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Cardiac surgery risk score

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https://www.readbyqxmd.com/read/28088600/development-and-validation-of-a-methodology-to-reduce-mortality-using-the-veterans-administration-surgical-quality-improvement-program-risk-calculator
#1
Deborah S Keller, Donald Kroll, Harry T Papaconstantinou, C Neal Ellis
BACKGROUND: To identify patients with a high risk of 30 day mortality after elective surgery that may benefit from referral for tertiary care, an institution-specific process using the Veterans Administration Surgical Quality Improvement Program (VASQIP) Risk Calculator was developed. The goal was to develop and validate the methodology. Our hypothesis was the process could optimize referrals and reduce mortality. STUDY DESIGN: A VASQIP risk score was calculated for all patients undergoing elective non-cardiac surgery at a single Veteran's Administration (VA) facility...
January 11, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28077532/modern-hydroxyethyl-starch-and-acute-kidney-injury-after-cardiac-surgery-a-prospective-multicentre-cohort
#2
M Vives, R Callejas, P Duque, G Echarri, D N Wijeysundera, A Hernandez, A Sabate, M Bes-Rastrollo, P Monedero
BACKGROUND: Recent trials have shown hydroxyethyl starch (HES) solutions increase the risk of acute kidney injury (AKI) in critically ill patients. It is uncertain whether these adverse effects also affect surgical patients. We sought to determine the renal safety of modern tetrastarch (6% HES 130/0.4) use in cardiac surgical patients. METHODS: In this multicentre prospective cohort study, 1058 consecutive patients who underwent cardiac surgery from 15th September 2012 to 15th December 2012 were recruited in 23 Spanish hospitals...
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28076963/long-term-consequences-of-atrial-fibrillation-after-aortic-valve-replacement
#3
Hiroki Kohno, Hideki Ueda, Kaoru Matsuura, Yusaku Tamura, Michiko Watanabe, Goro Matsumiya
Background Atrial fibrillation is a common complication after cardiac surgery, but the risk factors and long-term outcome after primary isolated aortic valve replacement remains to be clarified. Methods A single-center retrospective study was conducted on 157 patients who underwent first-time isolated aortic valve replacement between April 1999 and February 2015. Fifty-eight patients developed new-onset atrial fibrillation within 6 months postoperatively, and they were compared with patients who remained in sinus rhythm...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28074801/delirium-after-cardiac-surgery-a-pilot-study-from-a-single-tertiary-referral-center
#4
Ashok K Kumar, Aveek Jayant, V K Arya, Rohan Magoon, Ridhima Sharma
BACKGROUND: Advances in cardiac surgery has shifted paradigm of management to perioperative psychological illnesses. Delirium is a state of altered consciousness with easy distraction of thoughts. The pathophysiology of this complication is not clear, but identification of risk factors is important for positive postoperative outcomes. The goal of the present study was to prospectively identify the incidence, motoric subtypes, and risk factors associated with development of delirium in cardiac surgical patients admitted to postoperative cardiac intensive care, using a validated delirium monitoring instrument...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28069729/systematic-review-on-the-predictive-ability-of-frailty-assessment-measures-in-cardiac-surgery
#5
REVIEW
Yusuf S Abdullahi, Leonidas V Athanasopoulos, Roberto P Casula, Marco Moscarelli, Mark Bagnall, Hutan Ashrafian, Thanos Athanasiou
OBJECTIVES: Patient frailty is increasingly recognised as contributing to adverse postoperative outcomes in cardiothoracic surgery. The goal of this review is to evaluate the predictive ability of frailty scoring systems and their limitations in risk assessment of patients undergoing cardiac surgery. METHODS: Frailty studies were identified by searching electronic databases. Studies in which the measuring instrument was defined as a multidimensional tool focusing on a population undergoing cardiac operations were included...
January 9, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28054252/a-risk-factor-analysis-for-in-hospital-mortality-after-surgery-for-infective-endocarditis-and-a-proposal-of-a-new-predictive-scoring-system
#6
Giuseppe Gatti, Bernardo Benussi, Florida Gripshi, Alessio Della Mattia, Alberto Proclemer, Antonio Cannatà, Lorella Dreas, Roberto Luzzati, Gianfranco Sinagra, Aniello Pappalardo
PURPOSE: Risk stratification is of utmost importance for patients with infective endocarditis (IE) who need surgery. However, for these critically ill patients, aspecific scoring systems are used to predict the risk of death after surgery. The aim of this study was both to analyze the risk factors for in-hospital death, which complicates surgery for IE and to create a mortality risk score based on the results of this analysis. METHODS: Outcomes of 138 consecutive patients (mean age 60...
January 4, 2017: Infection
https://www.readbyqxmd.com/read/28052152/types-of-myocardial-infarction-among-human-immunodeficiency-virus-infected-individuals-in-the-united-states
#7
Heidi M Crane, Pathmaja Paramsothy, Daniel R Drozd, Robin M Nance, J A Chris Delaney, Susan R Heckbert, Matthew J Budoff, Greer A Burkholder, James H Willig, Michael J Mugavero, William C Mathews, Paul K Crane, Richard D Moore, Joseph J Eron, Sonia Napravnik, Peter W Hunt, Elvin Geng, Priscilla Hsue, Carla Rodriguez, Inga Peter, Greg S Barnes, Justin McReynolds, William B Lober, Kristina Crothers, Mathew Feinstein, Carl Grunfeld, Michael S Saag, Mari M Kitahata
Importance: The Second Universal Definition of Myocardial Infarction (MI) divides MIs into different types. Type 1 MIs result spontaneously from instability of atherosclerotic plaque, whereas type 2 MIs occur in the setting of a mismatch between oxygen demand and supply, as with severe hypotension. Type 2 MIs are uncommon in the general population, but their frequency in human immunodeficiency virus (HIV)-infected individuals is unknown. Objectives: To characterize MIs, including type; identify causes of type 2 MIs; and compare demographic and clinical characteristics among HIV-infected individuals with type 1 vs type 2 MIs...
January 4, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28048971/insulin-resistance-plays-a-potential-role-in-postoperative-cognitive-dysfunction-in-patients-following-cardiac-valve-surgery
#8
Ni Tang, Rongrong Jiang, Xiaobin Wang, Jian Wen, Li Liu, Jiali Wu, Chunxiang Zhang
Severe insulin resistance(IR) promotes the development of Alzheimer disease. IR and postoperative cognitive dysfunction (POCD) are a common complication during the cardiac perioperative period. The authors hypothesized that IR of individuals with cardiac valve surgery would have increased the risk of POCD. The purpose of the study was to analyze the association of IR and POCD after cardiac valve surgery. Total 131 patients who underwent valve replacement via cardiopulmonary bypass(CPB) were included. Cognitive function was assessed by a series of neuropsychological measurements at 1 day before and 7 days after the surgery...
December 31, 2016: Brain Research
https://www.readbyqxmd.com/read/28045412/transcatheter-aortic-valve-implantation-with-the-edwards-sapien-3-valve-first-experiences-in-turkey
#9
Abdullah Nabi Aslan, Serdal Baştuğ, Hacı Ahmet Kasapkara, Hüseyin Ayhan, Hakan Süygün, Telat Keleş, Tahir Durmaz, Nihal Akar Bayram, Emine Bilen, Engin Bozkurt
OBJECTIVE: Transcatheter aortic valve implantation (TAVI) has shown promising results in patients with severe aortic stenosis (AS) at high risk for open heart surgery. We aimed to evaluate outcomes of patients who underwent TAVI with Edwards SAPIEN 3 Transcatheter Heart Valve (S3), a second-generation TAVI device. METHODS: Between November 2014 and June 2016, 31 high-risk patients received balloon-expandable S3 valve at Atatürk Training and Research Hospital that has the largest case series in Turkey...
December 2016: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28034774/the-use-of-the-risk-assessment-and-prediction-tool-in-surgical-patients-in-a-bundled-payment-program
#10
James Slover, Kathleen Mullaly, Raj Karia, John Bendo, Patricia Ursomanno, Aubrey Galloway, Richard Iorio, Joseph Bosco
OBJECTIVES: The purpose of this study was to evaluate the relationship between the Risk Assessment and Predictor Tool (RAPT) and patient discharge disposition in an institution participating in bundled payment program for total joint replacement, spine fusion and cardiac valve surgery patients. METHOD: Between April 2014 and April 2015, RAPT scores of 767 patients (535 primary unilateral total joint arthroplasty; 150 cardiac valve replacement; 82 spinal fusions) were prospectively captured...
December 26, 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/28033082/surgical-site-infection-after-pediatric-cardiothoracic-surgery
#11
Anthony A Sochet, Alexander M Cartron, Aoibhinn Nyhan, Michael C Spaeder, Xiaoyan Song, Anna T Brown, Darren Klugman
BACKGROUND: Surgical site infection (SSI) occurs in 0.25% to 6% of children after cardiothoracic surgery (CTS). There are no published data regarding the financial impact of SSI after pediatric CTS. We sought to determine the attributable hospital cost and length of stay associated with SSI in children after CTS. METHODS: We performed a retrospective, matched cohort study in a 26-bed cardiac intensive care unit (CICU) from January 2010 through December 2013. Cases with SSI were identified retrospectively and individually matched to controls 2:1 by age, gender, Risk Adjustment for Congenital Heart Surgery score, Society of Thoracic Surgeons-European Association for Cardiothoracic Surgery category, and primary cardiac diagnosis and procedure...
January 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28029598/perioperative-outcome-of-laparoscopic-sleeve-gastrectomy-for-high-risk-patients
#12
Yves Borbély, Olivier Juilland, Julia Altmeier, Dino Kröll, Philipp C Nett
BACKGROUND: Morbidly obese patients with excessive concomitant disease carry a significantly increased perioperative risk. Although they may benefit most from a bariatric intervention, they are often denied surgery. Laparoscopic sleeve gastrectomy (LSG), as it is less complication-prone than other bariatric procedures, suits the needs of those patients. OBJECTIVE: To review the short-term outcome of LSG for high-risk patients SETTING: University hospital, Switzerland...
August 26, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28024808/total-and-free-cortisol-responses-and-their-relation-to-outcomes-after-cardiopulmonary-bypass-in-infants
#13
Eric L Wald, Carl L Backer, Joseph A Dearani, Zhuo Li, William C Oliver, Sheri S Crow
BACKGROUND: Hypothalamic-pituitary-adrenal (HPA) axis dysfunction may be partially responsible for the hemodynamic instability experienced by infants after cardiopulmonary bypass (CPB). We report the full spectrum of the HPA response surrounding CPB for infant congenital cardiac surgery. METHODS: We enrolled 84 infants who received 1 mg/kg of dexamethasone before initiation of CPB. Total cortisol (TC), free cortisol (FC), adrenocorticotropic hormone (ACTH), and corticosteroid-binding globulin (CBG) were measured at 3 time points: immediately before CPB (TP1), on intensive care unit arrival (TP2), and at 24 hours after surgery (TP3)...
November 21, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27998608/a-score-to-estimate-30-day-mortality-after-intensive-care-admission-after-cardiac-surgery
#14
Yoan Lamarche, Mahsa Elmi-Sarabi, Lillian Ding, James G Abel, Demetrios Sirounis, André Y Denault
OBJECTIVE: Several risk-scoring systems have been developed to predict surgical mortality and complications in cardiac surgical patients, but none of the current systems include factors related to the intraoperative period. The purpose of this study was to develop a score that incorporates both preoperative and intraoperative factors so that it could be used for patients admitted to a cardiac surgical intensive care unit (ICU) immediately after surgery. METHOD: Preoperative and intraoperative data from 30,350 patients in four hospitals were used to build a multiple logistic regression model estimating 30-day mortality after cardiac surgery...
November 23, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27997913/the-impact-of-diabetes-mellitus-on-patients-undergoing-cervical-spondylotic-myelopathy-a-meta-analysis
#15
Yang Liu, De-Xiang Ban, Shi-Lian Kan, Tai-Wei Cao, Shi-Qing Feng
AIMS: We conducted a meta-analysis of eligible studies to compare the surgical outcomes between diabetic patients and non-diabetic patients who have undergone cervical spondylotic myelopathy (CSM). METHODS: A systematic literature search of PubMed, Embase, and Web of Science (up to February 10, 2016) was conducted. Eligible studies were case-control or cohort studies that compared the outcomes of cervical surgery between diabetic patients and non-diabetic patients...
December 21, 2016: European Neurology
https://www.readbyqxmd.com/read/27992624/association-of-perioperative-statin-use-with-mortality-and-morbidity-after-major-noncardiac-surgery
#16
Martin J London, Gregory G Schwartz, Kwan Hur, William G Henderson
Importance: The efficacy of statins in reducing perioperative cardiovascular and other organ system complications in patients undergoing noncardiac surgery remains controversial. Owing to a paucity of randomized clinical trials, analyses of large databases may facilitate informed hypothesis generation and more efficient trial design. Objective: To evaluate associations of early perioperative statin use with outcomes in a national cohort of veterans undergoing noncardiac surgery...
December 19, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27988092/safety-of-tranexamic-acid-in-pediatric-cardiac-surgery-a-nationwide-database-study
#17
Takuma Maeda, Yusuke Sasabuchi, Hiroki Matsui, Yoshihiko Ohnishi, Shigeki Miyata, Hideo Yasunaga
OBJECTIVES: The present study aimed to examine the association between tranexamic acid (TXA) use and adverse effects (seizures, thromboembolism, and renal dysfunction) in a pediatric cardiac surgery population using a national inpatient database in Japan. The authors also assessed the association between TXA use and other clinical outcomes (length of hospital stay and in-hospital mortality). DESIGN: A nationwide, retrospective cohort study using propensity score analyses...
October 4, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27987229/neuronal-damage-biomarkers-in-the-identification-of-patients-at-risk-of-long-term-postoperative-cognitive-dysfunction-after-cardiac-surgery
#18
W F Kok, J Koerts, O Tucha, T W L Scheeren, A R Absalom
Biomarkers of neurological injury can potentially predict postoperative cognitive dysfunction. We aimed to identify whether classical neuronal damage-specific biomarkers, including brain fatty acid-binding protein, neuron-specific enolase and S100 calcium-binding protein β, as well as plasma-free haemoglobin concentration as a measure of haemolysis, could be used to predict the risk of long-term cognitive decline after coronary artery bypass grafting with or without cardiopulmonary bypass. We assessed cognitive function using the CogState brief computerised cognitive test battery at 3 months and at 15 months after surgery...
December 17, 2016: Anaesthesia
https://www.readbyqxmd.com/read/27982349/mortality-risk-after-cardiac-surgery-application-of-inscor-in-a-university-hospital-in-brazil-s-northeast
#19
João Vyctor Silva Fortes, Mayara Gabrielle Barbosa E Silva, Thiago Eduardo Pereira Baldez, Marina de Albuquerque Gonçalves Costa, Luan Nascimento da Silva, Renata Silva Pinheiro, Zullma Sampaio Fecks, Daniel Lago Borges
Objective: To apply the InsCor in patients undergoing cardiac surgery in a university hospital in Brazil's northeast. Methods: It is a retrospective, quantitative and analytical study, carried out at the University Hospital of the Federal University of Maranhão. InsCor is a remodeling of two risk score models. It evaluates the prediction of mortality through variables such as gender, age, type of surgery or reoperation, exams, and preoperative events. Data from January to December 2015 were collected, using a Physical Therapy Evaluation Form and medical records...
September 2016: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27977539/delirium-in-children-after-cardiac-bypass-surgery
#20
Anita K Patel, Katherine V Biagas, Eunice C Clarke, Linda M Gerber, Elizabeth Mauer, Gabrielle Silver, Paul Chai, Rozelle Corda, Chani Traube
OBJECTIVES: To describe the incidence of delirium in pediatric patients after cardiac bypass surgery and explore associated risk factors and effect of delirium on in-hospital outcomes. DESIGN: Prospective observational single-center study. SETTING: Fourteen-bed pediatric cardiothoracic ICU. PATIENTS: One hundred ninety-four consecutive admissions following cardiac bypass surgery, 1 day to 21 years old. INTERVENTIONS: Subjects were screened for delirium daily using the Cornell Assessment of Pediatric Delirium...
December 13, 2016: Pediatric Critical Care Medicine
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