinical outcomes after total knee arthroplasty (TKA). METHODS: A retrospective review identified 53 patients on preoperative opioids who were matched 1:2 to 106 opioid-naive patients undergoing primary TKA with at least 2-year follow-up. Opioid refills, Knee Society Score (preoperative and follow-up), morphine equivalent dose (MED) prescribed, and persistent opioid use were compared between groups...
January 16, 2018: Journal of Arthroplasty
Mohammed Jamil Asha, Benjamin Fisher, Jamilla Kausar, Hayley Garratt, Hari Krovvidi, Colin Shirley, Anwen White, Ramesh Chelvarajah, Ismail Ughratdar, James A Hodson, Hardev Pall, Rosalind D Mitchell
OBJECTIVES: The authors have previously reported on the technical feasibility of subthalamic nucleus deep brain stimulation (STN DBS) under general anesthesia (GA) with microelectrode recording (MER) guidance in Parkinsonian patients who continued dopaminergic therapy until surgery. This paper presents the results of a prospective cohort analysis to verify the outcome of the initial study, and report on wider aspects of clinical outcome and postoperative recovery. METHODS: All patients in the study group continued dopaminergic therapy until GA was administered...
February 2, 2018: Acta Neurochirurgica
P Maxwell Courtney, Mark I Froimson, R Michael Meneghini, Gwo-Chin Lee, Craig J Della Valle
BACKGROUND: The Centers for Medicare and Medicaid Services has solicited public comments for the 2017 Proposed Rule to consider removing total knee arthroplasty (TKA) from the Inpatient Only List. The purpose of this study is to compare the complication rates between outpatient (same-day discharge), short-stay (discharge within 1 day), and inpatient TKA and to identify the ideal candidates for a short-stay or outpatient procedure. METHODS: We queried the American College of Surgeons-National Surgical Quality Improvement Program database for patients over age 65 years who underwent TKA from 2014 to 2015...
January 16, 2018: Journal of Arthroplasty
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