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Pre operative risk stratification

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https://www.readbyqxmd.com/read/28703300/a-point-based-prediction-model-for-cardiovascular-risk-in-orthotopic-liver-transplantation-the-car-olt-score
#1
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/28688658/decreasing-30-day-surgical-mortality-in-a-va-medical-center-utilizing-the-acs-nsqip-surgical-risk-calculator
#2
SreyRam Kuy, Ramon A L Romero
BACKGROUND: The Overton Brooks VA Medical Center Surgical Service had a high mortality. In an effort to reduce surgical mortality, we implemented a series of quality improvement interventions, including utilization of the ACS Surgical Risk Calculator to identify high-risk surgical patients for discussion in a multidisciplinary Pre-Operative Consultation Committee. METHODS: Retrospective study describing the implementation of a risk stratification intervention incorporating the ACS Surgical Risk Calculator Tool and a multidisciplinary Pre-Operative Consultation Committee to target high-risk patients...
July 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28684167/sarcopaenia-in-surgical-populations-a-review
#3
REVIEW
Rachel S M Heard, George Ramsay, Diane R Hildebrand
Sarcopaenia, or decreased muscle mass, has been the subject of a large quantity of recent literature in both medical and surgical disciplines. It has been shown, as outlined below, to be of great prognostic importance, and also may be used in certain circumstances to guide treatment. The greatest volume of research into this topic is in oncological surgical populations, in whom the prevalence of sarcopaenia has been shown to be high. However it is being increasingly studied in other patient groups. Interest in using sarcopaenia as an objective and potentially modifiable marker of frailty is increasing, especially with regards to pre-operative risk stratification and amelioration...
July 3, 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/28673695/comparison-of-four-scoring-systems-used-to-predict-mortality-in-patients-with-acute-upper-gastrointestinal-bleeding-in-the-emergency-room
#4
Yuedong Tang, Jie Shen, Feng Zhang, Xiaoyong Zhou, Zhongyan Tang, Tingting You
OBJECTIVE: Acute upper gastrointestinal bleeding (UGIB) is a potentially life-threatening condition that requires rapid assessment in the emergency department (ED). We aimed to compare the performance of the AIMS65, Glasgow-Blatchford (Blatchford), preendoscopic Rockall (pre-Rockall), and preendoscopic Baylor bleeding (pre-Baylor) scores in predicting 30-day mortality in patients with acute UGIB in the ED setting. METHODS: Consecutive patients with acute UGIB who were admitted to the ED ward during 2012-2016 were retrospectively recruited...
June 27, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28663398/cardiac-disease-and-advanced-age-increase-the-mortality-risk-following-surgery-for-periprosthetic-femoral-fractures
#5
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/28655164/role-of-diastolic-function-indices-in-the-risk-stratification-of-patients-with-mixed-aortic-valve-disease
#6
Alexander C Egbe, Arooj R Khan, Amber Boler, Sameh M Said, Jeffrey B Geske, William R Miranda, Emmanuel Akintoye, Heidi M Connolly, Carole A Warnes, Jae K Oh
Aims: Determine the role of diastolic function indices in pre-operative and post-operative risk stratification in patients with moderate mixed aortic valve disease (MAVD). Methods and results: A retrospective study was conducted of asymptomatic patients with moderate MAVD (a combination of moderate aortic stenosis and moderate aortic regurgitation) and an ejection fraction of 50% or more who were followed up at Mayo Clinic from 1 January 2004, to 31 December 2013...
June 23, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28607592/the-role-of-adjuvant-chemotherapy-for-colorectal-liver-metastasectomy-after-pre-operative-chemotherapy-is-the-treatment-worthwhile
#7
Yun Wang, Zhi-Qiang Wang, Feng-Hua Wang, Yun-Fei Yuan, Bin-Kui Li, Pei-Rong Ding, Gong Chen, Xiao-Jun Wu, Zhen-Hai Lu, Zhi-Zhong Pan, De-Sen Wan, Peng Sun, Shu-Mei Yan, Rui-Hua Xu, Yu-Hong Li
Peri-operative chemotherapy has been proposed to improve the survival of patients with colorectal cancer hepatic metastases (CRCHM). However, the role of the adjuvant chemotherapy post-metastasectomy for CRCHM patients who have undergone pre-operative chemotherapy is still undetermined. We retrospectively analyzed the role of adjuvant chemotherapy post-metastasectomy on relapse-free survival (RFS) and overall survival (OS) in 163 CRCHM patients who received pre-operative chemotherapy using a Kaplan-Meier curve and univariate/multiple Cox model...
2017: Journal of Cancer
https://www.readbyqxmd.com/read/28559660/mean-platelet-volume-as-a-predictor-of-heart-failure-related-hospitalizations-in-stable-heart-failure-outpatients-with-sinus-rhythm
#8
Hakki Kaya, Mustafa Kutay Yıldırımlı, Recep Kurt, Osman Beton, Mehmet Birhan Yilmaz
BACKGROUND: In this study, we investigated the relationship between the mean platelet volume (MPV) with mortality and heart failure (HF)-related hospitalization in stable chronic HF outpatients with reduced ejection fraction (HFrEF) and with sinus rhythm (SR). METHODS: This retrospective cohort study included 197 consecutive stable chronic HFrEF outpatients with SR, who were admitted to our cardiology outpatient clinics for examination between January 2014 and January 2015...
May 2017: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/28552279/a-retrospective-study-multivariate-logistic-regression-analysis-of-the-outcomes-after-pressure-sores-reconstruction-with-fasciocutaneous-myocutaneous-and-perforator-flaps
#9
Yu-Jen Chiu, Wen-Chieh Liao, Tien-Hsiang Wang, Yu-Chung Shih, Hsu Ma, Chih-Hsun Lin, Szu-Hsien Wu, Cherng-Kang Perng
BACKGROUND: Despite significant advances in medical care and surgical techniques, pressure sore reconstruction is still prone to elevated rates of complication and recurrence. We conducted a retrospective study to investigate not only complication and recurrence rates following pressure sore reconstruction but also preoperative risk stratification. METHODS: This study included 181 ulcers underwent flap operations between January 2002 and December 2013 were included in the study...
April 23, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28543544/the-prognostic-utility-of-the-tumor-burden-score-based-on-preoperative-radiographic-features-of-colorectal-liver-metastases
#10
Kazunari Sasaki, Georgios A Margonis, Nikolaos Andreatos, Xu-Feng Zhang, Stefan Buettner, Jaeyun Wang, Amar Deshwar, Jin He, Christopher L Wolfgang, Matthew Weiss, Timothy M Pawlik
BACKGROUND: Recently, a tumor-burden "metro ticket" score (TBS) based on final pathology was proposed to predict outcome following resection of colorectal liver metastasis (CRLM). We sought to validate the TBS prognostic tool using preoperative radiologic cross-sectional imaging. METHODS: Imaging TBS was defined on a Cartesian plane that incorporated both maximum tumor size (x-axis) and lesion number (y-axis) assessed by pre-operative imaging. The discriminatory power (area under the curve [AUC]) and goodness-of-fit (Harrel's C statistic and Somer's D statistics) of the imaging TBS model was assessed...
May 25, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28542740/plasma-micrornas-as-biomarkers-of-pancreatic-cancer-risk-in-a-prospective-cohort-study
#11
Eric J Duell, Leila Lujan-Barroso, Núria Sala, Samantha Deitz McElyea, Kim Overvad, Anne Tjonneland, Anja Olsen, Elisabete Weiderpass, Lill-Tove Busund, Line Moi, David Muller, Paolo Vineis, Dagfinn Aune, Giuseppe Matullo, Alessio Naccarati, Salvatore Panico, Giovanna Tagliabue, Rosario Tumino, Domenico Palli, Rudolf Kaaks, Verena A Katzke, Heiner Boeing, H B As Bueno-de-Mesquita, Petra H Peeters, Antonia Trichopoulou, Pagona Lagiou, Anastasia Kotanidou, Ruth C Travis, Nick Wareham, Kay-Tee Khaw, Jose Ramon Quiros, Miguel Rodríguez-Barranco, Miren Dorronsoro, María-Dolores Chirlaque, Eva Ardanaz, Gianluca Severi, Marie-Christine Boutron-Ruault, Vinciane Rebours, Paul Brennan, Marc Gunter, Ghislaine Scelo, Greg Cote, Stuart Sherman, Murray Korc
Noninvasive biomarkers for early pancreatic ductal adenocarcinoma (PDAC) diagnosis and disease risk stratification are greatly needed. We conducted a nested case-control study within the Prospective Investigation into Cancer and Nutrition (EPIC) cohort to evaluate prediagnostic microRNAs (miRs) as biomarkers of subsequent PDAC risk. A panel of eight miRs (miR-10a, -10b, -21-3p, -21-5p, -30c, -106b, -155 and -212) based on previous evidence from our group was evaluated in 225 microscopically confirmed PDAC cases and 225 controls matched on center, sex, fasting status and age/date/time of blood collection...
September 1, 2017: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/28528537/intraoperative-mechanical-ventilation-state-of-the-art
#12
Lorenzo Ball, Federico Costantino, Giulia Orefice, Karthikka Chandrapatham, Paolo Pelosi
Mechanical ventilation is a cornerstone of the intraoperative management of the surgical patient and is still mandatory in several surgical procedures. In the last decades, research focused on preventing postoperative pulmonary complications (PPCs), both improving risk stratification through the use of predictive scores and protecting the lung adopting so-called protective ventilation strategies. The aim of this review is to give an up-to-date overview of the currently suggested intraoperative ventilation strategies, along with their pathophysiologic rationale, with a focus on challenging conditions, such as obesity, one-lung ventilation and cardiopulmonary bypass...
May 19, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28511024/cardiopulmonary-exercise-testing-and-surgery
#13
Paul O Older, Denny Zh Levett
The surgical patient population is increasingly elderly and comorbid and poses challenges to perioperative physicians. Accurate pre-operative risk stratification is important to direct perioperative care. Reduced aerobic fitness is associated with increased post-operative morbidity and mortality. Cardiopulmonary exercise testing is an integrated and dynamic test that gives an objective measure of aerobic fitness or functional capacity and identifies the cause of exercise intolerance. Cardiopulmonary exercise testing provides an individualized estimate of patient risk that can be used to predict post-operative morbidity and mortality...
May 16, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28498904/the-acef-ii-risk-score-for-cardiac-surgery-updated-but-still-parsimonious
#14
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
#15
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/28491887/risk-factors-for-surgical-site-infection-after-cholecystectomy
#16
David K Warren, Katelin B Nickel, Anna E Wallace, Daniel Mines, Fang Tian, William J Symons, Victoria J Fraser, Margaret A Olsen
BACKGROUND: There are limited data on risk factors for surgical site infection (SSI) after open or laparoscopic cholecystectomy. METHODS: A retrospective cohort of commercially insured persons aged 18-64 years was assembled using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) procedure or Current Procedural Terminology, 4th edition codes for cholecystectomy from December 31, 2004 to December 31, 2010. Complex procedures and patients (eg, cancer, end-stage renal disease) and procedures with pre-existing infection were excluded...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28488754/virtual-endovascular-treatment-of-intracranial-aneurysms-models-and-uncertainty
#17
REVIEW
Ali Sarrami-Foroushani, Toni Lassila, Alejandro F Frangi
Virtual endovascular treatment models (VETMs) have been developed with the view to aid interventional neuroradiologists and neurosurgeons to pre-operatively analyze the comparative efficacy and safety of endovascular treatments for intracranial aneurysms. Based on the current state of VETMs in aneurysm rupture risk stratification and in patient-specific prediction of treatment outcomes, we argue there is a need to go beyond personalized biomechanical flow modeling assuming deterministic parameters and error-free measurements...
May 10, 2017: Wiley Interdisciplinary Reviews. Systems Biology and Medicine
https://www.readbyqxmd.com/read/28458732/does-the-timing-of-pre-operative-medical-evaluation-influence-perioperative-total-hip-arthroplasty-outcomes
#18
Roy H Lan, Atul F Kamath
BACKGROUND: Medical evaluation pre-operatively is an important component of risk stratification and potential risk optimization. However, the effect of timing prior to surgical intervention is not well-understood. We hypothesized that total hip arthroplasty (THA) patients seen in pre-operative evaluation closer to the date of surgery would experience better perioperative outcomes. METHODS: We retrospectively reviewed 167 elective THA patients to study the relationship between the number of days between pre-operative evaluation (range, 0-80 days) and surgical intervention...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28454636/carotid-artery-disease-and-perioperative-stroke-risk-after-surgical-aortic-valve-replacement-a-nationwide-inpatient-sample-analysis
#19
Reshmi Udesh, Amol Mehta, Thomas Gleason, Parthasarathy D Thirumala
To study the role of carotid stenosis (CS) and cerebrovascular disease as independent risk factors for perioperative stroke following surgical aortic valve replacement (SAVR). The National Inpatient Sample (NIS) database was used for our study. All patients who underwent SAVR from 1999 to 2011 were identified using ICD-9 codes. Univariate and multivariate analysis of baseline characteristics, Elixhauser comorbidities and other covariates were examined to identify independent predictors of perioperative strokes following SAVR...
August 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28415003/less-favourable-prognosis-for-low-risk-endometrial-cancer-patients-with-a-discordant-pre-versus-post-operative-risk-stratification
#20
F A Eggink, C H Mom, K Bouwman, D Boll, J H Becker, C L Creutzberg, G C Niemeijer, W J van Driel, A K Reyners, A G van der Zee, G L Bremer, N P Ezendam, R F Kruitwagen, J M Pijnenborg, H Hollema, H W Nijman, M A van der Aa
BACKGROUND: Pre-operative risk stratification based on endometrial sampling determines the extent of surgery for endometrial cancer (EC). We investigated the concordance of pre- and post-operative risk stratifications and the impact of discordance on survival. METHODS: Patients diagnosed with EC within the first 6 months of the years 2005-2014 were selected from the Netherlands Cancer Registry (N = 7875). Pre- and post-operative risk stratifications were determined based on grade and/or histological subtype for 3784 eligible patients...
April 14, 2017: European Journal of Cancer
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