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Pre operative risk stratification

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https://www.readbyqxmd.com/read/28934761/comparison-between-mri-and-pathology-in-the-assessment-of-tumour-regression-grade-in-rectal-cancer
#1
Francesco Sclafani, Gina Brown, David Cunningham, Andrew Wotherspoon, Larissa Sena Teixeira Mendes, Svetlana Balyasnikova, Jessica Evans, Clare Peckitt, Ruwaida Begum, Diana Tait, Josep Tabernero, Bengt Glimelius, Susana Roselló, Janet Thomas, Jacqui Oates, Ian Chau
BACKGROUND: Limited data exist regarding the correlation between MRI tumour regression grade (mrTRG) and pathological TRG (pTRG) in rectal cancer. METHODS: mrTRG and pTRG were compared in rectal cancer patients from two phase II trials (EXPERT and EXPERT-C). The agreement between radiologist and pathologist was assessed with the weighted κ test while the Kaplan-Meier method was used to estimate survival outcomes. RESULTS: One hundred ninety-one patients were included...
September 21, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28906306/predicting-early-mortality-following-hip-fracture-surgery-the-hip-fracture-estimator-of-mortality-amsterdam-hema
#2
Julian Karres, Noera Kieviet, Jan-Peter Eerenberg, Bart C Vrouenraets
OBJECTIVES: Early mortality following hip fracture surgery is high and pre-operative risk assessment for the individual patient is challenging. A risk model could identify patients in need of more intensive perioperative care, provide insight in the prognosis and allow for risk-adjustment in audits. This study aimed to develop and validate a risk prediction model for 30-day mortality following hip fracture surgery: the Hip fracture Estimator of Mortality Amsterdam (HEMA). METHODS: Data on 1050 consecutive patients undergoing hip fracture surgery between 2004 and 2010 were retrospectively collected and randomly split into a development cohort (746 patients) and validation cohort (304 patients)...
September 11, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28844347/corrigendum-to-less-favourable-prognosis-for-low-risk-endometrial-cancer-patients-with-a-discordant-pre-versus-post-operative-risk-stratification-eur-j-cancer-78-2017-82-90
#3
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
No abstract text is available yet for this article.
August 22, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28811042/understanding-readmissions-in-children-undergoing-surgery-a-pediatric-nsqip-analysis
#4
Afif N Kulaylat, Dorothy V Rocourt, Anthony Y Tsai, Kathryn L Martin, Brett W Engbrecht, Mary C Santos, Robert E Cilley, Christopher S Hollenbeak, Peter W Dillon
BACKGROUND: Readmission is increasingly being utilized as an important clinical outcome and measure of hospital quality. Our aim was to delineate rates, risk factors, and reasons for unplanned readmission in pediatric surgery. MATERIALS AND METHODS: Retrospective review of pediatric patients (n=130,274) undergoing surgery (2013-2014) at hospitals enrolled in the Pediatric National Surgical Quality Improvement Program (NSQIP-P) was performed. Logistic regression was used to model factors associated with unplanned 30-day readmission...
July 31, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28781011/pre-operative-proteinuria-in-left-ventricular-assist-devices-and-clinical-outcome
#5
Rahatullah Muslem, Kadir Caliskan, Sakir Akin, Kavita Sharma, Nisha A Gilotra, Jasper J Brugts, Brian Houston, Glenn Whitman, Ryan J Tedford, Dennis A Hesselink, Ad J J C Bogers, Olivier C Manintveld, Stuart D Russell
BACKGROUND: This study evaluated the association of pre-operative proteinuria before continuous flow left ventricular assist device (CF-LVAD) implantation in relation to mortality and the need for renal replacement therapy (RRT) during the first year of follow-up. METHODS: This retrospective, multicenter cohort study evaluated all patients (n = 241) who underwent CF-LVAD implantation in the 2 participating tertiary referral centers. Patients were included if a urine dipstick was performed within 7 days before CF-LVAD implantation...
July 15, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28758236/morphometric-age-and-survival-following-kidney-transplantation
#6
Michael N Terjimanian, Patrick W Underwood, David C Cron, Joshua J Augustine, Kelly A Noon, Devan A Cote, Stewart C Wang, Michael J Englesbe, Kenneth J Woodside
BACKGROUND: As patients with chronic kidney disease become older, there is greater need to identify who will most benefit from kidney transplantation. Analytic morphomics has emerged as an objective risk assessment tool distinct from chronologic age. We hypothesize that morphometric age is a significant predictor of survival following transplantation. METHODS: A retrospective cohort of 158 kidney transplant patients from 2005 to 2014 with 1-year pre-operative imaging was identified...
July 31, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28751850/anmco-sic-sici-gise-sicch-executive-summary-of-consensus-document-on-risk-stratification-in-elderly-patients-with-aortic-stenosis-before-surgery-or-transcatheter-aortic-valve-replacement
#7
Giovanni Pulignano, Michele Massimo Gulizia, Samuele Baldasseroni, Francesco Bedogni, Giovanni Cioffi, Ciro Indolfi, Francesco Romeo, Adriano Murrone, Francesco Musumeci, Alessandro Parolari, Leonardo Patanè, Paolo Giuseppe Pino, Annalisa Mongiardo, Carmen Spaccarotella, Roberto Di Bartolomeo, Giuseppe Musumeci
Aortic stenosis is one of the most frequent valvular diseases in developed countries, and its impact on public health resources and assistance is increasing. A substantial proportion of elderly people with severe aortic stenosis is not eligible to surgery because of the advanced age, frailty, and multiple co-morbidities. Transcatheter aortic valve implantation (TAVI) enables the treatment of very elderly patients at high or prohibitive surgical risk considered ineligible for surgery and with an acceptable life expectancy...
May 2017: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://www.readbyqxmd.com/read/28747576/a-prospective-appraisal-of-preoperative-body-mass-index-in-d2-resected-patients-with-non-metastatic-gastric-carcinoma-and-siewert-type-ii-iii-adenocarcinoma-of-esophagogastric-junction-results-from-a-large-scale-cohort
#8
Lei Huang, Zhi-Jian Wei, Tuan-Jie Li, Yu-Ming Jiang, A-Man Xu
OBJECTIVE: To prospectively investigate associations of presurgical body mass index (BMI) with clinicopathological factors and its prognostic significance in radically D2-resected patients with non-metastasized gastric cancer (GC) and Siewert type II/III adenocarcinoma of esophagogastric junction (AEG). METHODS: A large prospective cohort consisting of radically-resected GC and AEG patients was analyzed. Follow-up was successful in 671 out of 700 patients, who were categorized into underweight (BMI<18...
July 12, 2017: Oncotarget
https://www.readbyqxmd.com/read/28703300/a-point-based-prediction-model-for-cardiovascular-risk-in-orthotopic-liver-transplantation-the-car-olt-score
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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...
August 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
#18
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...
September 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28542740/plasma-micrornas-as-biomarkers-of-pancreatic-cancer-risk-in-a-prospective-cohort-study
#19
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
#20
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
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