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Amputation risk score

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https://www.readbyqxmd.com/read/29147167/validation-of-the-risk-score-of-the-mortality-and-lower-limb-loss-considering-ambulatory-status-after-surgical-revascularization-in-maintaining-patients-with-dialysis
#1
Haruto Yamazaki, Hisae Hayashi, Morio Kawamura, Ayana Sasaki, Eriko Kondo, Shinya Ito, Kenji Wakai
Surgical revascularization is performed to preserve limb and to maintain functional status of patients with critical limb ischemia (CLI). The PREVENT III risk score helps to predict the postoperative course of CLI. However, this score is not available to estimate the risk of amputation or death properly in patients with hemodialysis (HD) and tissue loss (HD: 4 points, Tissue loss: 3 points), because they are classified as a high-risk group. Therefore, we investigated 213 patients with revascularized HD for CLI and proposed prognosis amputation or death for patients with HD risk score (PAD for HD risk score)...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29091033/perceived-concerns-of-patients-at-risk-for-lower-extremity-amputation
#2
Rhonda S Cornell, Andrew J Meyr
Despite a good understanding of risk factors for amputation and the development of multidisciplinary amputation prevention teams, thousands of lower limb amputations are performed on a daily basis. These amputations are often transformative events in the lives of patients with functional, psychological, social, and economic implications. OBJECTIVE: The objective of this investigation is to qualitatively and quantitatively explore the perceived concerns of patients with chronic wounds at risk for lower extremity amputation...
October 20, 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/29082520/necrotizing-soft-tissue-infections-a-multicentre-prospective-observational-study-infect-protocol-and-statistical-analysis-plan
#3
M B Madsen, S Skrede, T Bruun, P Arnell, A Rosén, M Nekludov, Y Karlsson, F Bergey, E Saccenti, V A P Martins Dos Santos, A Perner, A Norrby-Teglund, O Hyldegaard
BACKGROUND: The INFECT project aims to advance our understanding of the pathophysiological mechanisms in necrotizing soft tissue infections (NSTIs). The INFECT observational study is part of the INFECT project with the aim of studying the clinical profile of patients with NSTIs and correlating these to patient-important outcomes. With this protocol and statistical analysis plan we describe the methods used to obtain data and the details of the planned analyses. METHODS: The INFECT study is a multicentre, prospective observational cohort study...
October 29, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29032478/total-knee-arthroplasty-in-patients-with-a-history-of-illicit-intravenous-drug-abuse
#4
David E Bauer, Andreas Hingsammer, Lukas Ernstbrunner, Alexander Aichmair, Andrea B Rosskopf, Franziska Eckers, Karl Wieser, Sandro F Fucentese
PURPOSE: Injection drug users are at high risk for both infection with blood-borne pathogens, namely, human immune deficiency virus (HIV), hepatitis-B, -C virus, various bacterial infections, as well as early primary and secondary joint degeneration. When total knee arthroplasty (TKA) is anticipated the risk of septic complications is a major concern. The purpose of this study was to assess the clinical and radiographic outcome of patients with a history of intravenous drug use after total knee arthroplasty...
October 14, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28976830/a-comprehensive-scoring-system-to-evaluate-patient-centred-risk-factors-regarding-lower-extremity-amputation
#5
M S Miller, E W Newgent, S M O'Connell, C Broadus
Care of the patient with a presumed life- or limb-threatening lower extremity wound poses many challenges. The mindset regarding potential outcomes of such conditions is mostly driven by the experiences and expertise of those providing the care. This mindset generally appears as two primary actions presented to the afflicted patient: attempted resolution of the problem via medical, surgical or combination treatment, with the hope of low recurrence risk, or exacerbation and amputation-amputations at a level sufficient to, at least in the mind of the surgeon, eliminate the problem...
October 1, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28972278/a-retrospective-study-of-ketamine-administration-and-the-development-of-acute-or-post-traumatic-stress-disorder-in-274-war-wounded-soldiers
#6
G Mion, J Le Masson, C Granier, C Hoffmann
The objective of this study was to explore whether ketamine prevents or exacerbates acute or post-traumatic stress disorders in military trauma patients. We conducted a retrospective study of a database from the French Military Health Service, including all soldiers surviving a war injury in Afghanistan (2010-2012). The diagnosis of post-traumatic stress disorder was made by a psychiatrist and patients were analysed according to the presence or absence of this condition. Analysis included the following covariables: age; sex; acute stress disorder; blast injury; associated fatality; brain injury; traumatic amputation; Glasgow coma scale; injury severity score; administered drugs; number of surgical procedures; physical, neurosensory or aesthetic sequelae; and the development chronic pain...
December 2017: Anaesthesia
https://www.readbyqxmd.com/read/28964795/moca-item-score-analysis-and-relationship-to-mobility-outcomes-in-dysvascular-lower-extremity-amputees
#7
Courtney Frengopoulos, Michael Wc Payne, Ricardo Viana, Susan W Hunter
OBJECTIVES: To investigate the association between cognitive functioning, as measured by the Montreal Cognitive Assessment (MoCA), and functional outcomes upon discharge from prosthetic rehabilitation. DESIGN: Retrospective chart audit. SETTING: Rehabilitation hospital. PARTICIPANTS: Consecutive admissions (n=130, age 66.21 ± 11.19 years) with lower extremity amputation (LEA) of dysvascular etiology. INTERVENTIONS: Not applicable MAIN OUTCOME MEASURES: Cognitive status was assessed using the MoCA...
September 27, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28943004/importance-of-postprocedural-wound-ischemia-and-foot-infection-wifi-restaging-in-predicting-limb-salvage
#8
Charles Leithead, Zdenek Novak, Emily Spangler, Marc A Passman, Adam Witcher, Mark A Patterson, Adam W Beck, Benjamin J Pearce
OBJECTIVE: The Wound, Ischemia, and foot Infection (WIfI) classification system was created to encompass demographic changes and expanding techniques of revascularization to perform meaningful analyses of outcomes in the treatment of the threatened limb. The WIfI index is intended to be analogous to the TNM staging system for cancer, with restaging to be done after control of infection and after revascularization. Our goal was to evaluate the effectiveness of WIfI restaging after therapy in the prediction of limb outcomes...
September 21, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28934543/long-term-results-of-intercalary-endoprosthetic-short-segment-fixation-following-extended-diaphysectomy
#9
Nicholas S Tedesco, Alexandra L Van Horn, Robert M Henshaw
Intercalary endoprosthetic reconstruction following diaphyseal resection of osseous tumors offers functional advantages through preservation of native joints adjacent to the resected defect. Use of such implants is restricted by the amount of bone available for stem fixation adjacent to the defect. This study aimed to determine whether short osseous segment fixation with acceptable outcomes and complication rate can be reliably achieved with a customized intercalary endoprosthesis following extended diaphysectomy...
September 21, 2017: Orthopedics
https://www.readbyqxmd.com/read/28898514/risk-of-lower-extremity-amputations-in-people-with-type-2-diabetes-mellitus-treated-with-sodium-glucose-co-transporter-2-inhibitors-in-the-usa-a-retrospective-cohort-study
#10
Zhong Yuan, Frank J DeFalco, Patrick B Ryan, Martijn J Schuemie, Paul E Stang, Jesse A Berlin, Mehul Desai, Norm Rosenthal
AIMS: To examine the incidence of amputation in patients with type 2 diabetes mellitus (T2DM) treated with sodium glucose co-transporter 2 (SGLT2) inhibitors overall, and canagliflozin specifically, compared with non-SGLT2 inhibitor antihyperglycaemic agents (AHAs). MATERIALS AND METHODS: Patients with T2DM newly exposed to SGLT2 inhibitors or non-SGLT2 inhibitor AHAs were identified using the Truven MarketScan database. The incidence of below-knee lower extremity (BKLE) amputation was calculated for patients treated with SGLT2 inhibitors, canagliflozin, or non-SGLT2 inhibitor AHAs...
September 12, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28893312/the-validity-and-reliability-of-the-four-square-step-test-in-different-adult-populations-a-systematic-review
#11
Martha Moore, Karen Barker
BACKGROUND: The four square step test (FSST) was first validated in healthy older adults to provide a measure of dynamic standing balance and mobility. The FSST has since been used in a variety of patient populations. The purpose of this systematic review is to determine the validity and reliability of the FSST in these different adult patient populations. METHODS: The literature search was conducted to highlight all the studies that measured validity and reliability of the FSST...
September 11, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28887250/analysis-of-patients-undergoing-major-lower-extremity-amputation-in-the-vascular-quality-initiative
#12
Joshua Gabel, Brice Jabo, Sheela Patel, Sharon Kiang, Christian Bianchi, Jason Chiriano, Theodore Teruya, Ahmed M Abou-Zamzam
BACKGROUND: Despite an aggressive climate of limb salvage and revascularization, 7% of patients with peripheral artery disease undergo major lower extremity amputation (LEA). The purpose of this study was to describe the current demographics and early outcomes of patients undergoing major LEA in the Vascular Quality Initiative (VQI). METHODS: The VQI amputation registry was reviewed to identify patients who underwent major LEAs. Patient factors, limb characteristics, procedure type, and intraoperative variables were analyzed by the level of amputation...
September 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28885956/combat-casualties-and-severe-shock-risk-factors-for-death-at-role-3-military-facilities
#13
Michelle F Buehner, Brian J Eastridge, James K Aden, Joseph J DuBose, Lorne H Blackbourne, Ramon F Cestero
BACKGROUND: Although significant research has been conducted on combat casualties receiving blood products, there is limited data for the subpopulation presenting in shock. The purpose of this study was to evaluate combat casualties arriving to a role 3 facility with an initial systolic blood pressure (SBP) ≤ 90 in order to identify clinical characteristics and associations between presentation, transfusion therapy, and mortality outcomes. METHODS: The Department of Defense Trauma Registry was queried from 2001 to 2010 for trauma-related casualties who arrived at a role 3 combat surgical facility with a SBP ≤ 90...
September 2017: Military Medicine
https://www.readbyqxmd.com/read/28884985/staged-endovascular-repair-of-critical-limb-ischemia-in-high-risk-patients-the-procedural-and-clinical-outcomes
#14
Guang Liu, Chaoyi Cui, Minyi Yin, Kaichuang Ye, Xaiobing Liu, Jinbao Qin, Huihua Shi, Xintian Huang, Min Lu, Xinwu Lu, Weimin Li, Mier Jiang
PURPOSE: To retrospectively evaluate the procedural and clinical outcomes after staged angioplasty in high-risk, chronic, critical limb ischemia (CLI) patients. METHODS: Between 2013 and 2015, 29 patients (29 limbs) (mean age 77 years) were treated by staged revascularization procedures in (i) the iliac artery-DFA alone or with the femoropopliteal artery followed by (ii) the femoropopliteal artery and a below-the-knee artery. All patients had long-segment iliofemoral artery and below-the-knee artery (TASCII D) occlusions with abnormal serum myoglobin and ischemic lesions...
September 7, 2017: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/28870682/association-of-arterial-calcification-with-chronic-limb-ischemia-in-patients-with-peripheral-artery-disease
#15
Sara L Zettervall, Andre P Marshall, Paul Fleser, Raul J Guzman
OBJECTIVE: Arterial calcification is associated with an increased risk of limb events, including amputation. The association between calcification in lower extremity arteries and the severity of ischemia, however, has not been assessed. We thus sought to determine whether the extent of peripheral artery calcification (PAC) was correlated with Rutherford chronic ischemia categories and hypothesized that it could independently contribute to worsening limb status. METHODS: We retrospectively reviewed all patients presenting with symptomatic peripheral artery disease who underwent evaluation by contrast and noncontrast computed tomography scan of the lower extremities as part of their assessment...
September 1, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28863028/associations-of-plasma-nitrite-l-arginine-and-asymmetric-dimethylarginine-with-morbidity-and-mortality-in-patients-with-necrotizing-soft-tissue-infections
#16
Marco Bo Hansen, Lars Simon Rasmussen, Peter Garred, Katrine Pilely, Anna Mygind Wahl, Anders Perner, Martin Bruun Madsen, Elise Røge Hedegaard, Ulf Simonsen, Ole Hyldegaard
BACKGROUND: The nitric oxide system could play an important role in the pathophysiology related to necrotizing soft tissue infection (NSTI). Accordingly, we investigated the association between plasma nitrite level at admission and the presence of septic shock in patients with NSTI. We also evaluated the association between nitrite, asymmetric dimethylarginine (ADMA), L-arginine, L-arginine/ADMA-ratio and outcome. METHODS: We analyzed plasma from 141 NSTI patients taken upon hospital admission...
August 31, 2017: Shock
https://www.readbyqxmd.com/read/28858422/development-and-psychometric-properties-of-the-basic-amputee-mobility-score-for-use-in-patients-with-a-major-lower-extremity-amputation
#17
Morten Tange Kristensen, Anni Østergaard Nielsen, Ulla Madsen Topp, Jakob Holmehave-Brandt, Charlotte Falkenberg Petterson, Peter Gebuhr
AIM: To develop and examine the psychometric properties, including responsiveness and interrater reliability, of a new outcome measure for the evaluation of basic mobility activities after a major lower extremity amputation - The Basic Amputee Mobility Score (BAMS). METHODS: The four following essential activities were chosen through consensus meetings with experienced amputee physiotherapists: (i) supine in bed to sitting on the edge of the bed; (ii) bed to wheelchair transfer; (iii) indoor wheelchair mobility; and (iv) get up from a wheelchair to standing on the non-amputated leg...
August 31, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28722354/risk-factors-for-amputation-in-patients-with-diabetic-foot-infection-a-prospective-study
#18
Serhat Uysal, Bilgin Arda, Meltem I Taşbakan, Şevki Çetinkalp, Ilgın Y Şimşir, Anıl M Öztürk, Ayşe Uysal, İlgen Ertam
There is a variety of diagnostic and therapeutic algorithms for diabetic foot infections (DFIs). Some of them are too difficult to be applied in routine clinical approach. In the routine clinical approach, it is necessary to find new risk factors and end up with a quick and easy assessment of DFIs. In this study, we aimed to evaluate the independent risk factors for osteomyelitis, amputation and major amputation in patients with DFI using standard scoring procedures. We prospectively studied 379 patients with DFI...
July 19, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28712488/staged-reconstruction-of-diaphyseal-fractures-with-segmental-defects-surgical-and-patient-reported-outcomes
#19
S D Zoller, L A Cao, R A Smith, W Sheppard, E L Lord, C D Hamad, J H Ghodasra, C Lee, D Jeffcoat
INTRODUCTION: Two-stage limb reconstruction is an option for patients with critical size segmental bone defects following acute trauma or non-union. Reconstruction is technically demanding and associated with a high complication rate. Current protocols for limb reconstruction have well-documented challenges, and no study has reported on patient outcomes using a validated questionnaire. In this study, we aimed to examine the clinical and patient-centered outcomes following our surgical protocol for two-stage limb reconstruction following critical size segmental defects...
June 23, 2017: Injury
https://www.readbyqxmd.com/read/28673381/biomarkers-of-necrotising-soft-tissue-infections-aspects-of-the-innate-immune-response
#20
Marco Bo Hansen
Necrotising soft tissue infection (NSTI) is a life-threatening and rapidly progressing bacterial infection involving one or more layers of the soft tissue compartments causing necrosis. The amputation and mortality rates remain high despite increased focus on the patients. Timely treatment, including surgical intervention, reduces the risk of severe disability and death. However, the lack of pathognomonic signs impedes early diagnosis and treatment. Moreover, the rarity of the disease makes it difficult to conduct large prospective studies, thus prospective research is almost non-existent in this group of patients...
July 2017: Danish Medical Journal
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