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Cardiac surgery risk score

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https://www.readbyqxmd.com/read/28723830/early-versus-delayed-coronary-artery-bypass-graft-surgery-for-patients-with-non-st-elevation-myocardial-infarction
#1
Le Dung Ha, Gbolahan Ogunbayo, Ayman Elbadawi, Odunayo Olorunfemi, Adrian Messerli
BACKGROUND: Although coronary artery bypass graft surgery (CABG) has been proven to have mortality and morbidity benefits in patients with non-ST elevation myocardial infarction and multivessel disease, the appropriate timing of this procedure remains unclear. Therefore, we proposed a propensity score-matched analysis comparing the clinical outcomes between patients who underwent CABG within the first 48 h of admission (early CABG) and patients who underwent CABG after 48 h of admission (delayed CABG)...
July 18, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28715070/evaluation-of-the-relationship-between-renal-resistive-index-and-extensivity-and-complexity-of-coronary-artery-disease-in-patients-with-acute-coronary-syndrome
#2
Alaa Quisi, Ibrahim Halil Kurt, Durmuş Yıldıray Şahin, Onur Kaypaklı, Gökhan Söker, Ömer Kaya, Samir Allahverdiyev, Ömer Genç, Gökhan Alıcı, Mevlüt Koç
BACKGROUND: Despite the advances in cardiovascular medicine, acute coronary syndrome (ACS) is still a major cause of morbidity and mortality worldwide. Synergy between PCI ™ with TAXUS and Cardiac Surgery (SYNTAX) score is used to determine the extensivity and complexity of coronary artery disease (CAD). Renal resistive index (RRI), a renal Doppler ultrasound parameter, is used to detect renal hemodynamics. Although some risk factors for CAD, including hypertension and diabetes mellitus were demonstrated to have an association with RRI, direct relationship between the presence...
July 17, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28711540/in-hospital-complications-following-lumbar-spine-surgery-in-patients-with-parkinson-s-disease-evaluation-of-the-national-inpatient-sample-database
#3
Joseph F Baker, Shearwood McClelland, Breton G Line, Justin S Smith, Robert A Hart, Christopher P Ames, Chris Shaffrey, Shay Bess
BACKGROUND: Previous reports suggest that patients with Parkinson's disease (PD) have increased complication rates following spine surgery however data from these reports are limited by small patient size. The aim of this study was to utilize the National Inpatient Sample (NIS) database to compare in-hospital complications for PD compared to patients without following elective lumbar spine surgery. METHODS: The NIS database was accessed to find patients who underwent lumbar spine surgery with and without a diagnosis of PD...
July 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28711314/independent-predictors-of-the-duration-and-overall-burden-of-postoperative-delirium-after-cardiac-surgery-in-adults-an-observational-cohort-study
#4
Christian Cereghetti, Martin Siegemund, Sabine Schaedelin, Jens Fassl, Manfred D Seeberger, Friedrich S Eckstein, Luzius A Steiner, Nicolai Goettel
OBJECTIVE: Postoperative delirium (POD) is a common complication after cardiac surgery and is associated with increased patient morbidity and mortality. The objective of this study was to identify risk factors for long duration and overall burden of POD after cardiac surgery. DESIGN: One-year, single-center, retrospective, observational cohort study. SETTING: University hospital. PARTICIPANTS: Adult patients undergoing cardiac surgery with cardiopulmonary bypass in 2013...
March 31, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28703300/a-point-based-prediction-model-for-cardiovascular-risk-in-orthotopic-liver-transplantation-the-car-olt-score
#5
Lisa B VanWagner, Hongyan Ning, Maureen Whitsett, Josh Levitsky, Sarah Uttal, John T Wilkins, Michael M Abecassis, Daniela P Ladner, Anton I Skaro, Donald M Lloyd-Jones
Cardiovascular disease (CVD) complications are important causes of morbidity and mortality after orthotopic liver transplantation (OLT). There is currently no preoperative risk assessment tool that allows physicians to estimate the risk for CVD events following OLT. We sought to develop a point-based prediction model (risk score) for CVD complications after OLT, the CAR-OLT risk score, among a cohort of 1024 consecutive patients aged 18-75 years who underwent first OLT in a tertiary-care teaching hospital (2002-2011)...
July 13, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28703290/the-association-between-peri-operative-acute-risk-change-arc-and-long-term-survival-after-cardiac-surgery
#6
T G Coulson, M Bailey, C M Reid, L Tran, D V Mullany, J A Smith, D Pilcher
Acute risk change has been described as the difference in calculated mortality risk between the pre-operative and postoperative periods of cardiac surgery. We aimed to assess whether this was associated with long-term survival after cardiac surgery. We retrospectively analysed 22,570 cardiac surgical patients, with minimum and maximum follow-up of 1.0 and 6.7 years. Acute risk change was calculated as the arithmetic difference between pre- and postoperative mortality risk. 'Rising risk' represented an increase in risk from pre- to postoperative phase...
July 13, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28702944/impact-of-pre-operative-health-related-quality-of-life-on-outcomes-after-heart-surgery
#7
Ieva Norkienė, Indre Urbanaviciute, Greta Kezyte, Vaidas Vicka, Tomas Jovaisa
BACKGROUND: Long-term improvement in health-related quality of life (HRQOL) is one of the most important outcomes of cardiac surgery. The aim of this study is to define the impact of perioperative patient and procedural variables on HRQOL dynamics, a year after cardiac surgery. METHODS: Consecutive patients undergoing elective on-pump cardiac surgery were enrolled in this prospective observational cohort study. Patients completed the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) questionnaire a day before surgery and once again a year after surgery...
July 12, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28701592/risk-factors-of-postcardiotomy-ventricular-dysfunction-in-moderate-to-high-risk-patients-undergoing-open-heart-surgery
#8
Christoph Ellenberger, Tornike Sologashvili, Mustafa Cikirikcioglu, Gabriel Verdon, John Diaper, Tiziano Cassina, Marc Licker
INTRODUCTION: Ventricular dysfunction requiring inotropic support frequently occurs after cardiac surgery, and the associated low cardiac output syndrome largely contributes to postoperative death. We aimed to study the incidence and potential risk factors of postcardiotomy ventricular dysfunction (PCVD) in moderate-to-high risk patients scheduled for open-heart surgery. METHODS: Over a 5-year period, we prospectively enrolled 295 consecutive patients undergoing valve replacement for severe aortic stenosis or coronary artery bypass surgery who presented with Bernstein-Parsonnet scores >7...
July 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28699088/sepsis-prediction-in-critically-ill-patients-by-platelet-activation-markers-on-icu-admission-a-prospective-pilot-study
#9
Nathalie Layios, Céline Delierneux, Alexandre Hego, Justine Huart, Christian Gosset, Christelle Lecut, Nathalie Maes, Pierre Geurts, Arnaud Joly, Patrizio Lancellotti, Adelin Albert, Pierre Damas, André Gothot, Cécile Oury
BACKGROUND: Platelets have been involved in both immune surveillance and host defense against severe infection. To date, whether platelet phenotype or other hemostasis components could be associated with predisposition to sepsis in critical illness remains unknown. The aim of this work was to identify platelet markers that could predict sepsis occurrence in critically ill injured patients. METHODS: This single-center, prospective, observational, 7-month study was based on a cohort of 99 non-infected adult patients admitted to ICUs for elective cardiac surgery, trauma, acute brain injury, and post-operative prolonged ventilation and followed up during ICU stay...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28697572/delayed-recall-and-working-memory-mmse-domains-predict-delirium-following-cardiac-surgery
#10
Catherine C Price, Cynthia Garvan, Loren Hizel, Marcos G Lopez, Frederic T Billings
BACKGROUND: Reduced preoperative cognition is a risk factor for postoperative delirium. The significance for type of preoperative cognitive deficit, however, has yet to be explored and could provide important insights into mechanisms and prediction of delirium. OBJECTIVE: Our goal was to determine if certain cognitive domains from the general cognitive screener, the Mini-Mental State Exam (MMSE), predict delirium after cardiac surgery. METHODS: Patients completed a preoperative MMSE prior to undergoing elective cardiac surgery...
July 4, 2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28696880/performance-of-pediatric-risk-of-mortality-score-among-critically-ill-children-with-heart-disease
#11
Rebecca A Russell, Mallikarjuna Rettiganti, Nancy Brundage, Howard E Jeffries, Punkaj Gupta
OBJECTIVE: To evaluate the performance of the Pediatric Risk of Mortality 3 (PRISM-3) score in critically ill children with heart disease. METHODS: Patients <18 years of age admitted with cardiac diagnoses (cardiac medical and cardiac surgical) to one of the participating pediatric intensive care units in the Virtual Pediatric Systems, LLC, database were included. Performance of PRISM-3 was evaluated with discrimination and calibration measures among both cardiac surgical and cardiac medical patients...
July 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28692690/risk-of-surgical-site-infection-acute-kidney-injury-and-clostridium-difficile-infection-following-antibiotic-prophylaxis-with-vancomycin-plus-a-beta-lactam-versus-either-drug-alone-a-national-propensity-score-adjusted-retrospective-cohort-study
#12
MULTICENTER STUDY
Westyn Branch-Elliman, John E Ripollone, William J O'Brien, Kamal M F Itani, Marin L Schweizer, Eli Perencevich, Judith Strymish, Kalpana Gupta
BACKGROUND: The optimal regimen for perioperative antimicrobial prophylaxis is controversial. Use of combination prophylaxis with a beta-lactam plus vancomycin is increasing; however, the relative risks and benefits associated with this strategy are unknown. Thus, we sought to compare postoperative outcomes following administration of 2 antimicrobials versus a single agent for the prevention of surgical site infections (SSIs). Potential harms associated with combination regimens, including acute kidney injury (AKI) and Clostridium difficile infection (CDI), were also considered...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28691936/national-variation-in-the-use-of-tracheostomy-in-patients-with-congenital-heart-disease
#13
Joyce T Johnson, Bradley S Marino, Darren Klugman, Pirouz Shamszad
OBJECTIVES: The postsurgical care of children with congenital heart disease may be complicated by the need for cardiorespiratory support, including tracheostomy. The variation of the use of tracheostomy across multiple pediatric cardiac surgical centers has not been defined. We describe multicenter variation in the use of tracheostomy in children undergoing congenital heart surgery. DESIGN: We retrospectively analyzed a multicenter cohort. SETTING: Pediatric Health Information Systems database retrospective cohort...
July 6, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28684015/bioimpedance-spectroscopy-measurements-of-phase-angle-and-height-for-age-are-predictive-of-outcome-in-children-following-surgery-for-congenital-heart-disease
#14
L V Marino, R Meyer, M Johnson, C Newell, C Johnstone, A Magee, K Sykes, S A Wootton, J V Pappachan
OBJECTIVE: Children with congenital heart disease (CHD) are often growth restricted (low weight- and/or height-for-age) which may increase risk of poor post operative resilience. Bioelectrical impedance spectroscopy (BIS) has been used to determine body composition in different clinical settings and has been shown to mark differences in nutritional state and clinical outcome. In disease conditions were fluid is not normally distributed it is proposed that raw impedance values and BIS derived phase-angle may serve as prognostic indicators of clinical outcome...
June 28, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28666990/gene-expression-profiles-for-the-identification-of-prevalent-atrial-fibrillation
#15
Sébastien Thériault, Richard Whitlock, Kripa Raman, Jessica Vincent, Salim Yusuf, Guillaume Paré
BACKGROUND: Diagnosis of atrial fibrillation (AF) can be difficult, requiring cumbersome investigations. We aimed to determine the association of established whole-blood gene expression scores with prevalent AF and to evaluate their performance for the identification of AF in a SIRS (Steroids in Cardiac Surgery) trial cohort. METHODS AND RESULTS: Whole-blood, transcriptome-wide gene expression profiling was performed using the Illumina HumanHT-12 Expression BeadChip in 416 participants (65% men) before surgery, including 91 with a diagnosis of AF...
June 30, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28665964/therapy-options-in-deep-sternal-wound-infection-sternal-plating-versus-muscle-flap
#16
Martin Grapow, Martin Haug, Chistopher Tschung, Bernhard Winkler, Prerana Banerjee, Paul Philipp Heinisch, Jens Fassl, Oliver Reuthebuch, Friedrich Eckstein
BACKGROUND: Management of deep sternal wound infection (DSWI) in cardiac surgical patients still remains challenging. A variety of treatment strategies has been described. Aim of this cohort study was to analyse two different treatment strategies for DSWI: titanium sternal plating system (TSFS) and muscle flap coverage (MFC). METHODS: Between January 2007 and December 2011, from 3122 patients undergoing cardiac surgery 42 were identified with DSWI and treated with one of the above mentioned strategies...
2017: PloS One
https://www.readbyqxmd.com/read/28663398/cardiac-disease-and-advanced-age-increase-the-mortality-risk-following-surgery-for-periprosthetic-femoral-fractures
#17
S Märdian, C Perka, K-D Schaser, J Gruner, F Scheel, P Schwabe
AIMS: Periprosthetic fracture is a significant complication of total hip and knee arthroplasty. This study aimed to describe the survival of patients sustaining periprosthetic femoral fractures and compare this with that of the general population, as well as to identify the factors that influence survival. PATIENTS AND METHODS: A total of 151 patients (women: men 116:35, mean age 74.6 years, standard deviation 11.5) that sustained a periprosthetic fracture between January 2005 and October 2012 were retrospectively analysed...
July 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28652671/aortic-velocity-propagation-a-novel-echocardiographic-method-in-predicting-atherosclerotic-coronary-artery-disease-burden
#18
Pakala Vasudeva Chetty, Durgaprasad Rajasekhar, Velam Vanajakshamma, Kummaraganti P Ranganayakulu, Dommara Kranthi Chaithanya
BACKGROUND: The major burden of cardiovascular disease mortality around the globe is due to atherosclerosis and its complications. Hence its early detection and management with easily accessible and noninvasive methods are valuable. Aortic velocity propagation (AVP) through color M-mode of the proximal descending aorta determines aortic stiffness, reflecting atherosclerosis. The aim of this study was to find the utility of AVP in predicting coronary artery disease (CAD) burden assessed through SYNTAX (SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery) score and compared with carotid intima-media thickness (CIMT), which is an established surrogate marker of atherosclerosis...
July 2017: Journal of the Saudi Heart Association
https://www.readbyqxmd.com/read/28625392/a-novel-risk-score-to-predict-the-need-for-nutrition-support-after-cardiac-surgery
#19
Rika E Ohkuma, Todd C Crawford, Patricia M Brown, Joshua C Grimm, J Trent Magruder, Arman Kilic, Alejandro Suarez-Pierre, Sukyee Snyder, Justin D Wood, Eric Schneider, Marc S Sussman, Glenn J R Whitman
BACKGROUND: In specific patients, early postoperative nutrition mitigates malnutrition-related morbidity and mortality. The goal of this study was to develop and validate a prediction score designed to stratify patients immediately after cardiac surgery according to risk for nutrition support (NS). METHODS: We identified adult cardiac surgery patients at our institution in 2012 requiring postoperative NS, enteral or parenteral. Using multivariable logistic regression modeling, we developed a Johns Hopkins Hospital Nutrition Support (JHH NS) score from relative odds ratios generated by variables that independently predicted the need for NS...
May 18, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28625383/the-assessment-of-the-watchman-device-in-patients-unsuitable-for-oral-anticoagulation-asap-too-trial
#20
David R Holmes, Vivek Y Reddy, Maurice Buchbinder, Kenneth Stein, Myriah Elletson, Martin W Bergmann, Boris Schmidt, Jacqueline Saw
BACKGROUND: Oral anticoagulants (OACs) reduce stroke risks with nonvalvular atrial fibrillation (AF); however, they are underused because of absolute or relative contraindications due to real or perceived risk of bleeding. Although left atrial appendage closure is increasingly performed in OAC-ineligible patients, this has not been studied in a randomized controlled trial. STUDY OBJECTIVES: The ASAP-TOO study is designed to establish the safety and effectiveness of the Watchman left atrial appendage closure device in patients with nonvalvular AF who are deemed ineligible for OAC...
July 2017: American Heart Journal
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