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Pre operative risk stratification

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https://www.readbyqxmd.com/read/27899969/diagnostic-usefulness-of-the-risk-of-ovarian-malignancy-algorithm-using-the-electrochemiluminescence-immunoassay-for-he4-and-the-chemiluminescence-microparticle-immunoassay-for-ca125
#1
Anita Chudecka-Głaz, Aneta Cymbaluk-Płoska, Katarzyna Luterek-Puszyńska, Janusz Menkiszak
The present study aimed to investigate the usefulness of the Risk of Ovarian Malignancy Algorithm (ROMA) in the preoperative stratification of patients with ovarian tumors using a novel combination of laboratory tests. The study group (n=619) consisted of 354 premenopausal and 265 postmenopausal patients. The levels of carbohydrate antigen 125 (CA125) and human epididymis protein 4 (HE4) were determined, and ROMA calculations were performed for each pre- and postmenopausal patient. HE4 levels were determined using an electrochemiluminescence immunoassay, while CA125 levels were determined by a chemiluminescence microparticle immunoassay...
November 2016: Oncology Letters
https://www.readbyqxmd.com/read/27863640/assessment-of-adenotonsillar-size-and-caregiver-reported-sleep-symptoms-among-3-6-year-old-children-undergoing-adenotonsillectomy
#2
Onur Balaban, Hina Walia, Dmitry Tumin, Kris R Jatana, Vidya Raman, Joseph D Tobias
INTRODUCTION: Adenotonsillectomy remains the accepted first-line treatment for obstructive sleep apnea syndrome (OSAS) in children. Tonsillar size may be especially relevant in risk stratification as it may impact symptoms of sleep disordered breathing (SDB). This study assesses correlations among subjective tonsillar grading, measured tonsillar size, and degree of adenoid obstruction in patients age 3-6 years with caregiver-reported symptoms. METHODS: Children 3-6 years old undergoing adenotonsillectomy for OSAS were enrolled prospectively...
December 2016: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/27842949/the-hat-score-a-simple-risk-stratification-score-for-coagulopathic-bleeding-during-adult-extracorporeal-membrane-oxygenation
#3
Terence Lonergan, Daniel Herr, Zachary Kon, Jay Menaker, Raymond Rector, Kenichi Tanaka, Michael Mazzeffi
OBJECTIVE: The study objective was to create an adult extracorporeal membrane oxygenation (ECMO) coagulopathic bleeding risk score. DESIGN: Secondary analysis was performed on an existing retrospective cohort. Pre-ECMO variables were tested for association with coagulopathic bleeding, and those with the strongest association were included in a multivariable model. Using this model, a risk stratification score was created. The score's utility was validated by comparing bleeding and transfusion rates between score levels...
September 1, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27831987/development-of-validated-computer-based-preoperative-predictive-model-for-proximal-junction-failure-pjf-or-clinically-significant-pjk-with-86-accuracy-based-on-510-asd-patients-with-2-year-follow-up
#4
Justin K Scheer, Joseph A Osorio, Justin S Smith, Frank Schwab, Virginie Lafage, Robert A Hart, Shay Bess, Breton Line, Bassel G Diebo, Themistocles S Protopsaltis, Amit Jain, Tamir Ailon, Douglas C Burton, Christopher I Shaffrey, Eric Klineberg, Christopher P Ames
STUDY DESIGN: A retrospective review of large, multicenter adult spinal deformity (ASD) database. OBJECTIVE: The aim of this study was to build a model based on baseline demographic, radiographic, and surgical factors that can predict clinically significant proximal junctional kyphosis (PJK) and proximal junctional failure (PJF). SUMMARY OF BACKGROUND DATA: PJF and PJK are significant complications and it remains unclear what are the specific drivers behind the development of either...
November 15, 2016: Spine
https://www.readbyqxmd.com/read/27829503/risk-stratification-for-outpatient-parathyroidectomy-and-predictors-of-postoperative-complications
#5
Sarah M Kidwai, Arjun K Parasher, Yan W Ho, Marita S Teng, Eric M Genden
INTRODUCTION: The mainstay of treatment for primary hyperparathyroidism is surgery. Hypocalcemia after parathyroidectomy is common and poses a significant challenge, leading to increased patient morbidity and health care costs. While several groups have found predictor factors for hypocalcemia, none have created a risk stratification model. Here, we recognize important factors and optimal cut-off values that can allow risk stratification of patients. METHODS: A single-institution retrospective chart review of 339 patients that underwent parathyroidectomy from 2009 to 2012 was conducted...
September 28, 2016: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/27822310/anaphylactic-shock-during-cement-implantation-of-a-total-hip-arthroplasty-in-a-patient-with-underlying-mastocytosis-case-report-of-a-rare-intraoperative-complication
#6
Anita Ten Hagen, Pieter Doldersum, Tom van Raaij
BACKGROUND: Cemented total hip arthroplasty (THA) is a safe and common procedure. In rare cases life threatening bone cement implantation syndrome (BCIS) may occur, which is commonly caused by pulmonary embolism (PE). CASE PRESENTATION: We describe the rare case of a 70-year old patient who underwent an elective total hip replacement. Before surgery he was diagnosed with underlying systemic indolent mastocytosis, a rare pathological disorder that may result in anaphylaxis after massive systemic mast cell activation...
2016: Patient Safety in Surgery
https://www.readbyqxmd.com/read/27783141/emergency-abdominal-surgery-in-the-elderly-can-we-predict-mortality
#7
Anna E Sharrock, Jenny McLachlan, Robert Chambers, Ian S Bailey, James Kirkby-Bott
BACKGROUND: The United Kingdom population is ageing. Half of patients requiring an emergency laparotomy are aged over 70, 20 % die within 30 days, and less than half receive good care. Frailty and delay in management are associated with poor surgical outcomes. P-POSSUM risk scoring is widely accepted, but its validity in patients aged over 70 undergoing emergency laparotomy is unclear. AIMS: To assess if P-POSSUM risk stratification reliably predicts inpatient mortality in this group and establish whether those who died within 30 days received delayed care...
October 25, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27782813/additive-value-of-pre-operative-and-one-month-post-operative-lymphocyte-count-for-death-risk-stratification-in-patients-with-resectable-pancreatic-cancer-a-multicentric-study
#8
Christelle d'Engremont, Dewi Vernerey, Anne-Laure Pointet, Gaël Simone, Francine Fein, Bruno Heyd, Stéphane Koch, Lucine Vuitton, Stefano Kim, Marine Jary, Najib Lamfichek, Celia Turco, Zaher Lakkis, Anne Berger, Franck Bonnetain, Julien Taieb, Philippe Bachellier, Christophe Borg
BACKGROUND: Pancreatic adenocarcinoma (PDAC) incidence is increasing worldwide. Several studies have shown that lymphopenia was correlated with a poor prognosis but the potential interest to measure lymphopenia in the pre and post-operative setting as well as its added value among conventional prognostic factors was never investigated. METHODS: Data from two independent cohorts in whom patients underwent resection for pancreatic carcinoma were retrospectively recorded...
October 26, 2016: BMC Cancer
https://www.readbyqxmd.com/read/27740698/a-practical-decision-tree-model-to-predict-complexity-of-reconstructive-surgery-after-periocular-basal-cell-carcinoma-excision
#9
E Tan, F Lin, L Sheck, P Salmon, S Ng
PURPOSE: To derive a decision rule for predicting surgical complexity in periorbital basal cell carcinoma (pBCC). DESIGN: Prospective, cohort study. PARTICIPANTS: Patients referred to an oculoplastic service for excision of pBCC from September 2010 to November 2015 METHODS: This study was conducted at two centres in New Zealand from September 2010 to November 2015. Baseline demographic information, and an initial assessment of operative complexity (a four-point grading scale) were collected...
October 14, 2016: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/27725914/methylation-of-serum-sst-gene-is-an-independent-prognostic-marker-in-colorectal-cancer
#10
Yanqun Liu, Min Hoe Chew, Chee Kian Tham, Choong Leong Tang, Simon Yk Ong, Yi Zhao
There is an increasing demand for accurate prognostication for colorectal cancer (CRC). This study sought to assess prognostic potentials of methylation targets in the serum of CRC patients. A total of 165 CRC patients were enrolled in this prospective study. Promoter methylation levels of seven genes in pre-operative sera and matched tumor tissues were evaluated by quantitative methylation-specific PCR. Kaplan-Meier test, and univariate and multivariate Cox proportional hazards regression models were used for survival analyses...
2016: American Journal of Cancer Research
https://www.readbyqxmd.com/read/27692567/prognostic-impact-of-homocysteine-levels-and-homocysteine-thiolactonase-activity-on-long-term-clinical-outcomes-in-patients-undergoing-percutaneous-coronary-intervention
#11
Ahmed Hassan, Tomotaka Dohi, Katsumi Miyauchi, Manabu Ogita, Makoto Kurano, Ryunosuke Ohkawa, Kazuhiro Nakamura, Hiroshi Tamura, Kikuo Isoda, Shinya Okazaki, Yutaka Yatomi, Hiroyuki Daida
BACKGROUND: Numerous studies have reported the relationship between elevated homocysteine (Hcy) levels and the risk of coronary artery disease. However, there is insufficient information about the effects of Hcy levels on long-term clinical outcomes in patients with coronary artery disease undergoing percutaneous coronary intervention (PCI). METHODS: In the Juntendo-registry cohort from 2003 to 2004, pre-procedural Hcy levels and Hcy thiolactonase activity (HTlase) were measured in 315 consecutive all-comer patients who underwent PCI for stable coronary artery disease or acute coronary syndrome (ACS)...
September 27, 2016: Journal of Cardiology
https://www.readbyqxmd.com/read/27636535/renal-dysfunction-and-transcatheter-aortic-valve-implantation-outcomes
#12
Marco Barbanti, Giuseppe Gargiulo, Corrado Tamburino
Transcatheter aortic valve implantation (TAVI) underwent progressive improvements until it became the default therapy for inoperable patients, and a recommended therapy in high-risk operable patients with symptomatic severe aortic stenosis. Recent evidence will further support TAVI as treatment for a growing number of patients. Areas covered: This review will discuss on the current knowledge about the role of both pre-procedural chronic kidney disease (CKD) and post-procedural acute kidney injury (AKI) in adult patients with severe aortic stenosis undergoing TAVI...
December 2016: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27601737/an-observational-cohort-study-on-pre-operative-investigations-and-referrals-how-far-are-we-following-recommendations
#13
Habib Md Reazaul Karim, Md Yunus, Prithwis Bhattacharyya
BACKGROUND AND AIMS: Pre-operative investigations are often required to supplement information for risk stratification and assessing reserve for undergoing surgery. Although there are evidence-based recommendations for which investigations should be done, clinical practice varies. The present study aimed to assess the pre-operative investigations and referral practices and compare it with the standard guidelines. METHODS: The present observational study was carried out during 2014-appen2015 in a teaching institute after the approval from Institute Ethical Committee...
August 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/27593714/patient-bmi-is-an-independent-predictor-of-30-day-hospital-readmission-after-elective-spine-surgery
#14
Aladine A Elsamadicy, Owoicho Adogwa, Victoria D Vuong, Ankit I Mehta, Raul A Vasquez, Joseph Cheng, Isaac O Karikari, Carlos A Bagley
BACKGROUND: Hospital readmission within 30-days of index surgery is receiving increased scrutiny as an indicator of poor quality of care. Accordingly, reducing readmissions achieves the dual benefit of improving quality and reducing costs. With the growing prevalence of obesity, understanding its impact on 30-day unplanned readmissions and patients' perception of health status is important for appropriate risk stratification of patients. The aim of this study is to determine if obesity is an independent risk factor for unplanned 30-day readmissions following elective spine surgery...
September 1, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27548238/physical-activity-and-exertional-desaturation-are-associated-with-mortality-in-idiopathic-pulmonary-fibrosis
#15
Baruch Vainshelboim, Mordechai Reuven Kramer, Shimon Izhakian, Ricardo M Lima, Jose Oliveira
Idiopathic pulmonary fibrosis (IPF) is a chronic lung disease that manifests in hypoxemia, inactivity, and poor prognosis. This study aimed to assess the prognostic role of physical activity (PA) and exertional desaturation (ED) with mortality in IPF. At baseline, 34 IPF patients (68 (50-81) years) were interviewed using the International Physical Activity Questionnaire (IPAQ), and SpO₂ was assessed pre to post 6-min walking test (∆SpO₂). Patients were prospectively followed up for 40 months. Receiver operating characteristics curve analysis determined cut-off points associated with mortality, and Cox proportional hazard ratio (HR) were conducted...
August 18, 2016: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/27502336/pre-nela-vs-nela-has-anything-changed-or-is-it-just-an-audit-exercise
#16
M Mak, A R Hakeem, V Chitre
BACKGROUND Following evidence suggestive of high mortality following emergency laparotomies, the National Emergency Laparotomy Audit (NELA) was set up, highlighting key standards in emergency service provision. Our aim was to compare our NHS trust's adherence to these recommendations immediately prior to, and following, the launch of NELA, and to compare patient outcome. METHODS This was a retrospective study of patients who underwent an emergency laparotomy over the course of 6 months - 3 months either side of the initiation of NELA...
August 9, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27448846/percent-improvement-in-renal-pelvis-antero-posterior-diameter-pi-apd-prospective-validation-and-further-exploration-of-cut-off-values-that-predict-success-after-pediatric-pyeloplasty-supporting-safe-monitoring-with-ultrasound-alone
#17
M Rickard, L H Braga, J-P Oliveria, R Romao, J Demaria, A J Lorenzo
INTRODUCTION: Renograms are frequently obtained post-pyeloplasty in patients with residual hydronephrosis to confirm adequate drainage. Recent evidence suggests that percent improvement in antero-posterior diameter (PI-APD) ≥38 is predictive of success. We sought to further explore PI-APD ranges that would allow identification of patients who would benefit from ultrasound (US) monitoring alone vs. post-operative renal scan, and those more likely to develop recurrent ureteropelvic junction obstruction (rUPJO)...
August 2016: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/27390988/when-is-the-right-time-for-fontan-conversion-the-role-of-cardiopulmonary-exercise-test
#18
Alexander C Egbe, Heidi M Connolly, Joseph A Dearani, Crystal R Bonnichsen, Talha Niaz, Thomas G Allison, Jonathan N Johnson, Joseph T Poterucha, Sameh M Said, Naser M Ammash
BACKGROUND: To determine if Fontan conversion (FC) resulted in improvement in exercise capacity (EC), and to determine the role of cardiopulmonary exercise test (CPET) in risk stratification of patients undergoing FC. METHODS: A retrospective review of patients who underwent CPET prior to FC at Mayo Clinic from 1994 to 2014. The patients who also underwent post-operative CPET were selected for the analysis of improvement in EC defined as 10% increase in baseline peak oxygen consumption (VO2)...
October 1, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27374110/frailty-and-postoperative-outcomes-in-patients-undergoing-surgery-for-degenerative-spine-disease
#19
Alana M Flexman, Raphaële Charest-Morin, Liam Stobart, John Street, Christopher J Ryerson
BACKGROUND CONTEXT: Frailty is defined as a state of decreased reserve and susceptibility to stressors. The relationship between frailty and postoperative outcomes after degenerative spine surgery has not been studied. PURPOSE: 1) Determine prevalence of frailty in the degenerative spine population; 2) Describe patient characteristics associated with frailty; 3) Determine the association between frailty and postoperative complications, mortality, length of stay and discharge disposition...
June 30, 2016: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/27350916/in-hospital-mortality-after-surgery-a-retrospective-cohort-study-in-a-japanese-university-hospital
#20
Yo Shidara, Yoshihisa Fujita, Saiko Fukunaga, Kae Ikeda, Mayumi Uemura
BACKGROUND: The rapidly aging population affects Japan's health system, which is characterized by equity and full health insurance coverage for the entire population. However, the current outcomes after surgery in tertiary hospitals in Japan are not known. We aimed to gain an overview of postoperative mortality and death in a tertiary university hospital. METHODS: Using the administrative database of Kawasaki Medical School Hospital, we investigated the pattern of in-hospital mortality and death for patients who underwent surgery under general or regional anesthesia between January 2010 and December 2011...
2016: SpringerPlus
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