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Cardiac surgery risk score

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https://www.readbyqxmd.com/read/28931782/tumor-necrosis-factor-%C3%AE-gene-expression-in-epicardial-adipose-tissue-is-related-to-coronary-atherosclerosis-assessed-by-computed-tomography
#1
Toshiro Kitagawa, Hideya Yamamoto, Takuya Hattori, Kazuhiro Sentani, Shinya Takahashi, Atsuhiro Senoo, Yumiko Kubo, Wataru Yasui, Taijiro Sueda, Yasuki Kihara
AIMS: Tumor necrosis factor (TNF)-α reportedly has key pro-inflammatory properties in both atherosclerosis and adipocytes. To further investigate the biologic impact of epicardial adipose tissue (EAT) on coronary atherosclerosis, we evaluated the relationship between TNF-α gene expression in EAT and clinically-assessed coronary atherosclerosis on computed tomography (CT). METHODS: We studied 47 patients before cardiac surgery (coronary artery bypass grafting [CABG], n=26; non-CABG, n=21), assessing visceral adipose tissue (VAT) area, EAT volume, coronary calcium score (CCS), and the presence of non- and/or partially-calcified coronary plaque (NCP) on CT angiography...
September 20, 2017: Journal of Atherosclerosis and Thrombosis
https://www.readbyqxmd.com/read/28925651/exercise-stress-testing-indications-and-common-questions
#2
Kathryn K Garner, William Pomeroy, James J Arnold
Exercise stress testing is a validated diagnostic test for coronary artery disease in symptomatic patients, and is used in the evaluation of patients with known cardiac disease. Testing of asymptomatic patients is generally not indicated. It may be performed in select deconditioned adults before starting a vigorous exercise program, but no studies have compared outcomes from preexercise testing vs. encouraging light exercise with gradual increases in exertion. Preoperative exercise stress testing is helpful for risk stratification in patients undergoing vascular surgery or who have active cardiac symptoms before undergoing nonemergent noncardiac surgery...
September 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28912198/frequency-of-low-value-care-in-alberta-canada-a-retrospective-cohort-study
#3
Finlay A McAlister, Meng Lin, Jeff Bakal, Stafford Dean
OBJECTIVE: To determine how frequently 10 low-value services highlighted by Choosing Wisely are done and what factors influence their provision. METHODS: This is a retrospective cohort study using routinely collected health data from five linked data sets from 2012 to 2015 in the Canadian province of Alberta to determine the frequency with which 10 low-value services were provided. RESULTS: Between 2012 and 2015, 162 143 people (4% of all 3 814 536 adult Albertans and 5% of the 3 423 135 who saw a physician at least once in that time frame) received at least one of the 10 low-value services, including 29...
September 14, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28906389/risk-factor-analysis-for-nonocclusive-mesenteric-ischemia-following-cardiac-surgery-a-case-control-study
#4
Ju Yong Lim, Joon Bum Kim, Sung Ho Jung, Suk Jung Choo, Cheol Hyun Chung, Jae Won Lee
Although rare, postcardiac surgery nonocclusive mesenteric ischemia (NOMI) is a life-threatening condition. Identifying the risk factors for NOMI during immediate postoperative period may help early detection and intervention, which leads to improved clinical outcomes. The objective of this study was to identify the clinical features and risk factors of NOMI for prognosis identification after cardiac surgery, focusing on immediate postoperative parameters.Among 9445 patients who underwent cardiac surgery over a span of 9 years, 40 NOMI cases (0...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28906380/syntax-score-based-on-coronary-computed-tomography-angiography-may-have-a-prognostic-value-in-patients-with-complex-coronary-artery-disease-an-observational-study-from-a-retrospective-cohort
#5
Young Joo Suh, Kyunghwa Han, Suyon Chang, Jin Young Kim, Dong Jin Im, Yoo Jin Hong, Hye-Jeong Lee, Jin Hur, Young Jin Kim, Byoung Wook Choi
The SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery (SYNTAX) score is an invasive coronary angiography (ICA)-based score for quantifying the complexity of coronary artery disease (CAD). Although the SYNTAX score was originally developed based on ICA, recent publications have reported that coronary computed tomography angiography (CCTA) is a feasible modality for the estimation of the SYNTAX score.The aim of our study was to investigate the prognostic value of the SYNTAX score, based on CCTA for the prediction of major adverse cardiac and cerebrovascular events (MACCEs) in patients with complex CAD...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28903139/percutaneous-coronary-intervention-vs-coronary-artery-bypass-grafting-in-patients-with-left-main-coronary-artery-stenosis-a-systematic-review-and-meta-analysis
#6
Daniele Giacoppo, Roisin Colleran, Salvatore Cassese, Antonio H Frangieh, Jens Wiebe, Michael Joner, Heribert Schunkert, Adnan Kastrati, Robert A Byrne
Importance: In patients with left main coronary artery (LMCA) stenosis, coronary artery bypass grafting (CABG) has been the standard therapy for several decades. However, some studies suggest that percutaneous coronary intervention (PCI) with drug-eluting stents may be an acceptable alternative. Objective: To compare the long-term safety of PCI with drug-eluting stent vs CABG in patients with LMCA stenosis. Data Sources: PubMed, Scopus, EMBASE, Web of Knowledge, and ScienceDirect databases were searched from December 18, 2001, to February 1, 2017...
September 13, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28895284/usefulness-of-the-syntax-score-ii-to-validate-2-year-outcomes-in-patients-with-complex-coronary-artery-disease-undergoing-percutaneous-coronary-intervention-a-large-single-center-study
#7
Ying Song, Zhan Gao, Xiaofang Tang, Yuanliang Ma, Ping Jiang, Jingjing Xu, Yi Yao, Xueyan Zhao, Shubin Qiao, Yuejin Yang, Runlin Gao, Bo Xu, Jinqing Yuan
OBJECTIVE: This study aimed to assess the prognostic ability of synergy between percutaneous coronary intervention with Taxus and cardiac surgery score II (SS-II) in a large cohort of patients with complex coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI) in clinical practice. BACKGROUND: Few studies have explored the usefulness of SS-II in nonrandomized clinical patients with complex CAD undergoing temporary PCI. METHODS: We prospectively enrolled 4398 consecutive patients undergoing three-vessel and/or unprotected left main PCI in a single center from January 2013 to December 2013...
September 12, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28893748/effect-of-individual-patient-risk-centre-surgeon-and-anaesthetist-on-length-of-stay-in-hospital-after-cardiac-surgery-association-of-cardiothoracic-anaesthesia-and-critical-care-actacc-consecutive-cases-series-study-of-10-uk-specialist-centres
#8
Olympia Papachristofi, Andrew A Klein, John Mackay, Samer Nashef, Nick Fletcher, Linda D Sharples
OBJECTIVES: To determine the relative contributions of patient risk profile, local and individual clinical practice on length of hospital stay after cardiac surgery. DESIGN: Ten-year audit of prospectively collected consecutive cardiac surgical cases. Case-mix adjusted outcomes were analysed in models that included random effects for centre, surgeon and anaesthetist. SETTING: UK centres providing adult cardiac surgery. PARTICIPANTS: 10 of 36 UK specialist centres agreed to provide outcomes for all major cardiac operations over 10 years...
September 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28893702/risk-factors-associated-with-perioperative-myocardial-infarction-in-major-open-vascular-surgery
#9
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/28889811/cardiovascular-ct-for-evaluation-of-single-ventricle-heart-disease-risks-and-accuracy-compared-with-interventional-findings
#10
B Kelly Han, Marnie Huntley, David Overman, Dawn Witt, David Dassenko, Ross F Garberich, John R Lesser
OBJECTIVE: We sought to evaluate the risk and image quality from cardiovascular CT in patients across all stages of single-ventricle palliation, and to define accuracy by comparing findings with intervention and surgery. METHODS: Consecutive CT scans performed in patients with single-ventricle heart disease were retrospectively reviewed at a single institution. Diagnosis, sedation needs, estimated radiation dose, and adverse events were recorded. Anatomical findings, image quality (1-4, 1=optimal), and discrepancy compared with interventional findings were determined...
September 11, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28883736/omentum-flap-as-a-salvage-procedure-in-deep-sternal-wound-infection
#11
Nick Spindler, Christian D Etz, Martin Misfeld, Christoph Josten, Friedrich-Wilhelm Mohr, Stefan Langer
INTRODUCTION: Deep sternal wound infections (DSWIs) are rare but devastating complication after median sternotomy following cardiac surgery. Especially in the presence of artificial material or inadequate preliminary muscle flaps, the pedicled omentum flap is due to its immunological properties, the predetermined flap in salvage procedures. METHODS: We treated 14 patients suffering a mediastinitis and open thorax using a pedicled omentoplasty as a salvage procedure because of persisting DSWIs...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28865333/assessing-mood-symptoms-through-heartbeat-dynamics-an-hrv-study-on-cardiosurgical-patients
#12
Claudio Gentili, Simone Messerotti Benvenuti, Daniela Palomba, Alberto Greco, Enzo Pasquale Scilingo, Gaetano Valenza
BACKGROUND: Heart Rate Variability (HRV) is reduced both in depression and in coronary heart disease (CHD) suggesting common pathophysiological mechanisms for the two disorders. Within CHD, cardiac surgery patients (CSP) with postoperative depression are at greater risk of adverse cardiac events. Therefore, CSP would especially benefit from depression early diagnosis. Here we tested whether HRV-multi-feature analysis discriminates CSP with or without depression and provides an effective estimation of symptoms severity...
August 26, 2017: Journal of Psychiatric Research
https://www.readbyqxmd.com/read/28864961/the-effect-of-smoking-on-surgical-outcomes-in-ventral-hernia-repair-a-propensity-score-matched-analysis-of-the-national-surgical-quality-improvement-program-data
#13
N P Borad, A M Merchant
PURPOSE: Although studies have implicated smoking as a positive predictor of post-operative outcomes in inguinal hernia repair, its impact on ventral hernia repair (VHR) is not as clear. This study aims to fill this gap by investigating the impact of smoking on developing adverse 30-day post-operative outcomes in VHR. METHODS: Patients undergoing VHR between 2005 and 2014 were extracted from the American College of Surgeons National Surgical Quality Improvement Program database...
September 1, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/28863026/transfusion-of-older-red-blood-cells-increases-the-risk-of-acute-kidney-injury-after-orthotopic-liver-transplantation-a-propensity-score-analysis
#14
Yue Wang, Qingshan Li, Tao Ma, Xuemin Liu, Bo Wang, Zheng Wu, Shaonong Dang, Yi Lv, Rongqian Wu
BACKGROUND: Acute kidney injury (AKI) is a common and serious complication of orthotopic liver transplantation (OLT). Transfusion of older red blood cells (RBCs) has been implicated in poor outcomes in trauma, cardiac surgery, and critically ill patients. However, whether transfusion of older RBCs plays any role in post-OLT AKI remained unknown. The aim of this study was to investigate the effect of the age of transfused RBCs on post-OLT AKI. METHODS: The clinical data of consecutive adult patients who received donation after cardiac death and underwent OLT from December 2011 to December 2015 were analyzed...
August 31, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28859926/impact-of-accurate-30-day-status-on-operative-mortality-wanted-dead-or-alive-not-unknown
#15
W Steves Ring, James R Edgerton, Morley Herbert, Syma Prince, Cathy Knoff, Kristin M Jenkins, Michael E Jessen, Baron L Hamman
BACKGROUND: Risk-adjusted operative mortality is the most important quality metric in cardiac surgery for determining The Society of Thoracic Surgeons (STS) Composite Score for star ratings. Accurate 30-day status is required to determine STS operative mortality. The goal of this study was to determine the effect of unknown or missing 30-day status on risk-adjusted operative mortality in a regional STS Adult Cardiac Surgery Database cooperative and demonstrate the ability to correct these deficiencies by matching with an administrative database...
August 28, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28859061/is-the-new-zealand-early-warning-score-useful-following-cardiac-surgery
#16
Kevin Niall Peek, Michael Gillham
AIMS: The rate of medical emergency team (MET) calling among post-cardiac surgery patients is unknown. We set out to determine what the call frequency would be if MET activation occurred in every instance that the early warning score (EWS) breached our local threshold, what the outcome was for these patients and what the calling rate might be if the proposed New Zealand EWS (NZEWS) system was implemented with 100% adherence. METHODS: The clinical records of 400 consecutive post-cardiac surgery patients were examined...
September 1, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28854542/association-between-delirium-and-cognitive-change-after-cardiac-surgery
#17
A C Sauër, D S Veldhuijzen, T H Ottens, A J C Slooter, C J Kalkman, D van Dijk
Background: Previous studies provide inconsistent data on whether postoperative delirium (POD) is a risk factor for postoperative cognitive decline (POCD). We thus investigated the relationship between POD and cognitive change after cardiac surgery and assessed the relationship between preoperative cognitive domain scores and POD. Methods: Postoperative delirium was assessed with the Confusion Assessment Method (CAM) adapted for the intensive care unit and the conventional CAM accompanied by chart review...
August 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28854266/female-sex-is-not-a-risk-factor-for-post-procedural-mortality-in-coronary-bypass-surgery-in-the-elderly-a-secondary-analysis-of-the-gopcabe-trial
#18
Gloria Faerber, Michael Zacher, Wilko Reents, Jochen Boergermann, Utz Kappert, Andreas Boening, Anno Diegeler, Torsten Doenst
OBJECTIVE: Female sex is considered a significant risk in cardiac surgery and is included in the majority of scores for risk assessment. However, the evidence is controversial and older women undergoing cardiac surgery have not specifically been investigated. We assessed the influence of female sex on surgical risk (30-day mortality) in a secondary analysis of the GOPCABE trial (German Off-Pump Coronary Artery Bypass grafting in the Elderly (GOPCABE) trial, comparing on- to off-pump) and also evaluated its impact on risk prediction from commonly used risk scores...
2017: PloS One
https://www.readbyqxmd.com/read/28852333/perioperative-considerations-when-treating-isolated-periprosthetic-distal-femur-fractures
#19
Michael S Reich, Mindy Duong, Mary A Breslin, Mai P Nguyen, Heather A Vallier
BACKGROUND: Periprosthetic distal femur (PPDF) fractures occur most frequently via low energy mechanisms in elderly patients. This population is often frail and ill-suited to the physiologic burden of trauma and surgery. Here, we describe the perioperative and early hospital course for patients with PPDF fractures, and identify risk factors for poor outcomes. METHODS: Consecutive patients with isolated PPDF fractures from 2005 - 2015 were treated operatively at a Level I trauma center...
2017: Iowa Orthopaedic Journal
https://www.readbyqxmd.com/read/28846532/randomized-trial-of-sternal-closure-for-low-risk-patients-rigid-fixation-versus-wire-closure
#20
Graham Graham, Jeevan Kumar, Shinya Unai, Diehl T James, Hitoshi Hirose Md
BACKGROUND: A previous retrospective analysis of our cardiac surgery patients showed shortened ventilation time and hospital stay among patients receiving rigid sternal fixation compared to sternal wire fixation. We performed a prospective randomized study to further investigate these outcomes and determine if rigid closure can provide reduced pain after cardiac surgery. METHODS: Patients undergoing cardiac surgery between July 2011 and May 2014 were prospectively randomized into wire closure (Group C) or rigid fixation using sternal plates (Group R) groups...
August 28, 2017: Heart Surgery Forum
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