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Vascular surgery risk score

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https://www.readbyqxmd.com/read/28096064/evaluation-of-financial-burdens-following-complications-after-major-surgery-in-france-potential-returns-after-perioperative-goal-directed-therapy
#1
Alain Landais, Morgane Morel, Jacques Goldstein, Jerôme Loriau, Annie Fresnel, Corinne Chevalier, Gilles Rejasse, Pascal Alfonsi, Claude Ecoffey
OBJECTIVE: Perioperative goal directed therapy (PGDT) has been demonstrated to improve postoperative outcomes and reduce the length of hospital stays. The objective of our analysis was to evaluate the cost of complications, derived from French hospital payments, and calculate the potential cost savings and length of hospital stay reductions. METHODS: The billing of 2,388 patients who underwent scheduled high-risk surgery (i.e. major abdominal, gynaecologic, urological, vascular, and orthopaedic interventions) over three years was retrospectively collected from three French hospitals (one public - teaching, one public, and one private hospital)...
January 13, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28092285/perioperative-%C3%AE-blockers-in-patients-undergoing-noncardiac-surgery-scientific-misconduct-and-clinical-guidelines
#2
Dhauna Karam, Rohit Arora
BACKGROUND: β-blocker use in perioperative period of noncardiac surgeries has been a topic of debate since many years. Earlier studies conducted in the 90s showed decreased cardiac adverse events and improved postoperative outcomes with β-blocker use. Based on this, the ACCF and ESC published guidelines strongly supporting β-blocker use. But contemporaneous studies conducted revealed conflicting evidence and have also proven some of the earlier studies to be fraudulent. Although ACCF guidelines have been updated to partially reflect the changes, ESC guidelines continue to support β-blocker use...
January 10, 2017: American Journal of Therapeutics
https://www.readbyqxmd.com/read/28073665/predictive-ability-of-the-society-for-vascular-surgery-wound-ischemia-and-foot-infection-wifi-classification-system-after-first-time-lower-extremity-revascularizations
#3
Jeremy D Darling, John C McCallum, Peter A Soden, Raul J Guzman, Mark C Wyers, Allen D Hamdan, Hence J Verhagen, Marc L Schermerhorn
OBJECTIVE: The Society for Vascular Surgery (SVS) Wound, Ischemia and foot Infection (WIfI) classification system was proposed to predict 1-year amputation risk and potential benefit from revascularization. Our goal was to evaluate the predictive ability of this scale in a real-world selection of patients undergoing a first-time lower extremity revascularization for chronic limb-threatening ischemia (CLTI). METHODS: From 2005 to 2014, 1336 limbs underwent a first-time lower extremity revascularization for CLTI, of which 992 had sufficient data to classify all three WIfI components (wound, ischemia, and foot infection)...
January 7, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28045412/transcatheter-aortic-valve-implantation-with-the-edwards-sapien-3-valve-first-experiences-in-turkey
#4
Abdullah Nabi Aslan, Serdal Baştuğ, Hacı Ahmet Kasapkara, Hüseyin Ayhan, Hakan Süygün, Telat Keleş, Tahir Durmaz, Nihal Akar Bayram, Emine Bilen, Engin Bozkurt
OBJECTIVE: Transcatheter aortic valve implantation (TAVI) has shown promising results in patients with severe aortic stenosis (AS) at high risk for open heart surgery. We aimed to evaluate outcomes of patients who underwent TAVI with Edwards SAPIEN 3 Transcatheter Heart Valve (S3), a second-generation TAVI device. METHODS: Between November 2014 and June 2016, 31 high-risk patients received balloon-expandable S3 valve at Atatürk Training and Research Hospital that has the largest case series in Turkey...
December 2016: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28004457/clinical-and-ultrasound-characteristics-of-surgically-removed-adnexal-lesions-with-a-largest-diameter-%C3%A2-2-5-cm-a-pictorial-essay
#5
A Di Legge, P Pollastri, R Mancari, M Ludovisi, F Mascilini, D Franchi, D Jurkovic, M E Coccia, D Timmerman, G Scambia, A Testa, L Valentin
OBJECTIVES: The aim was to describe the ultrasound characteristics, the indications for surgery and the histological diagnoses of surgically removed adnexal masses with largest diameter <2.5 cm ("very small tumors"), to estimate sensitivity and specificity with regard to malignancy of subjective assessment of ultrasound images of very small tumors, and to present a gallery of ultrasound images of surgically removed very small tumors especially those causing diagnostic difficulties...
December 22, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27998608/a-score-to-estimate-30-day-mortality-after-intensive-care-admission-after-cardiac-surgery
#6
Yoan Lamarche, Mahsa Elmi-Sarabi, Lillian Ding, James G Abel, Demetrios Sirounis, André Y Denault
OBJECTIVE: Several risk-scoring systems have been developed to predict surgical mortality and complications in cardiac surgical patients, but none of the current systems include factors related to the intraoperative period. The purpose of this study was to develop a score that incorporates both preoperative and intraoperative factors so that it could be used for patients admitted to a cardiac surgical intensive care unit (ICU) immediately after surgery. METHOD: Preoperative and intraoperative data from 30,350 patients in four hospitals were used to build a multiple logistic regression model estimating 30-day mortality after cardiac surgery...
November 23, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27992624/association-of-perioperative-statin-use-with-mortality-and-morbidity-after-major-noncardiac-surgery
#7
Martin J London, Gregory G Schwartz, Kwan Hur, William G Henderson
Importance: The efficacy of statins in reducing perioperative cardiovascular and other organ system complications in patients undergoing noncardiac surgery remains controversial. Owing to a paucity of randomized clinical trials, analyses of large databases may facilitate informed hypothesis generation and more efficient trial design. Objective: To evaluate associations of early perioperative statin use with outcomes in a national cohort of veterans undergoing noncardiac surgery...
December 19, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27929930/validation-of-a-predictive-scoring-system-for-deep-sternal-wound-infection-after-bilateral-internal-thoracic-artery-grafting-in-a-cohort-of-french-patients
#8
Andrea Perrotti, Giuseppe Gatti, Enrica Dorigo, Gianfranco Sinagra, Aniello Pappalardo, Sidney Chocron
BACKGROUND: The Gatti score is a weighted scoring system based on risk factors for deep sternal wound infection (DSWI) that was created in an Italian center to predict DSWI risk after bilateral internal thoracic artery (BITA) grafting. No external evaluation based on validation samples derived from other surgical centers has been performed. The aim of this study is to perform this validation. PATIENTS AND METHODS: During 2015, BITA grafts were used as skeletonized conduits in all 255 consecutive patients with multi-vessel coronary disease who underwent isolated coronary bypass surgery at the Department of Thoracic and Cardio-Vascular Surgery, University Hospital Jean Minjoz, Besançon, France...
December 8, 2016: Surgical Infections
https://www.readbyqxmd.com/read/27907828/surgical-apgar-score-in-patients-undergoing-lumbar-fusion-for-degenerative-spine-diseases
#9
Chien-Yu Ou, Shih-Yuan Hsu, Jian-Hao Huang, Yu-Hua Huang
OBJECTIVE: Lumbar fusion is a procedure broadly performed for degenerative diseases of spines, but it is not without significant morbidities. Surgical Apgar Score (SAS), based on intraoperative blood loss, blood pressure, and heart rate, was developed for prognostic prediction in general and vascular operations. We aimed to examine whether the application of SAS in patients undergoing fusion procedures for degeneration of lumbar spines predicts in-hospital major complications. METHODS: One hundred and ninety-nine patients that underwent lumbar fusion operation for spine degeneration were enrolled in this retrospective study...
January 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/27871490/predictive-models-for-mortality-after-ruptured-aortic-aneurysm-repair-do-not-predict-futility-and-are-not-useful-for-clinical-decision-making
#10
Patrick C Thompson, Ronald L Dalman, E John Harris, Venita Chandra, Jason T Lee, Matthew W Mell
OBJECTIVE: The clinical decision-making utility of scoring algorithms for predicting mortality after ruptured abdominal aortic aneurysms (rAAAs) remains unknown. We sought to determine the clinical utility of the algorithms compared with our clinical decision making and outcomes for management of rAAA during a 10-year period. METHODS: Patients admitted with a diagnosis rAAA at a large university hospital were identified from 2005 to 2014. The Glasgow Aneurysm Score, Hardman Index, Vancouver Score, Edinburgh Ruptured Aneurysm Score, University of Washington Ruptured Aneurysm Score, Vascular Study Group of New England rAAA Risk Score, and the Artificial Neural Network Score were analyzed for accuracy in predicting mortality...
December 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27858894/preoperative-deep-vein-thrombosis-in-patients-with-cervical-spondylotic-myelopathy-scheduled-for-spinal-surgery
#11
Le Liu, Yan-Bin Liu, Jian-Min Sun, Hai-Feng Hou, Chen Liang, Tao Li, Heng-Tao Qi
INTRODUCTION: The prevalence of deep vein thrombosis (DVT) and its risk factors in patients with cervical spondylotic myelopathy (CSM) before spinal surgery are poorly understood. We investigated this association with a retrospective cross-sectional study. PATIENTS CONCERNS: The study cohort consisted of all consecutive patients with CSM who were scheduled for spinal surgery at our institution from 2013 to 2015. DVT was defined as an intraluminal filling defect in a lower extremity vein identified by Doppler ultrasonography...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27832989/risk-stratification-for-the-development-of-respiratory-adverse-events-following-vascular-surgery-using-the-society%C3%A2-of-vascular-surgery-s-vascular-quality-initiative
#12
Elizabeth A Genovese, Larry Fish, Rabih A Chaer, Michel S Makaroun, Donald T Baril
OBJECTIVE: Postoperative respiratory adverse events (RAEs) are associated with high rates of morbidity and mortality in general surgery, however, little is known about these complications in the vascular surgery population, a frail subset with multiple comorbidities. The objective of this study was to describe the contemporary incidence of RAEs in vascular surgery patients, the risk factors for this complication, and the overall impact of RAEs on patient outcomes. METHODS: The Vascular Quality Initiative was queried (2003-2014) for patients who underwent endovascular abdominal aortic repair, open abdominal aortic aneurysm repair, thoracic endovascular aortic repair, suprainguinal bypass, or infrainguinal bypass...
November 7, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27831826/hospitalist-vascular-surgery-comanagement-effects-on-complications-and-mortality
#13
Colin T Iberti, Alan Briones, Erin Gabriel, Andrew S Dunn
OBJECTIVES: Hospitalized vascular surgery patients have multiple severe comorbidities, poor functional status, and high perioperative cardiac risk. Thus they may be ideal patients for a collaborative care model. However, there is little evidence for a comanagement model on clinical outcomes. METHODS: The two-year pre-post study consisted of a comanagement model where a hospitalist actively participated in the medical care of American Society of Anesthesiologist Physical Status Classification scale 3 or 4 vascular surgery patients...
December 2016: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/27829447/autologous-bone-graft-in-the-treatment-of-post-traumatic-bone-defects-a-systematic-review-and-meta-analysis
#14
Matheus Lemos Azi, Alessandro Aprato, Irene Santi, Mauricio Kfuri, Alessandro Masse, Alexander Joeris
BACKGROUND: This meta-analysis aimed to determine the bone union rate of bone defects treated with the different autologous bone graft techniques. METHODS: The PubMed and the Cochrane Library databases were searched using the terms: 'fracture' AND ('bone loss' OR 'defect' OR 'defects') AND 'bone graft', restricted to English language, to human species, and to a publication period from January 1999 to November 2014. Data were extracted by one of the reviewers and then checked by the second...
9, 2016: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/27792099/indications-for-elective-tracheostomy-in-reconstructive-surgery-in-patients-with-oral-cancer
#15
Yoav Leiser, Michal Barak, Yasmine Ghantous, Noam Yehudai, Imad Abu El-Naaj
BACKGROUND: Oral cancer surgery carries a high risk of upper airway obstruction; yet optimal airway management approach remains controversial. AIM OF STUDY: The purpose of the present study was to evaluate the use of tracheostomy in oncological patients undergoing oral cancer surgery with intra oral flap reconstruction. METHODS: The study cohort included 75 patients with oral cancer, who underwent major intraoral resections and reconstruction with vascularized flaps...
October 27, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27763477/temporal-variability-of-readmission-determinants-in-postoperative-vascular-surgery-patients
#16
M J Lin, F Baky, B C Housley, N Kelly, E Pletcher, J D Balshi, S P Stawicki, D C Evans
INTRODUCTION: Clinical information continues to be limited regarding changes in the temporal risk profile for readmissions during the initial postoperative year in vascular surgery patients. We set out to describe the associations between demographics, clinical outcomes, comorbidity indices, and hospital readmissions in a sample of patients undergoing common extremity revascularization or dialysis access (ERDA) procedures. We hypothesized that factors independently associated with readmission will evolve from "short-term" to "long-term" determinants at 30-, 180-, and 360-day postoperative cutoff points...
October 2016: Journal of Postgraduate Medicine
https://www.readbyqxmd.com/read/27733533/screening-for-atrial-fibrillation-in-13%C3%A2-122-hong-kong-citizens-with-smartphone-electrocardiogram
#17
Ngai-Yin Chan, Chi-Chung Choy
OBJECTIVE: The purpose of this study was to assess the feasibility of community screening for atrial fibrillation (AF) using a smartphone-based wireless single-lead ECG (SL-ECG) and to generate epidemiological data on the prevalence and risk factors of AF in Hong Kong. METHODS: In the period between 1 May 2014 to 30 April 2015, 13 122 Hong Kong citizens consented and voluntarily participated in a territory-wide community-based AF screening programme. RESULTS: 56 (0...
January 1, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27707620/management-of-patients-with-acute-aortic-syndrome-through-a-regional-rapid-transport-system
#18
Miguel Manzur, Sukgu M Han, Joie Dunn, Ramsey S Elsayed, Fernando Fleischman, Yolee Casagrande, Fred A Weaver
OBJECTIVE: The objective of this study was to describe the outcomes of patients with acute aortic syndrome (AAS) during and after transfer to a regional aortic center by a rapid transport system. METHODS: Review of patients with AAS who were transferred by a rapid transport system to a regional aortic center was performed. Data regarding demographics, diagnosis, comorbidities, transportation, and hospital course were acquired. Severity of existing comorbidities was determined by the Society for Vascular Surgery Comorbidity Severity Score (SVSCSS)...
January 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27688661/development-of-a-prognostic-scoring-system-for-resectable-hepatocellular-carcinoma
#19
Carlo Sposito, Stefano Di Sandro, Federica Brunero, Vincenzo Buscemi, Carlo Battiston, Andrea Lauterio, Marco Bongini, Luciano De Carlis, Vincenzo Mazzaferro
AIM: To develop a prognostic scoring system for overall survival (OS) of patients undergoing liver resection (LR) for hepatocellular carcinoma (HCC). METHODS: Consecutive patients who underwent curative LR for HCC between 2000 and 2013 were identified. The series was randomly divided into a training and a validation set. A multivariable Cox model for OS was fitted to the training set. The beta coefficients derived from the Cox model were used to define a prognostic scoring system for OS...
September 28, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27665205/comparison-of-outcomes-of-transcatheter-aortic-valve-replacement-plus-percutaneous-coronary-intervention-versus-transcatheter-aortic-valve-replacement-alone-in-the-united-states
#20
Vikas Singh, Alex P Rodriguez, Badal Thakkar, Nileshkumar J Patel, Abhijit Ghatak, Apurva O Badheka, Carlos E Alfonso, Eduardo de Marchena, Rahul Sakhuja, Ignacio Inglessis-Azuaje, Igor Palacios, Mauricio G Cohen, Sammy Elmariah, William W O'Neill
Transcatheter aortic valve replacement (TAVR) with percutaneous coronary intervention (PCI) has emerged as a less-invasive therapeutic option for high surgical risk patients with aortic stenosis and coronary artery disease. The aim of this study was to determine the outcomes of TAVR when performed with PCI during the same hospitalization. We identified patients using the International Classification of Diseases, Ninth Revision, Clinical Modification procedure codes from the Nationwide Inpatient Sample between the years 2011 and 2013...
December 1, 2016: American Journal of Cardiology
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