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Perioperative mortality

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https://www.readbyqxmd.com/read/28544301/hospital-volume-and-perioperative-outcomes-for-radical-cystectomy-a-population-study
#1
Cristian Udovicich, Marlon Perera, Molla Huq, Lih-Ming Wong, Daniel Lenaghan
OBJECTIVES: To evaluate the association between hospital volume and perioperative outcomes of radical cystectomy (RC) using state population data for a contemporary Australian cohort. PATIENTS AND METHODS: Patients undergoing RC for urothelial malignancy in the state of Victoria, Australia between July 2003 and June 2014 were identified using the Victorian Admitted Episodes Dataset (VAED). Hospitals were divided into tertiles according to their caseload per year...
May 2017: BJU International
https://www.readbyqxmd.com/read/28543813/inhaled-pulmonary-vasodilator-therapy-for-management-of-right-ventricular-dysfunction-after-left-ventricular-assist-device-placement-and-cardiac-transplantation
#2
Leah A Sabato, David M Salerno, Jeremy D Moretz, Douglas L Jennings
Right ventricular failure (RVF) after cardiac transplant (CTX) or implantation of a continuous-flow left ventricular assist device (CF-LVAD) is associated with significant post-operative morbidity and mortality. A variety of modalities have been used to treat post-operative RVF, including management of volume status, intravenous inotropes and vasodilators, and right-sided mechanical support. Inhaled vasodilator agents are a unique treatment option aimed at minimizing systemic absorption by delivering therapy directly to the pulmonary vasculature...
May 24, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28543789/surgical-management-of-traumatic-tricuspid-insufficiency
#3
Zhiqi Zhang, Kanhua Yin, Lili Dong, Yongxin Sun, Changfa Guo, Yi Lin, Chunsheng Wang
BACKGROUND: This study reviews our experience with traumatic tricuspid insufficiency (TTI) following blunt chest trauma. METHODS: From January 2010 to June 2016, 10 patients (nine males, mean age 49.0 ± 12.4 years) underwent surgical treatment of TTI following blunt chest trauma. The mean intervals between trauma and diagnosis and between trauma and surgery were 74.1 and 81.8 months, respectively. Preoperatively, all patients exhibited severe tricuspid regurgitation...
May 24, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28542110/pneumonia-after-liver-transplantation
#4
Stephanie A K Angarita, Tara A Russell, Fady M Kaldas
PURPOSE OF REVIEW: Pneumonia occurs in 8-23% of patients after liver transplantation and contributes considerably to their morbidity and mortality. With the increasing acuity of liver transplantation patients in the current era, pneumonias, particularly ventilator-associated pneumonias, and multidrug-resistant pathogens, are of growing concern. RECENT FINDINGS: Postliver transplantation pneumonia cause varies with the timing of infection. In the early period (<1 month postliver transplantation), nosocomial pneumonias, including ventilator-associated pneumonias and multidrug-resistant species are most common...
May 24, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28541851/primary-malignancy-is-an-independent-determinant-of-morbidity-and-mortality-after-liver-resection
#5
Marc W Fromer, John P Gaughan, Umur M Atabek, Francis R Spitz
Although outcomes after liver resection have improved, there remains considerable perioperative morbidity and mortality with these procedures. Studies suggest a primary liver cancer diagnosis is associated with poorer outcomes, but the extent to which this is attributable to a higher degree of hepatic dysfunction is unclear. To better delineate this, we performed a matched pair analysis of primary versus metastatic malignancies using a national database. The American College of Surgeons National Surgical Quality Improvement Program (2005-2013) was analyzed to select elective liver resections...
May 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28540832/concerning-ct-features-used-to-select-patients-for-treatment-of-peritoneal-metastases-a-pictoral-essay
#6
Paul H Sugarbaker, Armando Sardi, Gina Brown, Clarisse Dromain, Pascal Rousset, James S Jelinek
BACKGROUND: During the Fifth International Workshop on Peritoneal Surface Malignancy in Milan in 2008, a consensus was reached that contrast-enhanced CT (ceCT) was the principal imaging modality for patients being evaluated for treatment of peritoneal metastases. This fact being accepted, the radiologic criteria for that may exclude patients from a high value cytoreductive surgery (CRS) plus hyperthermic perioperative chemotherapy (HIPEC) have not been reliably determined. METHODS: From a consensus of surgeons and radiologists, radiologic images were selected and their determinant radiologic characteristics described...
April 9, 2017: International Journal of Hyperthermia
https://www.readbyqxmd.com/read/28540605/characteristics-of-rheumatoid-arthritis-patients-undergoing-reverse-shoulder-arthroplasty
#7
Julio J Jauregui, J Paul Hovis, S Ashfaq Hasan
The risks and complication profile of reverse total shoulder arthroplasty (RSA) in rheumatoid arthritis (RA) patients has yet to be clearly defined as most studies have small cohorts. Using a large inpatient database, the purpose on our study was to determine the overall demographics, hospitalization characteristics, and early complication rates in rheumatoid patients and compared these to rotator-cuff arthropathy patients without RA undergoing RSA. Utilizing United States Nationwide Inpatient Sample from 2010 to 2013, we evaluated a total of 919 RA RSA and compared them to 8097 patients without RA undergoing RSA...
May 24, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28540144/spondylitis-transmitted-from-infected-aortic-grafts-a-review
#8
REVIEW
Panayiotis D Megaloikonomos, Thekla Antoniadou, Leonidas Dimopoulos, Marcos Liontos, Vasilios Igoumenou, Georgios N Panagopoulos, Efthymia Giannitsioti, Andreas Lazaris, Andreas F Mavrogenis
Graft infection following aortic aneurysms repair is an uncommon but devastating complication; its incidence ranges from <1% to 6% (mean 4%), with an associated perioperative and overall mortality of 12% and 17.5-20%, respectively. The most common causative organisms are Staphylococcus aureus and Escherichia coli; causative bacteria typically arise from the skin or gastrointestinal tract. The pathogenetic mechanisms of aortic graft infections are mainly breaks in sterile technique during its implantation, superinfection during bacteremia from a variety of sources, severe intraperitoneal or retroperitoneal inflammation, inoculation of bacteria during postoperative percutaneous interventions to manage various types of endoleaks, and external injury of the vascular graft...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28540132/more-risks-and-complications-for-elective-spine-surgery-in-morbidly-obese-patients
#9
REVIEW
Nancy E Epstein
BACKGROUND: The vast majority of studies emphasize the greater morbidity/mortality for elective spine surgery in morbidly obese patients. METHODS: This review focuses on the increased morbidity/mortality of performing elective spinal operations in morbidly obese patients. There are two definitions of morbid obesity; a body mass index (BMI) of equal to or greater than 35 plus two major comorbid factors (e.g., hypertension, diabetes, etc.) or a BMI (morbidly obese III) of =≥40 kg/m(2)...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28540113/comparison-of-3-different-perioperative-care-models-for-patients-with-hip-fractures-within-1-health-service
#10
Lillian Sarah Coventry, Austin Nguyen, Amalia Karahalios, Sasha Roshan-Zamir, Phong Tran
INTRODUCTION: Orthogeriatric care models have been introduced within many health-care facilities to improve outcomes for hip fracture patients. This study aims to evaluate differences in care between 3 models, an orthopedic model, a geriatric model, and a comanaged model. MATERIALS AND METHODS: A retrospective analysis was conducted for hip fracture patients treated at Western Health between November 2012 and March 2014. All patients aged 65 years or older were included in the analysis...
June 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28540112/comparison-of-postoperative-outcomes-in-elderly-patients-with-a-do-not-resuscitate-order-undergoing-elective-and-nonelective-hip-surgery
#11
Anair Beverly, Ethan Y Brovman, Richard D Urman
PURPOSE: Emergency hip surgery generally has worse outcomes than elective hip surgery, even when adjusted for patient and surgical factors. Do-not-resuscitate (DNR) status patients are typically at higher perioperative risk and undergo a narrow range of surgical procedures. We aimed to compare the outcomes after hip surgery of differing degrees of urgency in this cohort. MATERIALS AND METHODS: Using National Surgical Quality Improvement Program (NSQIP) data, we conducted univariate and multivariate analyses comparing outcomes of DNR status patients after emergency and nonemergency hip surgery (2007-2013)...
June 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28540073/viscoelastic-testing-inside-and-beyond-the-operating-room
#12
REVIEW
Liang Shen, Sheida Tabaie, Natalia Ivascu
Hemorrhage is a major contributor to morbidity and mortality during the perioperative period. Current methods of diagnosing coagulopathy have various limitations including long laboratory runtimes, lack of information on specific abnormalities of the coagulation cascade, lack of in vivo applicability, and lack of ability to guide the transfusion of blood products. Viscoelastic testing offers a promising solution to many of these problems. The two most-studied systems, thromboelastography (TEG) and rotational thromboelastometry (ROTEM), offer similar graphical and numerical representations of the initiation, formation, and lysis of clot...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28539544/postoperative-outcome-of-high-risk-octogenarians-undergoing-cardiac-surgery-a-multicenter-observational-retrospective-study
#13
Michal Porizka, Jan Kunstyr, Tomas Vanek, Michal Nejedly, Jana Buckova, Jiri Mokrejs, Frantisek Mosna
PURPOSE: Cardiac surgery in octogenarians with severely deteriorated functional status is increasingly common, but outcome data are still limited. The aim of this study was to compare postoperative outcome, survival, and quality of life of low-, medium-, and high-risk octogenarians undergoing cardiac surgery. METHODS: In all, 285 Czech octogenarians who underwent any cardiac surgical procedure between January 2011 and December 2012 were included in the study. Five out of all twelve national adult cardiac surgical centers participated in the study, representing almost half of all octogenarians operated in our country in that period...
May 24, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28539236/the-weekend-effect-for-hip-fracture-surgery
#14
Leontien M G Nijland, Julian Karres, Anouk E Simons, Jan M Ultee, Gino M M J Kerkhoffs, Bart C Vrouenraets
INTRODUCTION: Increased mortality rates have been reported for emergency admissions during weekends and outside office hours. Research on the weekend effect in hip fracture patients is however limited and demonstrates conflicting results. The aim of this study was to determine the effect of weekend admission and weekend surgery on 30-day and 1-year mortality following hip fracture surgery. PATIENTS AND METHODS: All patients who underwent hip fracture surgery in our hospital between 2004 and 2015 were included in this retrospective study...
May 15, 2017: Injury
https://www.readbyqxmd.com/read/28538638/perioperative-use-of-nonsteroidal-anti-inflammatory-drugs-and-the-risk-of-anastomotic-failure-in-emergency-general-surgery
#15
Nadeem N Haddad, Brandon R Bruns, Toby M Enniss, David Turay, Joseph V Sakran, Alisan Fathalizadeh, Kristen Arnold, Jason S Murry, Matthew M Carrick, Matthew Hernandez, Margaret H Lauerman, Martin D Zielinski
BACKGROUND: Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used analgesic and anti-inflammatory adjuncts. NSAID administration may potentially increase the risk of postoperative gastrointestinal anastomotic failure (AF). We aim to determine if perioperative NSAID utilization influences gastrointestinal anastomotic failure in emergency general surgery (EGS) patients undergoing gastrointestinal resection and anastomosis. METHODS: Post hoc analysis of a multi-institutional prospectively collected database was performed...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538534/enhanced-recovery-after-surgery-for-hip-and-knee-replacements
#16
David P Gwynne-Jones, Ginny Martin, Chris Crane
BACKGROUND: Enhanced recovery after surgery (ERAS) programs or hip and knee replacements have had a significant effect on streamlining patient care with shorter stays, no increase in complications, and improved outcomes including reduced mortality. PURPOSE: To compare outcomes following the introduction of an ERAS program for hip and knee replacements developed at our institution with a historical cohort of patients. METHODS: ERAS protocols were developed at our institution for patients undergoing hip and knee joint replacements...
May 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28537970/neuraxial-and-combined-neuraxial-general-anesthesia-compared-to-general-anesthesia-for-major-truncal-and-lower-limb-surgery-a-systematic-review-and-meta-analysis
#17
Lauren M Smith, Crispiana Cozowicz, Yoshiaki Uda, Stavros G Memtsoudis, Michael J Barrington
Neuraxial anesthesia may improve perioperative outcomes when compared to general anesthesia; however, this is controversial. We performed a systematic review and meta-analysis using randomized controlled trials and population-based observational studies identified in MEDLINE, PubMed, and EMBASE from 2010 to May 31, 2016. Studies were included for adult patients undergoing major surgery of the trunk and lower extremity that reported: 30-day mortality (primary outcome), cardiopulmonary morbidity, surgical site infection, thromboembolic events, blood transfusion, and resource use...
May 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28537563/anastomotic-leaks-in-gastrointestinal-surgery-and-their-prevention
#18
Tomasz Banasiewicz, Adam Dziki, Paweł Lampe, Zbigniew Lorenc, Marek Szczepkowski, Jacek Zieliński, Grzegorz Wallner
Anastomotic leak in the gastrointestinal tract is one of the most important complications of resection. They are the main cause of reoperation, their occurrence worsens the prognosis of the patient, increasing the proportion of direct mortality, as well as being a significant risk factor for recurrence of cancer. The risk of leaks within the gastrointestinal tract is greatly varied, depending on the location and extent of the resection, but also on patient, disease or a surgical procedure, including surgeon...
April 30, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28535775/factors-influencing-postoperative-atrial-fibrillation-in-patients-undergoing-on-pump-coronary-artery-bypass-grafting-single-center-experience
#19
Mohamed F Ismail, Ahmed F El-Mahrouk, Tamer H Hamouda, Hanan Radwan, Ali Haneef, Ahmed A Jamjoom
BACKGROUND: The reported incidence of AF after CABG surgery varies from 20 to 40%, with the arrhythmia usually occurring between second and fourth postoperative days. Postoperative AF after CABG was associated with greater in-hospital mortality and worse survival at long-term follow-up. Therefore, intensive attention has focused on the prevention of AF in high-risk patients. Many perioperative factors have been suggested to increase the incidence of postoperative AF after conventional CABG...
May 23, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28535730/palliative-endovascular-techniques-for-management-of-peripheral-vascular-blowout-syndrome-in-end-stage-malignancies
#20
Lauren A Huntress, Samuel Kogan, Khanjan Nagarsheth, Naiem Nassiri
Vascular blowout syndrome (VBOS) secondary to neoplastic erosion is a dreadful complication of advanced stage malignancies that can compromise quality of life and overall prognosis in a fragile patient population. Endovascular therapy can offer minimally invasive, life-saving maneuvers both acutely and prophylactically. Four patients with end-stage malignancies eroding into various peripheral vascular beds with impending, threatened, and acute VBOS underwent successful endovascular management. Technical success was achieved in all patients with no perioperative morbidity or mortality...
January 1, 2017: Vascular and Endovascular Surgery
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