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Cardiac surgery risk score

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https://www.readbyqxmd.com/read/29334510/comparing-peri-operative-complications-of-paediatric-and-adult-anaesthesia-a-retrospective-cohort-study-of-81%C3%A2-267-cases
#1
Andrie C Westerkamp, A Fred de Geus, Bouwe Molenbuur, Peter Meyer, J K Götz Wietasch, Michel M R F Struys, Herman G D Hendriks
BACKGROUND: Comparisons of peri-operative complications associated with paediatric (≤16 years) and adult anaesthesia are poorly available, especially in which cardiac surgery, organ transplantation and neurosurgery are involved. OBJECTIVE: The aim of this study was to evaluate the nature and incidence of peri-operative complications that might be due to anaesthesia and to identify independent risk factors for complications in children and adults, including those undergoing cardiac surgery, organ transplantation and neurosurgery...
January 13, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29332544/the-possible-use-of-preoperative-natriuretic-peptides-for-discriminating-low-versus-moderate-high-surgical-risk-patient
#2
Luigi Vetrugno, Daniele Orso, Carola Matellon, Marilù Giaccalone, Tiziana Bove, Elena Bignami
Perioperative risk scores for patients undergoing noncardiac surgery are generally considered inaccurate, poor, or, at best, modest. We propose estimating a patient's pretest and posttest probability of cardiac morbidity and death using the preoperative scoring system plus the negative likelihood ratio from brain natriuretic peptide (BNP) or N-terminal proB-type natriuretic peptide (NT-proBNP) plasma levels. Our clinical challenge scenario showed a pretest probability of postoperative major cardiac complications with the patient risk factor as 6...
January 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29327147/post-operative-catheterization-interventions-at-the-site-of-surgery-an-application-of-the-crisp-scoring-system
#3
Katie Mowers, Toby Rockefeller, David Balzer, Ramzi Nicolas, Shabana Shahanavaz
Catheter-based interventions in the early post-operative period are performed with caution due to concerns for increased procedural risk, particularly across fresh suture lines. The recently published CRISP scoring system provides prospective risk stratification based on pre-procedural criterion. In an effort to refine the assessment of risk in patients undergoing post-operative catheter-based interventions, the predicted risk of an adverse event based on CRISP scores was compared to actual adverse event rates...
January 12, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29325843/preoperative-intra-aortic-counterpulsation-in-cardiac-surgery-insights-from-a-retrospective-series-of-588-consecutive-high-risk-patients
#4
Giuseppe Gatti, Laura Morra, Gianluca Castaldi, Luca Maschietto, Florida Gripshi, Enrico Fabris, Andrea Perkan, Bernardo Benussi, Gianfranco Sinagra, Aniello Pappalardo
OBJECTIVE: To support a rational use of preoperative intra-aortic balloon pump (IABP) in cardiac surgery. DESIGN: Retrospective, observational study. SETTING: Single university hospital. PARTICIPANTS: The study included 588 (mean age 68.5 ± 9.6 yr) consecutive patients who received IABP before cardiac surgery from 1999 to 2016. INTERVENTIONS: Coronary surgery was performed in 573 (97.4%) cases...
December 6, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29324494/myocardial-protection-by-glucose-insulin-potassium-in-moderate-to-high-risk-patients-undergoing-elective-on-pump-cardiac-surgery-a-randomized-controlled-trial
#5
Christoph Ellenberger, Tornike Sologashvili, Lukas Kreienbühl, Mustafa Cikirikcioglu, John Diaper, Marc Licker
BACKGROUND: Low cardiac output syndrome is a main cause of death after cardiac surgery. We sought to assess the impact of glucose-insulin-potassium (GIK) to enhance myocardial protection in moderate- to high-risk patients undergoing on-pump heart surgery. METHODS: A randomized controlled trial was performed in adult patients (Bernstein-Parsonnet score >7) scheduled for elective aortic valve replacement and/or coronary artery bypass surgery. Patients were randomized to GIK (20 IU of insulin, 10 mEq of potassium chloride in 50 mL of glucose 40%) or saline infusion given over 60 minutes on anesthetic induction...
January 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29317974/global-risk-score-and-clinical-syntax-score-as-predictors-of-clinical-outcomes-of-patients-undergoing-unprotected-left-main-percutaneous-catheter-intervention
#6
Lucky Cuenza, Marianne P Collado, James Ho Khe Sui
Background: Risk stratification is an important component of left main percutaneous catheter intervention (PCI) which has emerged as a feasible alternative to cardiac surgery. We sought to compare the clinical SYNTAX score and the global risk score in predicting outcomes of patients undergoing unprotected left main PCI in our institution. Methods: Clinical, angiographic and procedural characteristics of 92 patients who underwent unprotected left main PCI (mean age 62 ± 12...
December 2017: Cardiology Research
https://www.readbyqxmd.com/read/29317910/impact-of-choice-of-skin-preparation-solution-in-cardiac-surgery-on-rate-of-surgical-site-infection-a-propensity-score-matched-analysis
#7
Shahzad G Raja, Melissa Rochon, Clair Mullins, Carlos Morais, Antonios Kourliouros, Ellie Wishart, Anthony De Souza, Sunil Bhudia
Background: Antiseptic skin preparations containing chlorhexidine gluconate and povidone iodine are routinely used to reduce the risk of surgical site infection (SSI). This study assesses the efficacy of two alcohol-based solutions, 2% chlorhexidine-alcohol and 10% povidone iodine-alcohol, on the incidence of cardiac SSI. Methods: A total of 738 consecutive patients undergoing cardiac surgery had skin preparation with 2% chlorhexidine gluconate in 70% isopropanol (ChloraPrep, BD Ltd, UK) were propensity matched to 738 patients with skin prepared with 10% povidone-iodine in 30% industrial methylated spirit (Videne Alcoholic Tincture, Ecolab Ltd, UK)...
January 2018: Journal of Infection Prevention
https://www.readbyqxmd.com/read/29317808/clinical-utility-of-the-revised-cardiac-risk-index-in-older-chinese-patients-with-known-coronary-artery-disease
#8
Lu Che, Li Xu, Yuguang Huang, Chunhua Yu
Objectives: The revised Cardiac Risk Index (RCRI) is the most widely used risk prediction tool for postoperative cardiac adverse events. We aim to explore the predictive ability of the RCRI in older Chinese patients with coronary artery disease (CAD) undergoing noncardiac surgery, which has not been previously evaluated. Methods: We performed a multicenter, prospective study. We enrolled a total of 1,202 patients, aged >60 years, with a history of CAD who underwent noncardiac surgery...
2018: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29316571/validation-of-three-postoperative-risk-prediction-models-for-intensive-care-unit-mortality-after-cardiac-surgery
#9
Samuel Henry Howitt, Camila Caiado, Charles McCollum, Michael Goldstein, Ignacio Malagon, Rajamiyer Venkateswaran, Stuart William Grant
BACKGROUND:  Several cardiac surgery risk prediction models based on postoperative data have been developed. However, unlike preoperative cardiac surgery risk prediction models, postoperative models are rarely externally validated or utilized by clinicians. The objective of this study was to externally validate three postoperative risk prediction models for intensive care unit (ICU) mortality after cardiac surgery. METHODS:  The logistic Cardiac Surgery Scores (logCASUS), Rapid Clinical Evaluation (RACE), and Sequential Organ Failure Assessment (SOFA) scores were calculated over the first 7 postoperative days for consecutive adult cardiac surgery patients between January 2013 and May 2015...
January 9, 2018: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/29311287/comparison-of-a-simple-angiographic-approach-with-a-synergy-between-percutaneous-coronary-intervention-with-taxus-and-cardiac-surgery-score-based-approach-for-left-main-coronary-artery-stenting-a-pooled-analysis-of-serial-precombat-premier-of-randomized-comparison
#10
Pil Hyung Lee, Jong-Young Lee, Cheol Whan Lee, Seon-Ok Kim, Jung-Min Ahn, Duk-Woo Park, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Seong-Wook Park, Seung-Jung Park
BACKGROUND: The applicability of Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery scores to left main coronary artery disease (CAD) has been questioned. A simplified alternative is needed for guiding decision making. METHODS AND RESULTS: We evaluated the prognostic value of a simplified angiographic classification in comparison with a Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery score-based approach for patients with left main CAD undergoing drug-eluting stent implantation...
January 2018: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29310559/arrhythmias-in-children-in-early-postoperative-period-after-cardiac-surgery
#11
Manoj Kumar Sahu, Anupam Das, Bharat Siddharth, Sachin Talwar, Sarvesh Pal Singh, Atul Abraham, Arin Choudhury
BACKGROUND: Postoperative arrhythmias are a known complication after cardiac surgical repairs for congenital heart disease. METHODS: Data were reviewed pertaining to incidence, diagnosis, potential risk factors, and management of postoperative arrhythmias in 369 consecutive patients under 18 years of age, undergoing elective open heart surgery. All children were admitted to the intensive care unit and continuous electrocardiographic monitoring was performed. Patient factors such as Aristotle Basic Complexity Score, total surgical duration, hypotension, tachycardia, serum lactate level, and inotropic score were analyzed...
January 2018: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29305561/trends-in-cardiovascular-risk-factor-and-disease-prevalence-in-patients-undergoing-non-cardiac-surgery
#12
Nathaniel R Smilowitz, Navdeep Gupta, Yu Guo, Joshua A Beckman, Sripal Bangalore, Jeffrey S Berger
OBJECTIVES: Cardiovascular risk factors are prevalent in the population undergoing non-cardiac surgery. Changes in perioperative cardiovascular risk factor profiles over time are unknown. The objective of this study was to evaluate national trends in cardiovascular risk factors and atherosclerotic cardiovascular disease (ASCVD) among patients undergoing non-cardiac surgery. METHODS: Adults aged ≥45 years old who underwent non-cardiac surgery were identified using the US National Inpatient Sample from 2004 to 2013...
January 5, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29305446/the-risk-of-cardiac-failure-following-metal-on-metal-hip-arthroplasty
#13
S A Sabah, J C Moon, S Jenkins-Jones, C Ll Morgan, C J Currie, J M Wilkinson, M Porter, G Captur, J Henckel, N Chaturvedi, P Kay, J A Skinner, A H Hart, C Manisty
AIMS: The aim of this study was to determine whether patients with metal-on-metal (MoM) arthroplasties of the hip have an increased risk of cardiac failure compared with those with alternative types of arthroplasties (non-MoM). PATIENTS AND METHODS: A linkage study between the National Joint Registry, Hospital Episodes Statistics and records of the Office for National Statistics on deaths was undertaken. Patients who underwent elective total hip arthroplasty between January 2003 and December 2014 with no past history of cardiac failure were included and stratified as having either a MoM (n = 53 529) or a non-MoM (n = 482 247) arthroplasty...
January 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29288657/a-pragmatic-preoperative-prediction-score-for-non-home-discharge-after-cardiac-surgery
#14
Jenna Stuebe, Jessica Rydingsward, Heather Lander, Jillian Ng, Xinling Xu, Tsuyoshi Kaneko, Prem Shekar, Jochen D Muehlschlegel, Simon C Body
BACKGROUND: Targeted rehabilitation of patients at risk for non-home discharge (NHD) following surgery is an appealing area for quality improvement. We sought to identify the primary predictors of NHD following cardiac surgery in order to generate a robust preoperative prediction tool for those at greatest risk. METHODS: The medical records of 5,253 patients undergoing cardiac surgery between 1/1/2012 - 3/31/2016 were reviewed. Two models of NHD were created; a preoperative model using only preoperative predictors and a postoperative model using the same preoperative predictors, and including postoperative adverse outcomes and duration of hospital stay...
December 27, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29284860/effect-of-locally-administered-dexmedetomidine-as-adjuvant-to-levobupivacaine-in-supraclavicular-brachial-plexus-block-double-blind-controlled-study
#15
Bikash Bisui, Swastika Samanta, Sumanta Ghoshmaulik, Amit Banerjee, Tirtha R Ghosh, Suman Sarkar
Context: Brachial plexus block is effective with good postoperative analgesia in upper limb surgery has gained importance as it safe, low cost, and maintains stable hemodynamics intraoperatively. To decrease the onset time and prolong the duration of nerve block bicarbonate, opioids (morphine, fentanyl, etc.), sympathomimetic agents (epinephrine, phenylephrine, etc.), α-2 agonists (clonidine and dexmedetomidine), calcium channel blocker (verapamil), magnesium sulfate, etc., were studied with local anesthetics and their isomers...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29279996/postoperative-mortality-and-morbidity-following-non-cardiac-surgery-in-a-healthy-patient-population
#16
Rodney A Gabriel, Jacklynn F Sztain, Alison M A'Court, Diana J Hylton, Ruth S Waterman, Ulrich Schmidt
PURPOSE: Perioperative mortality ranges from 0.4% to as high as nearly 12%. Currently, there are no large-scale studies looking specifically at the healthy surgical population alone. The primary objective of this study was to report 30-day mortality and morbidity in healthy patients and define any risk factors. METHODS: Using the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) dataset, all patients assigned an American Society of Anesthesiologists physical status (ASA PS) classification score of 1 or 2 were included...
December 26, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/29276030/the-impact-of-prehospital-assessment-and-ems-transport-of-acute-aortic-syndrome-patients
#17
Akira Yamashita, Tetsuo Maeda, Yoshihito Kita, Satoru Sakagami, Yasuhiro Myojo, Yukihiro Wato, Yutaka Yoshita, Hideo Inaba
BACKGROUND: The quality of acute aortic syndrome (AAS) assessment by emergency medical service (EMS) and the incidence and prehospital factors associated with 1-month survival remain unclear. METHODS: We retrospectively analyzed the data collected for 94,468 patients with non-traumatic medical emergency excluding out-of-hospital cardiac arrest during the period of 2011-2014. RESULTS: Of these transported by EMS, 22,075 had any of the AAS-related symptoms, and 330 had an EMS-assessed risk for AAS; of these, 195 received an in-hospital AAS diagnosis...
December 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29248382/risk-factors-for-nosocomial-infections-after-cardiac-surgery-in-newborns-with-congenital-heart-disease
#18
Heladia García, Beatriz Cervantes-Luna, Héctor González-Cabello, Guadalupe Miranda-Novales
BACKGROUND: Congenital heart diseases are among the most common congenital malformations. Approximately 50% of the patients with congenital heart disease undergo cardiac surgery. Nosocomial infections (NIs) are the main complications and an important cause of increased morbidity and mortality associated with congenital heart diseases. This study's objective was to identify the risk factors associated with the development of NIs after cardiac surgery in newborns with congenital heart disease...
November 23, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/29246552/the-use-of-del-nido-cardioplegia-in-adult-cardiac-surgery-a-prospective-randomized-trial
#19
Niv Ad, Sari D Holmes, Paul S Massimiano, Anthony J Rongione, Lisa M Fornaresio, David Fitzgerald
OBJECTIVES: The del Nido cardioplegia solution has been used extensively in congenital heart surgery for more than 20 years and more recently for adults. This randomized controlled trial examined whether expanding this technique to adult cardiac surgery confers benefits in surgical workflow and clinical outcome compared with blood-based cardioplegia. METHODS: Adult first-time coronary artery bypass grafting (CABG), valve, or CABG/valve surgery patients requiring cardiopulmonary bypass (CPB) were randomized to del Nido cardioplegia (n = 48) or whole blood cardioplegia (n = 41)...
November 13, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29246551/comparative-effectiveness-of-coronary-screening-in-heart-valve-surgery-computed-tomography-versus-conventional-coronary-angiography
#20
Wonjae Lee, Joon Bum Kim, Dong Hyun Yang, Cherry Kim, Jihoon Kim, Min Ho Ju, Ho Jin Kim, Joon-Won Kang, Sung-Ho Jung, Young-Hak Kim, Suk Jung Choo, Cheol Whan Lee, Cheol Hyun Chung, Jae Won Lee, Tae-Hwan Lim
BACKGROUND: Although conventional coronary angiography (CAG) is considered the gold standard for coronary artery disease (CAD) screening in the setting of heart valve surgery, coronary artery computed tomography angiography (CCTA) has emerged as an alternative modality. This study was conducted to evaluate the clinical outcomes of CCTA compared with conventional CAG for CAD screening in patients undergoing heart valve surgery. METHODS: A total of 3150 consecutive patients aged >40 years or with coronary risk factors undergoing elective valve operations between 2001 and 2015 were evaluated...
November 14, 2017: Journal of Thoracic and Cardiovascular Surgery
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