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Perioperative mortality

Justyna Bartoszko, Duminda N Wijeysundera, Keyvan Karkouti, Jeannie Callum, Vivek Rao, Mark Crowther, Hilary P Grocott, Ruxandra Pinto, Damon C Scales, Blaine Achen, Sukhpal Brar, Doug Morrison, David Wong, Jean S Bussières, Tonya de Waal, Christopher Harle, Étienne de Médicis, Charles McAdams, Summer Syed, Diem Tran, Terry Waters
BACKGROUND: Research into major bleeding during cardiac surgery is challenging due to variability in how it is scored. Two consensus-based clinical scores for major bleeding: the Universal definition of perioperative bleeding and the European Coronary Artery Bypass Graft (E-CABG) bleeding severity grade, were compared in this substudy of the Transfusion Avoidance in Cardiac Surgery (TACS) trial. METHODS: As part of TACS, 7,402 patients underwent cardiac surgery at 12 hospitals from 2014 to 2015...
March 15, 2018: Anesthesiology
Kazuyuki Komori, Aritoshi Hattori, Takeshi Matsunaga, Kazuya Takamochi, Shiaki Oh, Kenji Suzuki
PURPOSE: We evaluated the feasibility of surgery for pulmonary aspergilloma. METHODS: We retrospectively evaluated 35 surgical patients with pulmonary aspergilloma. The clinical characteristics and perioperative surgical morbidity were compared based on the operative modes. Preoperative artery embolization (PAE) was selectively performed to reduce the expected surgical stress caused by intraoperative blood loss. RESULTS: The cohort comprised 19 males and 16 females with a mean age of 56 years...
March 14, 2018: General Thoracic and Cardiovascular Surgery
Hsiu-An Lee, Chun-Yu Lin, Yung-Chang Chen, Shao-Wei Chen, Yu-Yun Nan, Kuo-Sheng Liu, Meng-Yu Wu, Yu-Sheng Chang, Jaw-Ji Chu, Pyng-Jing Lin, Feng-Chun Tsai
The feasibility and durability of mitral valve (MV) repair in active infective endocarditis (IE) has been reported, but proper management of perioperative neurological complications and surgical timing remains uncertain and may crucially affect the outcome.In this single-center retrospective observational study, patients who underwent isolated MV surgery for active native IE in our institution between August 2005 and August 2015 were reviewed and analyzed. Patients who were operated on for healed IE or who required combined procedures were excluded from this study...
March 2018: Medicine (Baltimore)
Tyler Sheetz, Cheryl T Lee
PURPOSE OF REVIEW: As the population ages, urologic oncologists are caring for older and more vulnerable patients that must withstand complex surgical treatments. Our healthcare environment emphasizes surgical quality, reductions in length of hospital stay, reduced readmission rates, and high patient satisfaction. So those who manage urologic malignancies must be able to optimize their patients. Understanding the concept of frailty, how to diagnose it in a timely and reliable manner, appreciate its perioperative impact, and consider interventions to reduce its effects may improve surgical outcomes...
March 13, 2018: Current Opinion in Urology
Li-Zhi Zhang, Jie Gao, Zhi-Cheng Zhang, Xiao-Wei Wang, Jian-Zheng Zhang, Tian-Sheng Sun
OBJECTIVE: To compare of clinical effects of different surgical methods in the treatment of elderly femoral neck fractures. METHODS: From January 2013 to June 2016, 144 elderly patients with femoral neck were treated and divided into artificial hip replacement group and cannulated screw fixation group according to the surgical methods. In the total hip arthroplasty group, there were 89 cases, 28 males and 61 females, with an average age of(84.10±3.10) years old;Hollow nail fixation group 55 cases, 20 males and 35 females, with an average age of (86...
February 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Shuangjiang Li, Zhiqiang Wang, Kun Zhou, Yan Wang, Yanming Wu, Pengfei Li, Guowei Che
Background: To evaluate the clinical significance of degree of pulmonary fissure completeness (PFC) on major in-hospital outcomes following video-assisted thoracoscopic (VATS) lobectomy for non-small-cell lung cancer (NSCLC). Materials and methods: We carried out a single-center retrospective analysis on the prospectively maintained database at our unit between August 2014 and October 2015. Patients were divided into two groups based on their fissure sum average (FSA)...
2018: Therapeutics and Clinical Risk Management
Mohamed Barkat, Iain Roy, Stavros A Antoniou, Francesco Torella, George A Antoniou
We aim to perform a systematic review and meta-analysis to investigate outcomes of treatment strategies for asymptomatic carotid disease. We searched electronic bibliographic sources (MEDLINE, EMBASE, CINAHL and CENTRAL) to identify randomised controlled trials (RCT) reporting comparative outcomes of carotid endarterectomy (CEA), carotid stenting (CAS) and best medical therapy (BMT) in asymptomatic carotid disease. We performed pairwise meta-analysis applying random or fixed-effects models and reported the results as the odds ratio (OR) or risk difference (RD) and 95% confidence interval (CI)...
March 13, 2018: Scientific Reports
Hermann Blessberger, Juergen Kammler, Hans Domanovits, Oliver Schlager, Brigitte Wildner, Danyel Azar, Martin Schillinger, Franz Wiesbauer, Clemens Steinwender
BACKGROUND: Randomized controlled trials have yielded conflicting results regarding the ability of beta-blockers to influence perioperative cardiovascular morbidity and mortality. Thus routine prescription of these drugs in unselected patients remains a controversial issue. OBJECTIVES: The objective of this review was to systematically analyse the effects of perioperatively administered beta-blockers for prevention of surgery-related mortality and morbidity in patients undergoing any type of surgery while under general anaesthesia...
March 13, 2018: Cochrane Database of Systematic Reviews
Long Pan, Mingyu Chen, Lin Ji, Longbo Zheng, Peijian Yan, Jing Fang, Bin Zhang, Xiujun Cai
OBJECTIVE: The aim of this study was to compare the efficacy and safety of the laparoscopic common bile duct exploration (LCBDE) and laparoscopic cholecystectomy (LC) with preoperative endoscopic sphincterotomy (pre-EST) and LC for concomitant gallstones and common bile duct (CBD) stones. BACKGROUND: It remains controversial whether LCBDE+LC is better than pre-EST+LC for gallstones and CBD stones. METHODS: A specific search of online databases was performed from January 2006 to October 2017...
March 12, 2018: Annals of Surgery
Lucyna Scislo, Radoslaw Pach, Anna Nowak, Elzbieta Walewska, Malgorzata Gadek, Philip Brandt, Grazyna Puto, Antoni M Szczepanik, Jan Kulig
BACKGROUND: Immunomodulating enteral nutrition in the perioperative period may reduce postoperative complications in cancer patients. Little is known if this effect translates to the better survival. The aim of study was to assess the impact of postoperative immunomodulating enteral nutrition on postoperative complications and survival of gastric cancer patients. METHODS: A group of 98 gastric cancer patients was randomly assigned for postoperative immunomodulating enteral nutrition n = 44 (Reconvan, Fresenius Kabi, Bad Homburg, Germany), or standard enteral nutrition n = 54 (Peptisorb, Nutricia, Schipol, The Netherlands)...
March 13, 2018: Nutrition and Cancer
Eligijus Poskus, Marius Kryzauskas, Tomas Poskus, Saulius Mikalauskas, Narimantas Evaldas Samalavicius, Oleg Aliosin, Sarunas Dailidenas, Algimantas Tamelis, Zilvinas Saladzinskas, Paulius Lizdenis, Audrone Jakaitiene, Giedre Smailyte, Kestutis Strupas
PURPOSE: To compare perioperative colorectal cancer care and survival in patient cohorts operated in 2005 and in 2010 in Lithuania. METHODS: Comparative observational cohort study was performed. The study was conducted in the three Lithuanian cancer hospitals. Patients, who underwent curative surgery for colorectal cancer in 2005 and 2010, were included. Demographic characteristics, distribution of the tumors, preoperative diagnostics and staging, surgical treatment, the quality of pathological examination, morbidity, and mortality were analyzed...
March 12, 2018: International Journal of Colorectal Disease
Julie Hallet, Alyson L Mahar, Avery B Nathens, Melanie E Tsang, Kaitlyn A Beyfuss, Yulia Lin, Natalie G Coburn, Paul J Karanicolas
Background: Bleeding and need for red blood cell transfusions (RBCT) remain a significant concern with hepatectomy. RBCT carry risk of transfusion-related immunomodulation that may impact post-operative recovery. This study soughs to assess the association between RBCT and post-hepatectomy morbidity. Methods: Using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) registry, we identified all adult patients undergoing elective hepatectomy over 2007-2012...
February 2018: Hepatobiliary Surgery and Nutrition
Taro Funakoshi, Takahiro Horimatsu, Michio Nakamura, Koichi Shiroshita, Koichi Suyama, Masashi Mukoyama, Takuro Mizukami, Tsutomu Sakurada, Eishi Baba, Kazuhiko Tsuruya, Akira Nozaki, Kensei Yahata, Yukinori Ozaki, Yoshifumi Ubara, Hisateru Yasui, Akihiro Yoshimoto, Shingo Fukuma, Naoya Kondo, Takeshi Matsubara, Kazuo Matsubara, Shunichi Fukuhara, Motoko Yanagita, Manabu Muto
Background: Cancer is a major cause of death in patients undergoing haemodialysis. However, information about the actual clinical practice of chemotherapy for patients with cancer undergoing haemodialysis is lacking. We conducted a nationwide survey using questionnaires on the clinical practice of chemotherapy for such patients. Patients and methods: The nationwide survey included patients undergoing haemodialysis who were subsequently diagnosed with cancer in 20 hospitals in Japan from January 2010 to December 2012...
2018: ESMO Open
Paolo Nardi, Calogera Pisano, Fabio Bertoldo, Sara R Vacirca, Guglielmo Saitto, Antonino Costantino, Emanuele Bovio, Antonio Pellegrino, Giovanni Ruvolo
We retrospectively analyzed early results of coronary artery bypass grafting (CABG) surgery using two different types of cardioplegia for myocardial protection: antegrade intermittent warm blood or cold crystalloid cardioplegia. From January 2015 to October 2016, 330 consecutive patients underwent isolated on-pump CABG. Cardiac arrest was obtained with use of warm blood cardioplegia (WBC group, n  = 297) or cold crystalloid cardioplegia (CCC group, n  = 33), according to the choice of the surgeon. Euroscore II and preoperative characteristics were similar in both groups, except for the creatinine clearance, slightly lower in WBC group (77...
December 2018: Cell Death Discovery
Erin Amanda Fender, Pranav Chandrashekar, Jackson J Liang, Priyank R Dhar, Terence T Sio, John M Stulak, Ryan J Lennon, Joshua P Slusser, Jonathan B Ashman, Robert C Miller, Joerg Herrmann, Abhiram Prasad, Gurpreet S Sandhu
Background and aim: Thoracic radiation therapy (XRT) for cancer is associated with the development of significant coronary artery disease that may require coronary artery bypass grafting surgery (CABG). Contemporary acute surgical outcomes and long-term postoperative survival of patients with prior XRT have not been well characterised. Methods: This was a retrospective, single-centre study of patients with a history of thoracic XRT who required CABG and who were propensity matched against 141 controls who underwent CABG over the same time period...
2018: Open Heart
A J Perez, I N Haskins, A S Prabhu, D M Krpata, C Tu, S Rosenblatt, K Hashimoto, T Diago, B Eghtesad, M L J Rosen
Background: Umbilical hernias are common in patients with end-stage liver disease undergoing liver transplantation. Management of those persisting at the time of liver transplantation is important to define. Objective: To evaluate the long-term results of patients undergoing simultaneous primary umbilical hernia repair (UHR) at the time of liver transplantation at a single institution. Methods: Retrospective chart review was performed on patients undergoing simultaneous UHR and liver transplantation from 2010 through 2016...
2018: International Journal of Organ Transplantation Medicine
Joshua L Chan, Justin G Miller, Mandy Murphy, Ann Greenberg, Peggy Iraola, Keith A Horvath
BACKGROUND: Prolonged intubation following cardiac surgery is associated with significant morbidity. A fast-track extubation protocol primarily driven by bedside providers was instituted for all postoperative cardiac surgery patients to facilitate safe and expeditious extubation. METHODS: A retrospective review of 1581 cardiac surgery patients over an 8-year period was performed. Prior to 2011, non-protocolized standard perioperative management was utilized (n=807)...
March 9, 2018: Annals of Thoracic Surgery
Robert M Van Haren, Reza J Mehran, Arlene M Correa, Mara B Antonoff, Carla M Baker, Ta Charra Woodard, Wayne L Hofstetter, Gabriel E Mena, Jack A Roth, Boris Sepesi, Stephen G Swisher, Ara A Vaporciyan, Garrett L Walsh, David C Rice
BACKGROUND: Enhanced recovery after surgery (ERAS) pathways aim to improve postoperative recovery through evidence-based practices including early ambulation, multimodal opioid-sparing analgesia, and reduction of surgical stress. The purpose of this study was to evaluate outcomes following implementation of ERAS in patients undergoing resection for pulmonary malignancy. METHODS: A retrospective review compared outcomes for patients undergoing pulmonary resection for primary lung cancer...
March 9, 2018: Annals of Thoracic Surgery
Tim G Coulson, Brian Gregson, Stephen Sandys, Samer A M Nashef, Stephen T Webb, Michael Bailey, Christopher M Reid, David Pilcher
OBJECTIVES: Cardiac surgical risk models predict mortality preoperatively, whereas intensive care unit (ICU) models predict mortality postoperatively. Finding a large difference between the 2 (an acute risk change [ARC]) may reflect an alteration in the status of the patient related to the surgery. An adverse ARC was associated with morbidity and mortality in an Australian population. The aims of this study were to validate ARC in a UK population and to investigate the possible mechanisms behind ARC...
January 12, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Sibel Kara, Nazan Sen, Ebru Kursun, Hakan Yabanoğlu, Sedat Yıldırım, Şule Akçay, Mehmet Haberal
OBJECTIVES: Pulmonary infections are a significant cause of morbidity and mortality in solid-organ transplant recipients despite enhanced facilities for perioperative care. The aim of this study was to evaluate the demographic characteristics, clinical course, and outcomes of renal transplant recipients with pneumonia. MATERIALS AND METHODS: The medical records of all renal transplant recipients from January 2010 to December 2014 were retrospectively reviewed, and patients diagnosed with pneumonia according to Centers for Disease Control and Prevention criteria were evaluated...
March 2018: Experimental and Clinical Transplantation
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