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Cardiac surgery risk score

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https://www.readbyqxmd.com/read/29779783/readmission-to-the-intensive-care-unit-following-cardiac-surgery-a-derived-and-validated-risk-prediction-model-in-4-869-patients
#1
Rebekah Thomson, Nick Fletcher, Oswaldo Valencia, Vivek Sharma
OBJECTIVE: To derive and validate a clinical risk index that can predict readmission to the intensive care unit (ICU) after cardiac surgery. DESIGN: Retrospective nonrandomized study to determine the perioperative variables associated with risk of readmission to the ICU after cardiac surgery. SETTING: The study was carried out in a single university hospital. PARTICIPANTS: This was an analysis of 4,869 consecutive adult patients...
April 18, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29773957/perioperative-predictors-of-delirium-and-incidence-factors-in-adult-patients-post-cardiac-surgery
#2
Stavros Theologou, Konstantinos Giakoumidakis, Christos Charitos
Background: Delirium is a quite common complication in adult patients post-cardiac surgery. The purpose of our study was to identify perioperative characteristics and also focus on incidence factors that could predict delirium in the cardiac surgery intensive care unit (CICU) postoperatively. Methods: We conducted a prospective study of 179 consecutive patients, who underwent open-heart surgical operation and were admitted to the CICU of a general tertiary hospital in Athens, Greece...
2018: Pragmatic and Observational Research
https://www.readbyqxmd.com/read/29771722/detection-of-deteriorating-patients-on-surgical-wards-outside-the-icu-by-an-automated-mews-based-early-warning-system-with-paging-functionality
#3
Axel R Heller, Sören T Mees, Benjamin Lauterwald, Christian Reeps, Thea Koch, Jürgen Weitz
BACKGROUND: The establishment of early warning systems in hospitals was strongly recommended in recent guidelines to detect deteriorating patients early and direct them to adequate care. Upon reaching predefined trigger criteria, Medical Emergency Teams (MET) should be notified and directed to these patients. The present study analyses the effect of introducing an automated multiparameter early warning score (MEWS)-based early warning system with paging functionality on 2 wards hosting patients recovering from highly complex surgical interventions...
May 16, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29765253/use-of-histamine-h-2-receptor-antagonists-and-outcomes-in-patients-with-heart-failure-a-nationwide-population-based-cohort-study
#4
Kasper Adelborg, Jens Sundbøll, Morten Schmidt, Hans Erik Bøtker, Noel S Weiss, Lars Pedersen, Henrik Toft Sørensen
Background: Histamine H2 receptor activation promotes cardiac fibrosis and apoptosis in mice. However, the potential effectiveness of histamine H2 receptor antagonists (H2RAs) in humans with heart failure is largely unknown. We examined the association between H2RA initiation and all-cause mortality among patients with heart failure. Methods: Using Danish medical registries, we conducted a nationwide population-based active-comparator cohort study of new users of H2RAs and proton pump inhibitors (PPIs) after first-time hospitalization for heart failure during the period 1995-2014...
2018: Clinical Epidemiology
https://www.readbyqxmd.com/read/29762119/hip-fracture-mortality-differences-between-intertrochanteric-and-femoral-neck-fractures
#5
Nicholas B Frisch, Nolan Wessell, Michael Charters, Alexander Greenstein, Jonathan Shaw, Edward Peterson, S Trent Guthrie
The purpose of this study was to identify the specific risk factors that affect mortality in patients with hip fractures and differentiate mortality-associated factors between intertrochanteric (IT) and femoral neck (FN) fractures. A total of 1538 consecutive patients with hip fractures were treated at the authors' institution between January 2005 and October 2013. Ultimately 858 IT and 479 FN fracture patients were included on the basis of age >60 years with an isolated hip fracture. Mortality rate at 90 days was 12...
2018: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/29761259/-sense-of-coherence-scale-according-to-antonovsky-as-a-possible-predictor-for-return-to-work-for-cardiac-surgery-intensive-care-patients
#6
C Benstoem, R Wübker, M Lüngen, T Breuer, G Marx, R Autschbach, A Goetzenich, H Schnoering
BACKGROUND: For cardiac surgery patients who were employed prior to surgery, the return to their professional life is of special importance. In addition to medical reasons, such as pre-existing conditions, the success of the operation or postoperative course and patient-intrinsic reasons, which can be assessed with the Sense of Coherence (SOC) scale by Antonovsky, may also play a role in the question of a possible return into working life. METHODS: In this study 278 patients (invasive coronary artery bypass graft surgery and/or surgery on heart valves, age < 60 years, employed) were questioned postoperatively via post with the SOC questionnaire...
May 14, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29756690/preoperative-predictive-model-for-acute-kidney-injury-after-elective-cardiac-surgery-a-prospective-multicentre-cohort-study
#7
Raquel Callejas, Alfredo Panadero, Marc Vives, Paula Duque, Gemma Echarri, Pablo Monedero
BACKGROUND: Predictive models of CS-AKI include emergency surgery and patients with haemodynamic instability. Our objective was to evaluate the performance of validated predictive models (Thakar and Demirjian) in elective cardiac surgery and to propose a better score in the case of poor performance. METHODS: A prospective, multicentre, observational study was designed. Data were collected from 942 patients undergoing cardiac surgery, after excluding emergency surgery and patients with an intraaortic balloon pump...
May 11, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29754790/aortic-clamping-strategy-and-postoperative-stroke
#8
Mohamad Alaeddine, Vinay Badhwar, Maria V Grau-Sepulveda, Lawrence M Wei, Chris C Cook, Michael E Halkos, Vinod H Thourani, Jeffrey P Jacobs, Roland Matsouaka, James Meza, Matthew Brennan, Thomas G Gleason, Danny Chu
OBJECTIVE: The effect of aortic clamping strategy on short-term stroke during proximal graft construction for coronary artery bypass grafting (CABG) remains undefined. The aim of this study was to test the hypothesis that partial occluding clamp (POC) technique does not increase incidence of postoperative stroke compared with single clamp (SC) technique for performing proximal coronary anastomoses. METHODS: We identified 52,611 patients who underwent on-pump CABG in the Society of Thoracic Surgeons Adult Cardiac Surgery Database from July 1, 2014 to March 31, 2015...
April 13, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29754693/preoperative-6-minute-walk-distance-is-associated-with-postoperative-cognitive-dysfunction
#9
Kazuhiro Hayashi, Hideki Oshima, Miho Shimizu, Kiyonori Kobayashi, Shigeyuki Matsui, Yoshihiro Nishida, Akihiko Usui
BACKGROUND: Postoperative cognitive dysfunction (POCD) is a neurologic dysfunction that occurs after surgery. POCD persists for a long period, ranging from weeks to months, and affects a patient's quality of life. A 6-minute walk distance (6MWD) has been used to predict postoperative complications after several operations. The present study investigated whether there was an independent association of a low preoperative 6MWD with POCD in patients who underwent cardiac operations. METHODS: The study included 181 patients who underwent a cardiac operation...
April 25, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29752534/effect-of-blood-transfusion-on-survival-after-hip-fracture-surgery
#10
S J M Smeets, J P A M Verbruggen, M Poeze
BACKGROUND: Our primary goal was to audit the incidence of erythrocyte blood transfusion (EBT) after hip fracture surgery and study the effects on perioperative complications and early and late mortality. METHODS: In a retrospective cohort study all patients 65 years old and above treated operatively for an acute hip fracture were included over a 48-month period with a 2-year follow-up period. Postoperative hemoglobin levels were used to investigate at what threshold EBT was used...
May 11, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29749243/the-predictive-value-of-risk-indices-for-cardiac-complications-in-living-donor-liver-transplantation
#11
I P Canbolat, Y Erdogan, G Adali, O Kaplan, M Dayangac, Y Yuzer, Y Tokat
BACKGROUND AND AIMS: The American College of Surgeons' National Surgical Quality Improvement Program (NSQIP) risk tool and Revised Cardiac Risk Index (RCRI) are recommended tools for cardiovascular assessment before non-cardiac surgery to predict early postoperative cardiac morbidity and mortality. Their predictive value for postoperative cardiovascular morbidity and mortality after liver transplantation is unknown. We aimed to evaluate the validity of these two risk tools to predict early (30-day) cardiovascular complications and in-hospital all-cause mortality...
2018: Bratislavské Lekárske Listy
https://www.readbyqxmd.com/read/29748956/neurobehavioral-evaluation-of-neonates-with-congenital-heart-disease-a-cohort-study
#12
Whitnee J Hogan, Sarah Winter, Nelangi M Pinto, Cindy Weng, Xiaoming Sheng, Elisabeth Conradt, Janine Wood, Michael D Puchalski, Lloyd Y Tani, Thomas A Miller
AIM: To describe neurobehavioral patterns in neonates with congenital heart disease (CHD). METHOD: A cohort study describing neurobehavioral performance of neonates with CHD requiring cardiac surgery. The neonates were evaluated preoperatively and postoperatively with the Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS) and scores were compared with published normative values. Clinical factors were obtained by chart review to assess their association with behavior...
May 10, 2018: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/29745623/the-role-of-intraoperative-stroke-volume-variation-on-bleeding-during-functional-endoscopic-sinus-surgery
#13
Roberta Di Mauro, Fabiana Lucci, Federica Martino, Maria B Silvi, Eleonora Gidaro, Santo Di Lorenzo, Nicola Toschi, Stefano Di Girolamo, Mario Dauri
BACKGROUNDː Functional Endoscopic Sinus Surgery (FESS) is a minimally-invasive surgical technique for patients with paranasal sinus pathology. Surgical bleeding reduces operative field visibility and increases the incidence of serious complications. Epinephrine injection into the nasal mucosa and controlled hypotension are used to minimise bleeding. Hypotension carries risks and sometimes does not reduce surgical bleeding. The goal of this study is to discover which haemodynamic parameter better correlates with surgical bleeding...
May 9, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29741482/mortality-risk-after-transcatheter-aortic-valve-implantation-analysis-of-the-predictive-accuracy-of-the-transcatheter-valve-therapy-registry-risk-assessment-model
#14
Pablo Codner, Waqas Malick, Remi Kouz, Amisha Patel, Cheng-Han Chen, Juan Terre, Uri Landes, Torsten Peter Vahl, Isaac George, Tamim Nazif, Ajay J Kirtane, Omar K Khalique, Rebecca T Hahn, Martin B Leon, Susheel Kodali
AIMS: Risk assessment tools currently used to predict mortality in transcatheter aortic valve implantation (TAVI) were designed for patients undergoing cardiac surgery. We aim to assess the accuracy of the TAVI dedicated American College of Cardiology / Transcatheter Valve Therapies (ACC/TVT) risk score in predicting mortality outcomes. METHODS AND RESULTS: Consecutive patients (n=1038) undergoing TAVI at a single institution from 2014 to 2016 were included. The ACC/TVT registry mortality risk score, the Society of Thoracic Surgeons - Patient Reported Outcomes (STS-PROM) score and the EuroSCORE II were calculated for all patients...
May 8, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29735354/prediction-of-sudden-death-risk-in-obstructive-hypertrophic-cardiomyopathy-potential-for-refinement-of-current-criteria
#15
Milind Y Desai, Nicholas G Smedira, Ashwat Dhillon, Ahmad Masri, Oussama Wazni, Mohamad Kanj, Kimi Sato, Maran Thamilarasan, Zoran B Popovic, Harry M Lever
BACKGROUND: In patients with hypertrophic cardiomyopathy (HCM), the use of an implantable cardioverter defibrillator (ICD) can prevent sudden cardiac death (SCD). In patients with obstructive HCM, we sought to determine the prognostic utility of European Society of Cardiology (ESC) SCD risk score and to evaluate whether additional factors modulate SCD risk. METHODS: We studied 1809 consecutive patients with obstructive HCM (mean age, 50 ± 14 years; 63% males; mean maximal outflow tract gradient, 93 ± 40 mm Hg)...
April 12, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29732423/predicting-critical-care-unit-level-complications-after-long-segment-fusion-procedures-for-adult-spinal-deformity
#16
Rafael De la Garza-Ramos, Jonathan Nakhla, Yaroslav Gelfand, Murray Echt, Aleka N Scoco, Merritt D Kinon, Reza Yassari
Background: To identify predictive factors for critical care unit-level complications (CCU complication) after long-segment fusion procedures for adult spinal deformity (ASD). Methods: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database [2010-2014] was reviewed. Only adult patients who underwent fusion of 7 or more spinal levels for ASD were included. CCU complications included intraoperative arrest/infarction, ventilation >48 hours, pulmonary embolism, renal failure requiring dialysis, cardiac arrest, myocardial infarction, unplanned intubation, septic shock, stroke, coma, or new neurological deficit...
March 2018: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/29731076/application-of-the-revised-cardiac-risk-index-to-the-model-for-end-stage-liver-disease-score-improves-the-prediction-of-cardiac-events-in-patients-undergoing-liver-transplantation
#17
Y-S Park, Y-J Moon, I-G Jun, J-G Song, G-S Hwang
INTRODUCTION: Although the revised cardiac risk index (RCRI) is a useful tool for estimating the risk of postoperative cardiac events, whether it improves the prediction of cardiac events in patients undergoing liver transplantation (LT) has not been sufficiently demonstrated. METHODS: We retrospectively analyzed 1429 patients who underwent LT. Cardiac events were defined as myocardial infarction, death, or combined events within 30 days after surgery. The RCRI was defined as the number of independent predictors including high-risk surgery, ischemic heart disease, congestive heart failure, cerebrovascular disease, insulin treatment, and creatinine level >2 mg/dL...
May 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29730345/hemiarch-reconstruction-vs-clamped-aortic-anastomosis-for-concomitant-ascending-aortic-aneurysm
#18
Ibrahim Sultan, Valentino Bianco, Ibrahim Yajzi, Arman Kilic, Keith Dufendach, Arturo Cardounel, Andrew D Althouse, Ahmad Masri, Forozan Navid, Thomas G Gleason
BACKGROUND: Deep hypothermic circulatory arrest (DHCA) is often avoided in patients with concomitant ascending aortic pathology when treating other cardiac disease to avoid increased risk of morbidity and mortality. We hypothesized that the use of DHCA with retrograde cerebral perfusion (RCP) does not add incremental risk to ascending aortic replacement alone in the setting of concomitant cardiac surgery. METHODS: 408 ascending aortic ± hemiarch replacements and aortic (root)/mitral/tricuspid valve(s), CABG, or MAZE procedures were performed for concomitant cardiac disease...
May 3, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29706371/an-anticoagulation-protocol-for-use-after-congenital-cardiac-surgery
#19
Asha G Nair, Olubunmi O Oladunjoye, Cameron C Trenor, Meena LaRonde, Sarah J van den Bosch, Lynn A Sleeper, Christina VanderPluym, Sitaram M Emani, John N Kheir
BACKGROUND: Patients undergoing surgery for congenital heart disease are at high risk for bleeding as well as thrombosis in the postoperative period. The objective of the study was to describe the design and effects of implementing a standardized unfractionated heparin anticoagulation protocol for children after congenital heart surgery. METHODS: We created a tiered guideline for the postoperative management of bleeding and thrombosis. In patients treated with unfractionated heparin, anti-factor Xa activity level as well as activated partial thromboplastin time were used for dose titration...
April 7, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29704693/cardiac-arrest-during-spine-surgery-in-the-prone-position-case-report-and-review-of-the-literature
#20
REVIEW
Victor E Staartjes, Shiva A Schillevoort, Patricia G Blum, J Peter van Tintelen, Wouter E Kok, Marc L Schröder
OBJECTIVE: Intraoperative cardiac arrest (CA) is usually attributable to pre-existing disease, or to intraoperative complications. In rare cases, intraoperative stress can demask certain genetic diseases, such as Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT). It is essential that neurosurgeons are aware of the etiologies, risk factors, and initial management of CA during surgery in the prone position. METHODS: We present a case of CA directly after spinal fusion for lumbar spondylolisthesis, and review the literature on cardiac arrests during spinal neurosurgery in the prone position...
April 26, 2018: World Neurosurgery
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