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Quality improvment in cardiac surgery

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https://www.readbyqxmd.com/read/29016439/examining-the-ability-of-artificial-neural-networks-machine-learning-models-to-accurately-predict-complications-following-posterior-lumbar-spine-fusion
#1
Jun S Kim, Robert K Merrill, Varun Arvind, Deepak Kaji, Sara D Pasik, Chuma C Nwachukwu, Luilly Vargas, Nebiyu S Osman, Eric K Oermann, John M Caridi, Samuel K Cho
STUDY DESIGN: Cross-sectional database study. OBJECTIVE: To train and validate machine learning models to identify risk factors for complications following posterior lumbar spine fusion. SUMMARY OF BACKGROUND DATA: Machine learning models such as artificial neural networks (ANNs) are valuable tools for analyzing and interpreting large and complex datasets. ANNs have yet to be used for risk factor analysis in orthopedic surgery. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried for patients who underwent posterior lumbar spine fusion...
October 9, 2017: Spine
https://www.readbyqxmd.com/read/28987857/intracranial-hemorrhage-in-patients-with-durable-mechanical-circulatory-support-devices-institutional-review-and-proposed-treatment-algorithm
#2
Wyatt L Ramey, Robyn L Basken, Christina M Walter, Zain Khalpey, G Michael Lemole, Travis M Dumont
OBJECTIVE: Spontaneous intracranial hemorrhage (ICH) is frequently managed in neurosurgery. Patients with durable mechanical circulatory support devices, including total artificial hearts (TAHs) and left ventricular assist devices (LVADs) are often encountered in the setting of ICH. While durable mechanical circulatory support devices have improved survival and quality of life for patients with advanced heart failure, ICH is one of the most feared complications following LVAD and TAH implantation...
October 4, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28973289/early-postoperative-complications-for-elderly-patients-undergoing-single-level-decompression-for-lumbar-disc-herniation-ligamentous-hypertrophy-or-neuroforaminal-stenosis
#3
Arpan V Prabhu, Bryan A Lieber, Jenson K Henry, Nitin Agarwal, Monir Tabbosha, David O Okonkwo
BACKGROUND: Lumbar decompression for disc herniation is frequently performed on elderly patients, and this trend will continue as the population ages. Clinical reports on the complications of lumbar discectomy show good results and cost effectiveness in young or middle-aged patients. OBJECTIVE: To assess and compare the morbidity of single-level lumbar disc surgery for radicular pain in a cohort of patients greater than 80 yr of age to that of a middle-aged cohort...
July 18, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28971404/evaluating-the-homeostasis-assessment-model-insulin-resistance-and-the-cardiac-autonomic-system-in-bariatric-surgery-patients-a-meta-analysis
#4
Styliani A Geronikolou, Konstantinos Albanopoulos, George Chrousos, Dennis Cokkinos
Morbid obesity is a severe chronic disease and subject to surgical methods for losing weight. This intervention is expected to drive to better quality of life and health status. Other important aspects which may be influenced are: HOMA-IR (as insulin resistance marker) and heart rate variability (as cardiac function and autonomic nervous system marker), which are independent and valid predictors of future cardiac, neurological, metabolic health. We pooled 4 studies (646 subjects) resulting to HOMA-IR and nine HRV components-grouped in those undergone to gastric bypass (RYGP) and those operated with vertical sleeve gastrectomy (SG) method...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28967727/the-criteria-of-inoperability
#5
Stefano Romagnoli, Laura Paparella, Paolo Boninsegni
In the literature, the term "inoperable" mainly refers to two specific clinical aspects: cancer staging and technical difficulty/impossibility in performing. In light of this clarification, the statement "the patient cannot be anesthetized" has no medical foundation. On the contrary, the physicians have to carefully stratify the perioperative risk and optimize the patients' preoperative clinical status. In order to perform a precise risk stratification, the European Society of Cardiology and the European Society of Anaesthesiology have joined and published the guidelines for the perioperative cardiovascular management of patients scheduled to undergo non-cardiac surgery...
July 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28967721/prognostic-impact-of-frailty-in-elderly-cardiac-surgery-patients
#6
Francesco Vetta, Gabriella Locorotondo, Giampaolo Vetta, Maria Mignano, Sonia Bracchitta
Over the past few decades, the progressive aging of the population combined with the resulting increase in cardiovascular disease and the marked improvement of technologies applied to surgery justify the marked increase of the elderly patients requiring cardiovascular surgery. This claims a highly skilled perioperative management, which should be aimed at treating cardiac disease without increasing risk of hospitalization-related harmful events. Current preoperative assessment for cardiac surgery, such as the European System for Cardiac Operative Risk Evaluation II (EUROSCORE II) and the Society of Thoracic Surgeons (STS) risk score, are limited in their ability to predict perioperative outcomes in older patients...
July 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28967720/current-multivariate-risk-scores-in-patients-undergoing-non-cardiac-surgery
#7
Gian Francesco Mureddu
Several indexes to predict perioperative cardiovascular risk have been proposed overtime. The most widely used is the Revised Cardiac Risk Index (RCRI) developed by Lee since 1999. It predicts major cardiac outcomes from five independent clinical determinants: history of ischemic heart disease, history of cardiovascular disease, heart failure, insulin-dependent diabetes mellitus, and chronic renal failure (i.e. serum creatinine >2 mg/dl). In external validation studies, the RCRI showed high negative predictive value in all groups of age, indicating that it may be used to identify people at low risk for perioperative adverse cardiovascular events in noncardiac surgery...
July 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28967716/age-related-prevalence-of-non-cardiac-surgery-indications
#8
Nera Agabiti
A clear trend in Italy over the last 20 years has been the increasing prevalence of 'very old' people (over 75 years of age) within the general population. Routine statistics as well as population surveys and ad hoc epidemiological studies all confirm this trend. The proportion of so-called 'very old patients in good health' is the category which is increasing the most. This is due to the economic well-being and generally good living conditions in Italy as well as progress in medical care and the introduction of new treatments and technologies in clinical practice that have improved survival and quality of life...
July 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28963710/effects-of-a-pre-surgery-supervised-exercise-training-1%C3%A2-year-after-bariatric-surgery-a-randomized-controlled-study
#9
Aurélie Baillot, Carol-Anne Vallée, Warner M Mampuya, Isabelle J Dionne, Emilie Comeau, Anne Méziat-Burdin, Marie-France Langlois
BACKGROUND: We have previously reported on the benefits of Pre-Surgical Exercise Training (PreSET) on physical fitness and social interactions in subjects awaiting bariatric surgery (BS). However, data are needed to know whether these benefits are maintained post-BS. OBJECTIVES: The purpose of this paper was to evaluate the effect of PreSET on physical activity (PA) level, physical fitness, PA barriers, and quality of life (QoL) 1 year (1-Y) after BS. METHODS: Of the 30 participants randomized into two groups (PreSET and usual care), 25 were included in the final analysis...
September 30, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28947230/indications-risk-factors-and-outcomes-of-30-day-readmission-after-infrarenal-abdominal-aneurysm-repair
#10
Hanaa N Dakour Aridi, Satinderjit Locham, Besma Nejim, Nasr S Ghajar, Husain Alshaikh, Mahmoud B Malas
OBJECTIVE: Reducing readmissions is an important target for improving patient care and enhancing health care quality and cost-effectiveness. The aim of this study was to assess rates, risk factors, and indications of 30-day readmission after open aortic repair (OAR) and endovascular aneurysm repair (EVAR) of infrarenal abdominal aortic aneurysms (AAAs). METHODS: A retrospective analysis of the Premier Healthcare Database from 2009 to 2015 was performed. Indications for readmission after the index procedure, risk factors, and outcomes of the index admission and rehospitalization were evaluated...
September 22, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28944174/hypertrophic-obstructive-cardiomyopathy-the-leipzig-experience
#11
Jawad Khalil, Michael Kuehl, Pirose Davierwala, Friedrich Wilhelm Mohr, Martin Misfeld
BACKGROUND: Management of hypertrophic obstructive cardiomyopathy (HOCM) has evolved considerably over the last fifty years, and includes medical treatment as well as septal myectomy (SM) to relief symptoms caused by left ventricular outflow tract obstruction (LVOTO). We report the Leipzig Heart Center experience in the surgical management of patients with HOCM. METHODS: We collected data from all patient treated surgically with a myectomy for LVOTO in patients with HOCM between 1997 and 2016...
July 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28927188/measuring-the-quality-of-perioperative-care-in-cardiac-surgery
#12
Tim G Coulson, Daniel V Mullany, Christopher M Reid, Michael Bailey, David Pilcher
Quality of care is of increasing importance in health and surgical care. In order to maintain and improve quality, we must be able to measure it and identify variation. In this narrative review, we aim to identify measures used in the assessment of quality of care in cardiac surgery and to evaluate their utility. The electronic databases Pubmed/MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database of Systematic Reviews, and CINAHL were searched for original published studies using the terms 'cardiac surgery' and 'quality or outcome or process or structure' as either keywords in the title or text or MeSH terms...
January 1, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/28922269/extubation-failure-is-associated-with-increased-mortality-following-first-stage-single-ventricle-reconstruction-operation
#13
Thomas Scodellaro, Jane M McKenzie, Yves d'Udekem, Warwick Butt, Siva P Namachivayam
OBJECTIVES: To identify the prevalence, causes, risk factors, and outcomes associated with extubation failure following first stage single ventricle reconstruction surgery. DESIGN: Retrospective cohort analysis of neonates who underwent a first stage single ventricle reconstruction operation. Extubation failure was defined as endotracheal reintubation within 48 hours of first extubation attempt. SETTING: The Royal Children's Hospital, Melbourne...
September 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28905303/measuring-what-matters-to-the-patient-health-related-quality-of-life-after-aortic-valve-and-thoracic-aortic-surgery
#14
Frederiek de Heer, Arjen L Gökalp, Jolanda Kluin, Johanna J M Takkenberg
With improved outcomes following cardiac surgery, health related quality of life (HRQoL) gains increasing importance for the better judgement of choosing the preferred treatment strategy in the individual patient. The physician perception of patient preferences can differ considerably from actual patient preferences, underlining the importance of gathering evidence of actual patient preferences before and quality of life after cardiac surgery. The objective of the current review is to provide an overview of current insights into the quality of life measurements after aortic valve and thoracic aortic surgery and to provide starting points for the application of HRQoL measurements toward the future...
September 13, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28902932/non-pharmacological-interventions-to-promote-the-sleep-of-patients-after-cardiac-surgery-a-systematic-review
#15
Fernanda de Souza Machado, Regina Claudia da Silva Souza, Vanessa Brito Poveda, Ana Lucia Siqueira Costa
Objective: to analyze evidence available in the literature concerning non-pharmacological interventions that are effective to treat altered sleep patterns among patients who underwent cardiac surgery. Method: systematic review conducted in the National Library of Medicine-National Institutes of Health, Cochrane Central Register of Controlled Trials, Latin American and Caribbean Health Sciences Literature, Scopus, Embase, Cumulative Index to Nursing and Allied Health Literature and PsycINFO databases, and also grey literature...
September 12, 2017: Revista Latino-americana de Enfermagem
https://www.readbyqxmd.com/read/28901228/the-world-database-for-pediatric-and-congenital-heart-surgery-the-dawn-of-a-new-era-of-global-communication-and-quality-improvement-in-congenital-heart-disease
#16
REVIEW
James D St Louis, Hiromi Kurosawa, Richard A Jonas, Nestor Sandoval, Jorge Cervantes, Christo I Tchervenkov, Jeffery P Jacobs, Kisaburo Sakamoto, Giovanni Stellin, James K Kirklin
The World Society for Pediatric and Congenital Heart Surgery was founded with the mission to "promote the highest quality comprehensive cardiac care to all patients with congenital heart disease, from the fetus to the adult, regardless of the patient's economic means, with an emphasis on excellence in teaching, research, and community service." Early on, the Society's members realized that a crucial step in meeting this goal was to establish a global database that would collect vital information, allowing cardiac surgical centers worldwide to benchmark their outcomes and improve the quality of congenital heart disease care...
September 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28893702/risk-factors-associated-with-perioperative-myocardial-infarction-in-major-open-vascular-surgery
#17
Danielle C Sutzko, Elizabeth A Andraska, Andrea T Obi, Peter K Henke, Nicholas H Osborne
BACKGROUND: Among patients undergoing non-cardiac surgery, major vascular surgery is associated with a high risk of perioperative myocardial infarction (MI). Currently there are no perioperative MI risk calculators accounting for intraoperative and postoperative risk factors in vascular surgery patients. We aimed to investigate specific risk factors for perioperative MI after major open vascular surgery to determine which patients are at highest risk of MI, and the association of perioperative MI with perioperative transfusion...
September 8, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28891912/postoperative-complications-affecting-survival-after-cardiac-arrest-in-general-surgery-patients
#18
Minjae Kim, Guohua Li
BACKGROUND: Postoperative cardiac arrest is uncommon but associated with a high mortality risk in general surgery patients and is often preceded by postoperative complications. The relationships between previous complications and mortality after cardiac arrest in general surgery patients have not been completely evaluated. METHODS: retrospective, observational cohort of general surgery in patients with cardiac arrest occurring after postoperative day (POD) #0 (and up to POD #30) was obtained from the 2012-2013 American College of Surgeons National Surgical Quality Improvement Program...
September 7, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28881069/person-centred-discharge-education-following-coronary-artery-bypass-graft-a-critical-review
#19
Melanie Rushton, Michelle Howarth, Maria J Grant, Felicity Astin
AIMS AND OBJECTIVES: This critical review examines the extent that individualised education helps reduce depression, anxiety and improves self-care for people who've undergone Coronary Artery Bypass Graft surgery (CABG). BACKGROUND: Individualised discharge planning is increasingly important following cardiac surgery due to recurrent admissions as well as the issue of anxiety and depression, often due to lack of preparation. The hospital to home transition is fundamental in the recovery process...
September 7, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28877948/appropriateness-of-percutaneous-coronary-interventions-in-patients-with-ischaemic-heart-disease-in-italy-the-apache-pilot-study
#20
Sergio Leonardi, Marcello Marino, Gabriele Crimi, Florinda Maiorana, Diego Rizzotti, Corrado Lettieri, Luca Bettari, Marco Zuccari, Paolo Sganzerla, Simone Tresoldi, Marianna Adamo, Sergio Ghiringhelli, Carlo Sponzilli, Giampaolo Pasquetto, Andrea Pavei, Luigi Pedon, Luciano Bassan, Mario Bollati, Paola Camisasca, Daniela Trabattoni, Marta Brancati, Arnaldo Poli, Claudio Panciroli, Maddalena Lettino, Giuseppe Tarelli, Giuseppe Tarantini, Leonardo De Luca, Ferdinando Varbella, Giuseppe Musumeci, Stefano De Servi
OBJECTIVES: To first explore in Italy appropriateness of indication, adherence to guideline recommendations and mode of selection for coronary revascularisation. DESIGN: Retrospective, pilot study. SETTING: 22 percutaneous coronary intervention (PCI)-performing hospitals (20 patients per site), 13 (59%) with on-site cardiac surgery. PARTICIPANTS: 440 patients who received PCI for stable coronary artery disease (CAD) or non-ST elevation acute coronary syndrome were independently selected in a 4:1 ratio with half diabetics...
September 5, 2017: BMJ Open
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