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Perioperative risk model

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https://www.readbyqxmd.com/read/30336117/identifying-drivers-of-multiple-readmissions-following-pulmonary-lobectomy
#1
Raymond A Jean, Alex S Chiu, Jessica R Hoag, Justin D Blasberg, Daniel J Boffa, Frank C Detterbeck, Anthony W Kim
BACKGROUND: Readmissions after pulmonary lobectomy for lung cancer are important markers of healthcare quality for surgeons and hospitals. The implications on resources and quality are magnified when examining patients who require multiple readmissions within the perioperative period. METHODS: The Nationwide Readmission Database (NRD) between 2013 and 2014 was investigated for patients with a primary diagnosis of lung cancer who underwent pulmonary lobectomy. Using adjusted hierarchical regression models, demographic and clinical factors during the index hospitalization were investigated for associations with single and multiple readmissions during the 90-day postoperative period...
October 15, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/30334884/perioperative-tranexamic-acid-treatment-and-risk-of-cardiovascular-events-or-death-after-total-hip-arthroplasty-a-population-based-cohort-study-from-national-danish-databases
#2
Alexander Dastrup, Anton Pottegård, Jesper Hallas, Søren Overgaard
BACKGROUND: There have been concerns that the antifibrinolytic drug tranexamic acid (TXA) might increase the postoperative risk of cardiovascular events. Our objective was to determine whether perioperative TXA use is associated with cardiovascular events and death within 30 days after primary total hip arthroplasty (THA). METHODS: We conducted a nationwide cohort study of cardiovascular outcomes after perioperative exposure to tranexamic acid during THA. We included 45,290 patients who had a THA in the study period of 2006 to 2013; 38,586 received perioperative TXA, and 6,704 did not...
October 17, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/30334856/association-between-concomitant-hysterectomy-and-repeat-surgery-for-pelvic-organ-prolapse-repair-in-a-cohort-of-nearly-100-000-women
#3
Kai Dallas, Christopher S Elliott, Raveen Syan, Ericka Sohlberg, Ekene Enemchukwu, Lisa Rogo-Gupta
OBJECTIVE: To evaluate the association of hysterectomy at the time of pelvic organ prolapse (POP) repair with the risk of undergoing subsequent POP surgery in a large population-based cohort. METHODS: Data from the California Office of Statewide Health Planning and Development were used in this retrospective cohort study to identify all women who underwent an anterior, apical, posterior or multiple compartment POP repair at nonfederal hospitals between January 1, 2005, and December 31, 2011, using Current Procedural Terminology and International Classification of Diseases, 9th Revision procedure codes...
October 15, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/30328066/risk-assessments-for-broncho-pleural-fistula-and-respiratory-failure-after-lung-cancer-surgery-by-national-clinical-database-japan
#4
Shunsuke Endo, Norihiko Ikeda, Takashi Kondo, Jun Nakajima, Haruhiko Kondo, Yoshihisa Shimada, Masami Sato, Shinichi Toyooka, Yoshinori Okada, Yukio Sato, Ichiro Yoshino, Morihito Okada, Meinoshin Okumura, Masayuki Chida, Eriko Fukuchi, Hiroaki Miyata
BACKGROUND: Broncho-pleural fistula (BPF) and respiratory failure (RF) are life-threatening complications after lung cancer surgery and can result in long-term hospitalization and decreased quality of life. Risk assessments for BPF and RF in addition to mortality and major morbidities are indispensable in surgical decision-making and perioperative care. METHODS: The characteristics and operative data of 80,095 patients who had undergone lung cancer surgery were derived from the 2014 and 2015 National Clinical Database (NCD) of Japan datasets...
October 16, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/30323657/frailty-and-anesthesia-risks-during-and-post-surgery
#5
REVIEW
Hui-Shan Lin, Rebecca L McBride, Ruth E Hubbard
Frailty is a state of decreased physiologic reserve and resistance to stressors. Its prevalence increases with age and is estimated to be 26% in those aged above 85 years. As the population ages, frailty will be increasingly seen in surgical patients receiving anesthesia. Here, we evaluate the instruments which have been developed and validated for measuring frailty in surgical patients and summarize frailty tools used in 110 studies linking frailty status with adverse outcomes post-surgery. Frail older people are vulnerable to geriatric syndromes, and complications such as postoperative cognitive dysfunction and delirium are explored...
2018: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/30321526/menopausal-symptoms-and-surgical-complications-after-opportunistic-bilateral-salpingectomy-a-register-based-cohort-study
#6
Elin Collins, Annika Strandell, Gabriel Granåsen, Annika Idahl
BACKGROUND: In recent years, the fallopian tubes have been found to play a critical role in the pathogenesis of ovarian cancer. Therefore, bilateral salpingectomy at the time of hysterectomy has been proposed as a preventive procedure, but with scarce scientific evidence to support the efficiency and safety. OBJECTIVE: Our primary objective was to evaluate the risk of surgical complications and menopausal symptoms performing bilateral salpingectomy in addition to benign hysterectomy...
October 12, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/30316905/the-current-place-of-mini-invasive-surgery-in-uterine-leiomyoma-management
#7
REVIEW
Jean Dubuisson
Uterine leiomyomas are the most common benign tumors in women of reproductive age. Most of leiomyomas are asymptomatic. They are often found incidentally, and require neither monitoring nor treatment. For symptomatic women who wish to become pregnant, surgical myomectomy remains the conservative treatment of choice. It can be performed in various routes depending on the location and the number of leiomyomas and the experience of the surgeon. A minimally invasive procedure should always be the preferred option so as to improve woman satisfaction and to decrease perioperative morbidity...
October 11, 2018: Journal of Gynecology Obstetrics and Human Reproduction
https://www.readbyqxmd.com/read/30302017/using-long-term-mortality-to-determine-which-perioperative-risk-factors-of-mortality-following-hip-and-knee-replacement-may-be-causal
#8
Linda P Hunt, Michael R Whitehouse, Peter W Howard, Yoav Ben-Shlomo, Ashley W Blom
Observational studies have identified surgical factors that are associated with a reduced risk of mortality after joint replacement. It is not clear whether these are causal or reflect patient selection. Data on the first primary hip (n = 424,156) and knee replacements (n = 469,989) performed for osteoarthritis in the National Joint Registry were analysed. Flexible parametric survival modelling was used to determine if risk factors for mortality in the perioperative period persisted. To explore selection bias, standardised mortality ratios were calculated for all-cause, respiratory and smoking related cancer mortality using population rates...
October 9, 2018: Scientific Reports
https://www.readbyqxmd.com/read/30301692/endovascular-aneurysm-repair-in-patients-over-75-is-associated-with-excellent-5-year-survival-which-suggests-benefit-from-expanded-screening-into-this-cohort
#9
Thomas F X O'Donnell, Jacqueline E Wade, Patric Liang, Chun Li, Nicholas J Swerdlow, Randall R DeMartino, Mahmoud B Malas, Bruce E Landon, Marc L Schermerhorn
BACKGROUND: Endovascular aneurysm repair (EVAR) has decreased the perioperative mortality for patients undergoing abdominal aortic aneurysm repair and has increased the rates of elective aneurysm repair in the elderly. However, Medicare will not cover abdominal aortic aneurysm screening for beneficiaries over 75 years of age. Consequently, abdominal aortic aneurysm treatment in this population depends on incidental detection. Targeted coverage for screening in this population, however, might be beneficial for a subgroup of patients...
October 6, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/30300182/implementing-a-pediatric-perioperative-surgical-home-integrated-care-coordination-pathway-for-laryngeal-cleft-repair
#10
Izabela Leahy, Connor Johnson, Steven J Staffa, Reza Rahbar, Lynne R Ferrari
BACKGROUND: The Pediatric Perioperative Surgical Home (PPSH) model is an integrative care model designed to provide better patient care and value by shifting focus from the patient encounter level to the overarching surgical episode of care. So far, no PPSH model has targeted a complex airway disorder. It was hypothesized that the development of a PPSH for laryngeal cleft repair would reduce the high rates of postoperative resource utilization observed in this population. METHODS: Institutional review board approval was obtained for the purpose of data collection and analysis...
October 8, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/30292628/development-of-a-prediction-tool-for-exclusive-locoregional-recurrence-after-radical-cystectomy-in-patients-with-muscle-invasive-bladder-cancer
#11
Andrea Necchi, Gregory R Pond, Marco Moschini, Elizabeth R Plimack, Gunter Niegisch, Evan Y Yu, Aristotelis Bamias, Neeraj Agarwal, Ulka Vaishampayan, Christine Theodore, Srikala S Sridhar, Jonathan E Rosenberg, Joaquim Bellmunt, Andrea Gallina, Renzo Colombo, Francesco Montorsi, Alberto Briganti, Matthew D Galsky
BACKGROUND: Limited information is available about the pattern of relapse after perioperative chemotherapy with radical cystectomy (RC) vs. RC alone in muscle-invasive bladder cancer. PATIENTS AND METHODS: Data from 1082 patients of the Retrospective International Study of Invasive/Advanced Cancer of the Urothelium database, treated from February 1990 to December 2013 at 27 centers in the United States, Europe, Israel, and Canada, were collected. Locoregional relapse was defined as any pelvic lymph node or soft tissue-only recurrences...
September 13, 2018: Clinical Genitourinary Cancer
https://www.readbyqxmd.com/read/30289479/prevalence-of-venous-thromboembolism-after-lung-surgery-in-china-a-single-centre-prospective-cohort-study-involving-patients-undergoing-lung-resections-without-perioperative-venous-thromboembolism-prophylaxis
#12
Chunfeng Song, Yaron Shargall, Hui Li, Bo Tian, Shuo Chen, Jinbai Miao, Yili Fu, Bin You, Bin Hu
OBJECTIVES: Venous thromboembolism (VTE) is a common postoperative complication. Previous studies have shown that the incidence of VTE after major thoracic surgery ranges from 2.3% to 15%. However, there have been no such data from China so far. To evaluate the incidence of postoperative VTE, we conducted a single-centre, prospective cohort study. METHODS: Patients who underwent lung resections between July 2016 and March 2017 were enrolled in this study. None of the patients received any prophylaxis perioperatively...
October 4, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/30284135/resveratrol-improves-recovery-and-survival-of-diet-induced-obese-mice-undergoing-extended-major-80-hepatectomy
#13
Xiaoling Jin, Teresa A Zimmers, Zongxiu Zhang, Leonidas G Koniaris
INTRODUCTION: Loss of hepatic epidermal growth factor receptor (EGFR) expression is a cause for the increased perioperative risk for complications and death in patients with obesity and fatty liver undergoing liver resection. Herein, we set out to identify agents that might increase EGFR expression and improve recovery for patients with fatty liver undergoing resection. Using the diet-induced obese (DIO) mouse model of fatty liver, we examined resveratrol as a therapy to induce EGFR expression and improve outcomes following 80% partial hepatectomy (PH) in a murine model...
October 3, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/30281195/perioperative-respiratory-adverse-event-risk-assessment-in-children-with-upper-respiratory-tract-infection-validation-of-the-colds-score
#14
Lisa K Lee, Marsha Kristel L Bernardo, Tristan R Grogan, David A Elashoff, Wendy H P Ren
BACKGROUND: The decision to proceed with anesthesia and surgery has been controversial in pediatric patients with an upper respiratory tract infection. The COLDS score was proposed by Lee and August as a potential risk stratification scheme, but no validation has been performed on this scale. AIMS: The aim of this study was to evaluate the utility of the COLDS score in predicting perioperative respiratory adverse events and optimize its predictive ability. METHODS: COLDS scores, incidence of perioperative respiratory adverse events, surgical procedure type, and age were prospectively collected for 536 patients who met inclusion criteria...
October 3, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/30275710/comparison-of-short-term-outcomes-between-minimally-invasive-mckeown-and-ivor-lewis-esophagectomy-for-esophageal-or-junctional-cancer-a-systematic-review-and-meta-analysis
#15
REVIEW
Jianqing Deng, Qingqing Su, Zhipeng Ren, Jiaxin Wen, Zhiqiang Xue, Lianbin Zhang, Xiangyang Chu
Purpose: Minimally invasive esophagectomy is increasingly performed for esophageal or gastroesophageal junctional cancer, with advantages of improved perioperative outcomes in comparison with open esophagectomy. McKeown and Ivor Lewis are widely used procedures of minimally invasive esophagectomy, and there have been controversies on which one is preferred for patients with resectable esophageal or junctional cancer. Patients and methods: This review was registered at the International Prospective Register of Systematic Reviews (number CRD42017075989)...
2018: OncoTargets and Therapy
https://www.readbyqxmd.com/read/30271785/a-risk-stratification-model-for-cardiovascular-complications-during-the-3-month-period-after-major-elective-vascular-surgery
#16
Mladjan Golubovic, Dragana Stanojevic, Milan Lazarevic, Velimir Peric, Tomislav Kostic, Miodrag Djordjevic, Sasa Zivic, Dragan J Milic
Introduction: The Revised Cardiac Risk Index (RCRI) is an extensively used simple risk stratification tool advocated by the European Society of Cardiology and European Society of Anesthesiology (ESC/ESA). Purpose: The aim of this study was to find the best model for predicting 3-month cardiovascular complications in elective major vascular surgical patients using preoperative clinical assessment, calculation of the RCRI and Vascular Physiological and Operative Severity Score for the enumeration of mortality and morbidity (V-POSSUM) scores, and the preoperative levels of N-terminal brain natriuretic peptide (NT pro-BNP), high-sensitivity troponin I (hs TnI), and high-sensitivity C-reactive protein (hs CRP)...
2018: BioMed Research International
https://www.readbyqxmd.com/read/30268552/discharge-destination-as-a-predictor-of-postoperative-outcomes-and-readmission-following-posterior-lumbar-fusion
#17
Annie E Arrighi-Allisan, Sean N Neifert, Jonathan S Gal, Brian C Deutsch, John M Caridi
BACKGROUND: Posterior lumbar fusions (PLF) are performed to treat various spinal deformities, degenerative diseases, fractures, infections, and tumors. The possibility of episode-based bundled payments for spine surgery necessitates analysis of the factors predicting readmissions and postoperative complications. METHODS: Patients undergoing PLF in the American College of Surgeons National Surgical Quality Improvement Program were queried via Current Procedural Terminology codes 22630, 22633, and 22612...
September 27, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/30259149/analysis-of-prognostic-factors-of-more-equal-to10-years-of-survival-for-liver-cancer-patients-after-liver-transplantation
#18
Xinyu Li, Lei Huang, Xisheng Leng
OBJECTIVE: To investigate prognostic factors of  more than 10 years of survival for liver cancer patients after liver transplantation. METHODS: From May 2000 to May 2007, a total of 134 liver cancer patients who underwent liver transplantation in the Department of Hepatobiliary Surgery, Peking University People's Hospital, were continuously and retrospectively enrolled. The patients included 120 males and 14 females. There were 124 cases (92.5%) of primary hepatocellular carcinoma, 9 cases (6...
September 26, 2018: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/30256316/costs-and-complications-of-increased-length-of-stay-following-adolescent-idiopathic-scoliosis-surgery
#19
Matthew R Boylan, Aldo M Riesgo, Alice Chu, Carl B Paulino, David S Feldman
Accelerated discharge protocols for scoliosis surgery have recently been described in the literature. There are limited data describing the association of length of stay (LOS) during the index admission with postoperative outcomes. We sought to define the economic and clinical implications of an additional 1 day in the hospital for scoliosis surgery. The Statewide Planning and Research Cooperative System database was used to identify patients with adolescent idiopathic scoliosis who underwent spinal fusion from 1 October 2007 to 30 September 2012 at high-volume institutions (>20 cases/year) in the state of New York...
September 25, 2018: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/30255251/extent-of-enhancement-on-multiphase-contrast-enhanced-ct-images-is-a-potential-prognostic-factor-of-stage-i-iii-colon-cancer
#20
Zhanhuai Wang, Yao Ye, Yeting Hu, Shugao Han, Lifeng Sun, Dong Xu, Kefeng Ding
OBJECTIVE: By evaluating extent of tumour enhancement on preoperative contrast-enhanced MDCT, we aimed to establish an imaging-based model to predict cancer-specific survival in stage I-III colon cancer. METHODS: A total of 548 stage I-III colon cancer patients who underwent curative resection from 2007 to 2013 were retrospectively included and divided into primary cohort and validation cohort according to admission time. The attenuation coefficient of each colon cancer was measured on the workstation by drawing the ROI in CT images...
September 25, 2018: European Radiology
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