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Cardiac surgery risk score

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https://www.readbyqxmd.com/read/28549016/liberal-bilateral-internal-thoracic-artery-use-in-people-with-diabetes-neutralizes-the-negative-impact-of-insulin-requiring-status
#1
Giuseppe Gatti, Bernardo Benussi, Marina Bollini, Gabriella Forti, Angela Poletti, Elisabetta Rauber, Marco Gabrielli, Ariella De Monte, Gianfranco Sinagra, Aniello Pappalardo
AIMS: Bilateral internal thoracic artery (BITA) grafts are underused in insulin-dependent diabetic patients because of increased risk of postoperative complications. The impact of the insulin-requiring status on outcomes after routine BITA grafting was investigated in this retrospective study. METHODS: Skeletonized BITA grafts were used in 3228 (71.6%) of 4508 consecutive patients having multivessel coronary disease who underwent isolated coronary bypass surgery at the authors' institution from January 1999 to August 2015...
May 25, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28544396/current-trends-in-racial-ethnic-and-healthcare-disparities-associated-with-pediatric-cardiac-surgery-outcomes
#2
Jennifer K Peterson, Yanjun Chen, Danh V Nguyen, Shaun P Setty
OBJECTIVE: Despite overall improvements in congenital heart disease outcomes, racial and ethnic disparities have continued. The purpose of this study is to examine the effect of race and ethnicity, as well as other risk factors on congenital heart surgery length of stay and in-hospital mortality. DESIGN: From the 2012 Healthcare Cost and Utilization Project Kids Inpatient Database (KID), we identified 13 130 records with Risk Adjustment in Congenital Heart Surgery complexity score-eligible procedures...
May 22, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28539544/postoperative-outcome-of-high-risk-octogenarians-undergoing-cardiac-surgery-a-multicenter-observational-retrospective-study
#3
Michal Porizka, Jan Kunstyr, Tomas Vanek, Michal Nejedly, Jana Buckova, Jiri Mokrejs, Frantisek Mosna
PURPOSE: Cardiac surgery in octogenarians with severely deteriorated functional status is increasingly common, but outcome data are still limited. The aim of this study was to compare postoperative outcome, survival, and quality of life of low-, medium-, and high-risk octogenarians undergoing cardiac surgery. METHODS: In all, 285 Czech octogenarians who underwent any cardiac surgical procedure between January 2011 and December 2012 were included in the study. Five out of all twelve national adult cardiac surgical centers participated in the study, representing almost half of all octogenarians operated in our country in that period...
May 24, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28526942/development-of-a-new-risk-nomogram-of-perioperative-major-adverse-cardiac-events-for-chinese-patients-undergoing-colorectal-carcinoma-surgery
#4
Juhong Zhang, Ying Xiao, Daya Yang, Xiaodong Zhuang, Ling Wang, Xiuren Gao, Zhibin Huang
PURPOSE: The purpose of this study is to create a new risk nomogram to predict perioperative major adverse cardiac events in patients undergoing colorectal carcinoma surgery. METHODS: A total of 1899 patients who underwent colorectal carcinoma surgery at a tertiary teaching hospital in China between 2007 and 2012 were recruited. Logistic regression analysis was used to define risk factors for major adverse cardiac events. A nomogram-predicting model was built based on the logistic regression model and discrimination was tested by receiver operating characteristic curves...
May 19, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28525506/haptoglobin-administration-in-cardiovascular-surgery-patients-its-association-with-the-risk-of-postoperative-acute-kidney-injury
#5
Kenta Kubota, Moritoki Egi, Satoshi Mizobuchi
BACKGROUND: Acute kidney injury (AKI) often occurs after cardiac surgery. During cardiac surgery, plasma free hemoglobin (fHb) would increase due to hemolysis. Since plasma fHb is thought to be nephrotoxic, haptoglobin, which is an fHb scavenger, may have the potential to prevent postoperative AKI (pAKI). However, there have been few studies in which the association of intraoperative administration of haptoglobin with the incidence of AKI after cardiac surgery was assessed. METHODS: This study was a retrospective observational study to assess the independent association of intraoperative administration of haptoglobin with the incidence pAKI in cardiac surgery patients...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28515851/blood-conservation-pediatric-cardiac-surgery-in-all-ages-and-complexity-levels
#6
Mohsen Karimi, Jill M Sullivan, Carrie Linthicum, Anil Mathew
AIM: To demonstrate the feasibility of blood conservation methods and practice across all ages and risk categories in congenital cardiac surgery. METHODS: We retrospectively analyzed a collected database of 356 patients who underwent cardiac surgery using cardiopulmonary bypass (CPB) from 2010-2015. The patients were grouped into blood conservation (n = 138) and non-conservation (n = 218) groups and sub-grouped based on their ages and procedural complexity scores...
April 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28515370/acute-kidney-injury-following-cardiopulmonary-bypass-in-children%C3%A3-risk-factors-and-outcomes
#7
Seon Hwa Lee, Soo-Jin Kim, Hyung Joong Kim, Jae Sung Son, Ran Lee, Tae Gyoon Yoon
BACKGROUND: Acute kidney injury (AKI) is the most common and most serious complication following heart surgery. We aimed to determine the prevalence of, and risk factors for, AKI following pediatric cardiac surgery.Methods and Results:We retrospectively analyzed 135 patients aged ≤18 years who underwent cardiac surgery for congenital heart defects; by RACHS-1 category, 58 patients (43%) had an operative risk score ≥3. AKI was defined and classified using the pediatric pRIFLE criteria (Pediatric Risk, Injury, Failure, Loss, and End-stage Kidney Disease); 19 patients (14...
May 17, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28514878/anticoagulant-cessation-following-atrial-fibrillation-ablation-limits-of-the-ecg-guided-approach
#8
Matteo Anselmino, Chiara Rovera, Giovanni Marchetto, Federico Ferraris, Davide Castagno, Fiorenzo Gaita
Long-term cessation of oral anticoagulation (OAC) following successful catheter or surgical ablation of atrial fibrillation (AF) is debated. Usually, in the presence of sinus rhythm at serial ECG recordings, the CHADS2, CHA2DS2VASc, and HAS-BLED scores are adopted to guide decision regarding OAC management. Areas covered: The safety of OAC cessation in patients without recurrent AF but with historically elevated risk for thromboembolism remains largely unknown. Taking the cue from two clinical cases, we provide an updated summary of the latest evidence regarding how to manage OAC after a successful atrial fibrillation ablation...
May 18, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28514319/prospective-external-validation-of-three-preoperative-risk-scores-for-prediction-of-new-onset-atrial-fibrillation-after-cardiac-surgery
#9
Matthew J Cameron, Diem T T Tran, Jean Abboud, Ethan K Newton, Houman Rashidian, Jean-Yves Dupuis
BACKGROUND: Postoperative atrial fibrillation (POAF) is associated with early and late morbidity and mortality of cardiac surgical patients. Prophylactic treatment of atrial fibrillation (AF) has been recommended to improve outcome in cardiac surgical patients at high risk of developing POAF. Reliable models for prediction of POAF are needed to achieve that goal. This study attempted to externally validate 3 risk models proposed for preoperative prediction of POAF in cardiac surgical patients: the POAF score, the CHA2DS2-VASc score, and the Atrial Fibrillation Risk Index...
May 12, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28499655/validating-the-thoracic-revised-cardiac-risk-index-following-lung-resection
#10
Daniel C Thomas, Justin D Blasberg, Brian N Arnold, Joshua E Rosen, Michelle C Salazar, Frank C Detterbeck, Daniel J Boffa, Anthony W Kim
BACKGROUND: The Thoracic Revised Cardiac Index (ThRCRI) is a tool that differentiates patients who may proceed to lung resection (classes A or B) from those who should receive additional cardiac evaluation (classes C or D). This study aims to describe the ability of the ThRCRI to stratify patients based on major cardiac complication rates using a large multi-institutional dataset. METHODS: Patients undergoing lobectomy or pneumonectomy were identified in the American College of Surgeons National Surgical Quality Improvement Program dataset from 2005 to 2012...
May 9, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28498904/the-acef-ii-risk-score-for-cardiac-surgery-updated-but-still-parsimonious
#11
Marco Ranucci, Valeria Pistuddi, Sabino Scolletta, Carlo de Vincentiis, Lorenzo Menicanti
Aims: The age, creatinine, and ejection fraction (ACEF) score was introduced in 2009 and is presently included in the guidelines for myocardial revascularization of the European Society of Cardiology and Association for Cardio-Thoracic Surgery as a risk stratification tool for surgical and percutaneous myocardial revascularization. The present study introduces an updated version of the ACEF (ACEF II) inclusive of emergency surgery and pre-operative anaemia. Methods and results: The development series includes 7011 consecutive cardiac surgery patients operated at a single institution...
May 12, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28494887/preoperative-risk-stratification-of-critically-ill-patients
#12
Curtis C Copeland, Andrew Young, Tristan Grogan, Eilon Gabel, Anahat Dhillon, Vadim Gudzenko
STUDY OBJECTIVE: Risk assessment historically emphasized cardiac morbidity and mortality in elective, outpatient, non-cardiac surgery. However, critically ill patients increasingly present for therapeutic interventions. Our study investigated the relationship of American Society of Anesthesiologists (ASA) class, revised cardiac risk index (RCRI), and sequential organ failure assessment (SOFA) score with survival to discharge in critically ill patients with respiratory failure. DESIGN: Retrospective cohort analysis over a 21-month period...
June 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28488370/patients-with-cirrhosis-who-have-coronary-artery-disease-treated-with-cardiac-stents-have-high-rates-of-gastrointestinal-bleeding-but-no-increased-mortality
#13
T Krill, G Brown, R A Weideman, D J Cipher, S J Spechler, E Brilakis, L A Feagins
BACKGROUND: Patients with coronary artery disease (CAD) treated with stents require dual antiplatelet therapy (DAPT). For cirrhotics, who often have varices and coagulopathy, it is not clear if the risk of gastrointestinal bleeding (GIB) should preclude use of DAPT. AIM: To compare GIB and mortality rates in cirrhotics with CAD treated medically or with stents. METHODS: Using institutional databases, we identified patients with cirrhosis and CAD treated with stents or medical therapy between January 2000-September 2015...
May 9, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28486891/assessing-contemporary-intensive-care-unit-outcome-development-and-validation-of-the-australian-and-new-zealand-risk-of-death-admission-model
#14
E Paul, M Bailey, J Kasza, D V Pilcher
The Australian and New Zealand Risk of Death (ANZROD) model currently used for benchmarking intensive care units (ICUs) in Australia and New Zealand utilises physiological data collected up to 24 hours after ICU admission to estimate the risk of hospital mortality. This study aimed to develop the Australian and New Zealand Risk of Death admission (ANZROD<sub>0</sub>) model to predict hospital mortality using data available at presentation to ICU and compare its performance with the ANZROD in Australian and New Zealand hospitals...
May 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28486386/fluid-overload-and-cumulative-thoracostomy-output-are-associated-with-surgical-site-infection-after-pediatric-cardiothoracic-surgery
#15
Anthony A Sochet, Aoibhinn Nyhan, Michael C Spaeder, Alexander M Cartron, Xiaoyan Song, Darren Klugman, Anna T Brown
OBJECTIVES: To determine the impact of cumulative, postoperative thoracostomy output, amount of bolus IV fluids and peak fluid overload on the incidence and odds of developing a deep surgical site infection following pediatric cardiothoracic surgery. DESIGN: A single-center, nested, retrospective, matched case-control study. SETTING: A 26-bed cardiac ICU in a 303-bed tertiary care pediatric hospital. PATIENTS: Cases with deep surgical site infection following cardiothoracic surgery were identified retrospectively from January 2010 through December 2013 and individually matched to controls at a ratio of 1:2 by age, gender, Risk Adjustment for Congenital Heart Surgery score, Society of Thoracic Surgeons-European Association for Cardiothoracic Surgery category, primary cardiac diagnosis, and procedure...
May 8, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28481987/does-the-use-of-a-free-internal-mammary-artery-graft-on-the-left-anterior-descending-artery-compromise-long-term-survival-%C3%A2
#16
Nicola Vistarini, Dimitri Kalavrouziotis, François Dagenais, Eric Dumont, Pierre Voisine, Siamak Mohammadi
OBJECTIVES: The aim of the study was to determine if there is a long-term outcomes disadvantage associated with using the internal mammary artery (IMA) as a free graft to the left anterior descending artery (LAD) during coronary artery bypass graft surgery. METHODS: Between 1991 and 2014, 21 876 consecutive patients underwent isolated primary coronary artery bypass graft surgery at our institution. Among these, 238 underwent a free IMA (f-IMA) graft to bypass the LAD...
May 8, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28481752/preoperative-cognitive-performance-and-postoperative-delirium-are-independently-associated-with-future-dementia-in-older-people-who-have-undergone-cardiac-surgery-a-longitudinal-cohort-study
#17
Helena Claesson Lingehall, Nina S Smulter, Elisabeth Lindahl, Marie Lindkvist, Karl Gunnar Engström, Yngve G Gustafson, Birgitta Olofsson
OBJECTIVE: To investigate if postoperative delirium was associated with the development of dementia within 5 years after cardiac surgery. DESIGN: Longitudinal cohort study. SETTING: Cardiothoracic Division, Umeå University Hospital, Sweden. PATIENTS: Patients aged 70 years old or older (n = 114) scheduled for routine cardiac procedures with cardiopulmonary bypass without documented dementia were enrolled in 2009. INTERVENTION: Structured assessments were performed preoperatively, 1 and 4 days after extubation, and 1, 3, and 5 years postoperatively...
May 5, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28473107/current-interventions-for-the-left-main%C3%A2-bifurcation
#18
REVIEW
Tanveer Rab, Imad Sheiban, Yves Louvard, Fadi J Sawaya, Jun Jie Zhang, Shao Liang Chen
Contemporary clinical trials, registries, and meta-analyses, supported by recent results from the EXCEL (Everolimus-Eluting Stents or Bypass Surgery for Left Main Coronary Artery Disease) and NOBLE (Percutaneous Coronary Angioplasty Versus Coronary Artery Bypass Grafting in Treatment of Unprotected Left Main Stenosis) trials, have established percutaneous coronary intervention of left main coronary stenosis as a safe alternative to coronary artery bypass grafting in patients with low and intermediate SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) scores...
May 8, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28472145/preoperative-aspirin-use-and-acute-kidney-injury-after-cardiac-surgery-a-propensity-score-matched-observational-study
#19
Min Hur, Chang-Hoon Koo, Hyung-Chul Lee, Sun-Kyung Park, Minkyung Kim, Won Ho Kim, Jin-Tae Kim, Jae-Hyon Bahk
BACKGROUND: The association between preoperative aspirin use and postoperative acute kidney injury (AKI) in cardiovascular surgery is unclear. We sought to evaluate the effect of preoperative aspirin use on postoperative AKI in cardiac surgery. METHODS: A total of 770 patients who underwent cardiovascular surgery under cardiopulmonary bypass were reviewed. Perioperative clinical parameters including preoperative aspirin administration were retrieved. We matched 108 patients who took preoperative aspirin continuously with patients who stopped aspirin more than 7 days or did not take aspirin for the month before surgery...
2017: PloS One
https://www.readbyqxmd.com/read/28456394/reexamining-the-role-of-surgical-aortic-valve-replacement-after-mediastinal-radiation-therapy
#20
Aly Ghoneim, Ismail Bouhout, Louis P Perrault, Denis Bouchard, Michel Pellerin, Yoan Lamarche, Philippe Demers, Michel Carrier, Raymond Cartier, Ismail El-Hamamsy
BACKGROUND: The risk of aortic valve replacement (AVR) for patients after mediastinal radiation therapy (MRT) remains unaccounted for in traditional risk scores. The aim of this study was to examine perioperative and midterm outcomes in patients undergoing AVR after MRT in the current era. METHODS: From 2000 to 2016, 49 consecutive patients previously exposed to MRT underwent AVR with or without concomitant procedures at a single center. Patients were divided into two groups: isolated AVR (n = 18) and AVR with concomitant procedures (n = 31)...
April 26, 2017: Annals of Thoracic Surgery
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