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Frailty surgery

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https://www.readbyqxmd.com/read/28709946/frailty-and-sarcopenia-do-not-predict-adverse-events-in-an-elderly-population-undergoing-non-complex-primary-elective-surgery-for-degenerative-conditions-of-the-lumbar-spine
#1
Raphaële Charest-Morin, John Street, Honglin Zhang, Taren Roughead, Tamir Ailon, Michael Boyd, Marcel Dvorak, Brian Kwon, Scott Paquette, Nicolas Dea, Charles G Fisher, Alana M Flexman
BACKGROUND CONTEXT: Sarcopenia measured by normalized total psoas area (NTPA) has been shown to predict mortality and adverse events (AE) in numerous surgical populations. The relationship between sarcopenia and postoperative outcomes after surgery for degenerative spine disease (DSD) has not been investigated. PURPOSE: This study aimed to determine the relationships between sarcopenia, frailty and postoperative adverse events in the elderly DSD population. Secondary objectives were to describe the distribution and predictors of NTPA and to determine the relationship between sarcopenia, frailty and length of stay, discharge to a facility and in-hospital mortality...
July 11, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28701190/a-novel-algorithm-for-the-treatment-strategy-for-advanced-epithelial-ovarian-cancer-consecutive-imaging-frailty-assessment-and-diagnostic-laparoscopy
#2
Kyung Jin Eoh, Jung Won Yoon, Jung-Yun Lee, Eun Ji Nam, Sunghoon Kim, Sang Wun Kim, Young Tae Kim
BACKGROUND: This study aimed to evaluate the perioperative outcomes and prognostic impact of the consecutive steps of imaging, frailty assessment, and diagnostic laparoscopy (DLS) in patients with advanced epithelial ovarian cancer (EOC). METHODS: Patients diagnosed with EOC during 2012-2015 were analyzed retrospectively. Surgical and survival outcomes were compared between three treatment groups: patients without high tumor dissemination (HTD) who underwent primary debulking surgery (PDS group); patients with HTD who underwent DLS (DLS group); and patients with HTD diagnosed by cytological confirmation of malignancy followed by neoadjuvant chemotherapy (NACT group)...
July 12, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28693934/frailty-in-older-adults-undergoing-aortic%C3%A2-valve-replacement-the-frailty-avr-study
#3
Jonathan Afilalo, Sandra Lauck, Dae H Kim, Thierry Lefèvre, Nicolo Piazza, Kevin Lachapelle, Giuseppe Martucci, Andre Lamy, Marino Labinaz, Mark D Peterson, Rakesh C Arora, Nicolas Noiseux, Andrew Rassi, Igor F Palacios, Philippe Généreux, Brian R Lindman, Anita W Asgar, Caroline A Kim, Amanda Trnkus, José A Morais, Yves Langlois, Lawrence G Rudski, Jean-Francois Morin, Jeffrey J Popma, John G Webb, Louis P Perrault
BACKGROUND: Frailty is a geriatric syndrome that diminishes the potential for functional recovery after a transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR) procedure; however, its integration in clinical practice has been limited by a lack of consensus on how to measure it. OBJECTIVES: This study sought to compare the incremental predictive value of 7 different frailty scales to predict poor outcomes following TAVR or SAVR...
July 1, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28669651/frailty-in-major-oncologic-surgery-of-upper-gastrointestinal-tract-how-to-improve-postoperative-outcomes
#4
M Mazzola, C Bertoglio, M Boniardi, C Magistro, P De Martini, P Carnevali, L Morini, G Ferrari
INTRODUCTION: Certain surgical interventions, especially those involving upper GI tract remain challenging, due to high morbidity and mortality rates. The study of frailty in the surgical population has allowed the identification of those patients with a higher risk of poor postoperative outcomes. There remains a lack of evidence regarding the possibility of improving these results through a preoperative holistic management of the patients. The aim of this study is to evaluate whether preoperative treatment, in carefully selected patients, can improve the outcome following surgery...
June 23, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28666616/the-cost-of-frailty-in-cardiac-surgery
#5
EDITORIAL
Bobby Yanagawa, David A Latter, Paul W M Fedak, Charles Cutrara, Subodh Verma
No abstract text is available yet for this article.
May 25, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28649755/preoperative-geriatric-assessment-and-tailored-interventions-in-frail-older-patients-with-colorectal-cancer-a-randomised-controlled-trial
#6
Nina Ommundsen, Torgeir B Wyller, Arild Nesbakken, Arne O Bakka, Marit S Jordhøy, Eva Skovlund, Siri Rostoft
BACKGROUND: Colorectal cancer (CRC) is prevalent in the older population, and surgery is the mainstay in curative treatment. A preoperative geriatric assessment (GA) can identify frail older patients at risk for developing postoperative complications. In this randomised controlled trial we wanted to investigate whether tailored interventions based on a preoperative GA could reduce the frequency of postoperative complications in frail patients operated for CRC. METHODS: Patients >65 years scheduled for elective CRC surgery and fulfilling predefined criteria for frailty were randomised to either a preoperative GA followed by a tailored intervention, or care as usual...
June 26, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28647199/influence-of-frailty-on-treatment-outcomes-after-revascularization-in-patients-with-critical-limb-ischemia
#7
Koichi Morisaki, Terutoshi Yamaoka, Kazuomi Iwasa, Takahiro Ohmine
OBJECTIVE: It is unclear whether frailty adversely affects treatment outcomes in patients with critical limb ischemia (CLI). The aim of this study was to investigate the influence of frailty on CLI patients after revascularization. METHODS: Patients undergoing infrapopliteal revascularization between 2007 and 2015 were retrospectively analyzed. The patient was defined as CLI frail when two or more of the following were present: low Geriatric Nutritional Risk Index, low skeletal muscle mass index, or nonambulatory status...
June 21, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28616346/emergent-aortic-surgery-in-octogenarians-is-the-advanced-age-a-contraindication
#8
REVIEW
Mario Castaño, Javier Gualis, Jose M Martínez-Comendador, Elio Martín, Pasquale Maiorano, Laura Castillo
Surgery of both the ascending and descending aortic segments in the context of an acute aortic syndrome is one of the greatest challenges for the cardiac surgeon. In the case of surgery of the descending aorta, surgical risk increases due to the technical complexity, the required aggressive approach and because surgical indication is usually established as a result of complications and therefore involves, almost always, critically ill patients. The aging of the population is causing such surgery to be considered in an increasing number of octogenarians...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28602153/frailty-as-a-predictor-of-mortality-in-the-elderly-emergency-general-surgery-patient
#9
Jens Goeteyn, Louis A Evans, Siem De Cleyn, Sigrid Fauconnier, Caroline Damen, Jonathan Hewitt, Wim Ceelen
BACKGROUND: The number of surgical procedures performed in elderly and frail patients has greatly increased in the last decades. However, there is little research in the elderly emergency general surgery patient. The aim of this study was to assess the prevalence of frailty in the emergency general surgery population in Belgium. Secondly, we examined the length of hospital stay, readmission rate and mortality at 30 and 90 days. METHODS: We conducted a prospective observational study at Ghent University Hospital...
June 10, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28592272/betaine-promotes-cell-differentiation-of-human-osteoblasts-in-primary-culture
#10
Isabella Villa, Pamela Senesi, Anna Montesano, Anita Ferraretto, Fernanda Vacante, Alice Spinello, Michela Bottani, Simona Bolamperti, Alessandro Rubinacci, Livio Luzi, Ileana Terruzzi
BACKGROUND: Betaine (BET), a component of many foods, is an essential osmolyte and a source of methyl groups; it also shows an antioxidant activity. Moreover, BET stimulates muscle differentiation via insulin like growth factor I (IGF-I). The processes of myogenesis and osteogenesis involve common mechanisms with skeletal muscle cells and osteoblasts sharing the same precursor. Therefore, we have hypothesized that BET might be effective on osteoblast cell differentiation. METHODS: The effect of BET was tested in human osteoblasts (hObs) derived from trabecular bone samples obtained from waste material of orthopedic surgery...
June 7, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/28589402/the-preoperative-assessment-and-optimization-of-patients-undergoing-major-urological-surgery
#11
REVIEW
Helen W Cui, Benjamin W Turney, John Griffiths
PURPOSE OF REVIEW: Improving patient outcomes from major urological surgery requires not only advancement in surgical technique and technology, but also the practice of patient-centered, multidisciplinary, and integrated medical care of these patients from the moment of contemplation of surgery until full recovery. This review examines the evidence for recent developments in preoperative assessment and optimization that is of relevance to major urological surgery. RECENT FINDINGS: Current perioperative medicine recommendations aim to improve the short-term safety and long-term effectiveness of surgical treatments by the delivery of multidisciplinary integrated medical care...
July 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28587892/the-modified-frailty-index-to-predict-morbidity-and-mortality-for-retroperitoneal-sarcoma-resections
#12
Jiwon Sarah Park, Sarah B Bateni, Richard J Bold, Amanda R Kirane, Daniel J Canter, Robert J Canter
BACKGROUND: The modified frailty index (mFI) is an important method to risk-stratify surgical patients and has been validated for general surgery and selected surgical subspecialties. However, there are currently no data assessing the efficacy of the mFI to predict acute morbidity and mortality in patients undergoing surgery for retroperitoneal sarcoma. METHODS: Using the American College of Surgeons' National Surgical Quality Improvement Program from 2007 to 2012, we performed a retrospective analysis of patients with a diagnosis of primary malignant retroperitoneal neoplasm who underwent surgical resection...
May 11, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28561149/-preoperative-evaluation-and-arrangements-the-elderly-patient
#13
Cynthia Olotu-Steffen, Simone Gurlit, Rainer Kiefmann
With a constantly growing portion of elderly within our population and the advances of modern medicine, surgery on aged and very aged patients has become a daily hospital routine. Due to the physical and mental features of ageing these patients face special perioperative risks. They display a higher rate of complications, morbidity and cognitive deficits which might in the end lead to persisting need of care. Even in the healthy elderly, most organ functions are "physiologically" instable or deficient and the homeostasis of health and disease is fragile...
May 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28559045/physical-activity-and-frailty-as-indicators-of-cardiorespiratory-reserve-and-predictors-of-surgical-prognosis-general-and-digestive-surgery-population-characterization
#14
F Dana, D Capitán, M Ubré, A Hervás, R Risco, G Martínez-Pallí
INTRODUCTION: Frailty and low physical activity and cardiorespiratory reserve are related to higher perioperative morbimortality. The crucial step in improving the prognosis is to implement specific measures to optimize these aspects. It is critical to know the magnitude of the problem in order to implement preoperative optimization programmes. OBJECTIVE: To characterize surgical population in a university hospital. METHODS: All patients undergoing preoperative evaluation for abdominal surgery with admission were prospectively included during a 3-month period...
May 27, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28527727/patient-outcomes-following-lower-leg-major-amputations-for-peripheral-arterial-disease-a-series-review
#15
Susan Monaro, Sandra West, Janice Gullick
INTRODUCTION: Despite improvements in revascularization, major amputation remains a significant part of the case-mix in vascular surgical units. These patients tend to be elderly with complex pathology, resulting in poor outcomes and longer lengths of stay (LOS). AIM: This series review provides a description of the patient complexities and outcomes in an Australian cohort undergoing major lower limb amputation for peripheral arterial disease. METHOD: Medical records coded for major amputation between July 2012 and June 2013 in an Australian government funded, tertiary hospital were retrospectively reviewed and descriptively analyzed...
June 2017: Journal of Vascular Nursing: Official Publication of the Society for Peripheral Vascular Nursing
https://www.readbyqxmd.com/read/28493165/minimally-invasive-distal-pancreatectomy-greatest-benefit-for-the-frail
#16
Ioannis T Konstantinidis, Aaron Lewis, Byrne Lee, Susanne G Warner, Yanghee Woo, Gagandeep Singh, Yuman Fong, Laleh G Melstrom
OBJECTIVE: The benefits of minimally invasive distal pancreatectomy (MIDP) over open surgery continue to be investigated. Frailty is a known predictor of postoperative outcome. We hypothesized that the benefit of minimally invasive distal pancreatectomy is the greatest for the frailest of patients. METHODS: Data from the pancreas-targeted National Surgical Quality Improvement Program (NSQIP) database for 2014 were reviewed. A modified frailty index (mFI) with 11 preoperative variables previously validated for use in NSQIP was used to determine the correlation between frailty and postoperative outcomes, including Clavien grade IV complications...
May 10, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28467535/association-of-the-modified-frailty-index-with-30-day-surgical-readmission
#17
Tyler S Wahl, Laura A Graham, Mary T Hawn, Joshua Richman, Robert H Hollis, Caroline E Jones, Laurel A Copeland, Edith A Burns, Kamal M Itani, Melanie S Morris
Importance: Frail patients are known to have poor perioperative outcomes. There is a paucity of literature investigating how the Modified Frailty Index (mFI), a validated measure of frailty, is associated with unplanned readmission among military veterans following surgery. Objective: To understand the association between frailty and 30-day postoperative unplanned readmission. Design, Setting, and Participants: A retrospective cohort study was conducted among adult patients who underwent surgery and were discharged alive from Veterans Affairs hospitals for orthopedic, general, and vascular conditions between October 1, 2007, and September 30, 2014, with a postoperative length of stay between 2 and 30 days...
May 3, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28462224/the-impact-of-frailty-on-mortality-after-transcatheter-aortic-valve-replacement
#18
EDITORIAL
Charat Thongprayoon, Wisit Cheungpasitporn, Kianoush Kashani
Frailty is a notably common problem in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR) evaluation. Studies have demonstrated significant associations between frailty and worse outcomes in patients undergoing TAVR including higher risks of disability and mortality and admissions to long-term care facility. While there are multiple methods to identify and measure frailty, there is a critical need for a precise definition of frailty and its standardized assessment protocol based on well-established tests covering all aspects of the frailty, as a syndrome...
March 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28449296/frailty-index-intensive-care-unit-complications-in-head-and-neck-oncologic-regional-and-free-flap-reconstruction
#19
Nicholas B Abt, Yanjun Xie, Sidharth V Puram, Jeremy D Richmon, Mark A Varvares
BACKGROUND: Head and neck extirpations requiring reconstruction are challenging surgeries with high postoperative complication risk. METHODS: Regional and free flap reconstructions of head and neck defects were collected from the 2006-2013 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. The modified frailty index was made of 15 variables, with increasing index scores indicative of frailer patients. Intensive care unit (ICU)-level complications were defined by Clavien-Dindo classification IV and analyzed with multivariable logistic regression...
August 2017: Head & Neck
https://www.readbyqxmd.com/read/28431425/the-association-of-frailty-with-outcomes-and-resource-use-after-emergency-general-surgery-a-population-based-cohort-study
#20
Daniel I McIsaac, Husein Moloo, Gregory L Bryson, Carl van Walraven
BACKGROUND: Older patients undergoing emergency general surgery (EGS) experience high rates of postoperative morbidity and mortality. Studies focused primarily on elective surgery indicate that frailty is an important predictor of adverse outcomes in older surgical patients. The population-level effect of frailty on EGS is poorly described. Therefore, our objective was to measure the association of preoperative frailty with outcomes in a population of older patients undergoing EGS. METHODS: We created a population-based cohort study using linked administrative data in Ontario, Canada, that included community-dwelling individuals aged >65 years having EGS...
May 2017: Anesthesia and Analgesia
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