Read by QxMD icon Read

Pre operative risk stratification

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
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
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
Marco Barbanti, Giuseppe Gargiulo, Corrado Tamburino
INTRODUCTION: 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...
September 20, 2016: Expert Review of Cardiovascular Therapy
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
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
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...
2016: Journal of Clinical Medicine
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
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
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
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
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
M A Faasse, E K Johnson, D K Bowen, B W Lindgren, M Maizels, C R Marcus, B D Jovanovic, E B Yerkes
INTRODUCTION: Recent studies have suggested that a smaller glans penis size may be associated with a higher likelihood of complications after hypospadias repair. Accurate identification of risk factors other than the well-understood variable of meatal location would allow development of better prognostic models and individualized risk stratification. OBJECTIVE: To test the hypothesis that a smaller width of the glans penis predicts adverse outcomes after hypospadias surgery...
August 2016: Journal of Pediatric Urology
R Wolf, E Morinello, G Kestler, B Käsmann-Kellner, M Bischoff, T Hager, J Schöpe, L H J Eberhart
BACKGROUND: Following strabismus surgery, patients frequently develop variable degrees of postoperative nausea and vomiting (PONV). These symptoms cause discomfort and result in serious complications such as intramuscular bleeding and subconjunctival hemorrhage. In children long lasting PONV can lead to and electrolyte imbalance and dehydration. A prolonged course of recovery is the consequence. For the hospital, PONV can also involve negative economic impacts because of a damaged public reputation of the institution...
July 2016: Der Anaesthesist
Romain Mathieu, Mihai D Vartolomei, Aurélie Mbeutcha, Pierre I Karakiewicz, Alberto Briganti, Morgan Roupret, Shahrokh F Shariat
INTRODUCTION: The aim of this review was to provide an overview of current biomarkers and risk stratification models in urothelial cancer of the upper urinary tract (UTUC). EVIDENCE ACQUISITION: A non-systematic Medline/PubMed literature search was performed using the terms "biomarkers", "preoperative models", "postoperative models", "risk stratification", together with "upper tract urothelial carcinoma". Original articles published between January 2003 and August 2015 were included based on their clinical relevance...
August 2016: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
Amir Sabet, Ina Binse, Hong Grafe, Samer Ezziddin, Rainer Görges, Thorsten D Poeppel, Andreas Bockisch, Sandra J Rosenbaum-Krumme
PURPOSE: Nodal involvement is an independent risk factor of recurrence in papillary thyroid cancer (PTC). Neither the international guidelines nor the recently introduced ongoing risk adaptation concept consider the extent of initial surgical clearance of radioiodine sensitive lymph node metastases in their stratification systems. We investigated the prognostic relevance of incomplete initial surgical clearance in patients with purely lymphogeneous metastatic PTC (pN1 M0) despite successful radioiodine therapy...
October 2016: European Journal of Nuclear Medicine and Molecular Imaging
Jeffrey Douaiher, Mashaal Dhir, Lynette Smith, Chandrakanth Are
The safety of hepatic resection is well documented, but outcome studies comparing right and left hepatic lobectomy are sparse, especially in the context of malignancy. This study analyzes the differences in outcomes between right and left hepatic lobectomy in patients with malignant diagnoses. All patients undergoing right and left hepatic lobectomies for malignancy were extracted from the National Surgical Quality Improvement Program (NSQIP) database (2005-2010). The data was analyzed to determine differences in perioperative mortality and morbidity between the two groups...
March 2016: Indian Journal of Surgical Oncology
Tibor Szarvas, Henning Reis, Frank Vom Dorp, Stephan Tschirdewahn, Christian Niedworok, Peter Nyirady, Kurt W Schmid, Herbert Rübben, Ilona Kovalszky
BACKGROUND: PSA-screening detects many cases of clinically non-aggressive prostate cancer (PC) leading to significant overtreatment. Therefore, pre-operatively available prognostic biomarkers are needed to help therapy decisions. Syndecan-1 (SDC1) is a promising prognostic tissue marker in several cancers including PC but serum levels of shedded SDC1-ectodomain (sSDC1) have not been assessed in PC. METHODS: A total of 150 patients with PC were included in this study (n = 99 serum samples, n = 103 paraffin-embedded samples (FFPE), n = 52 overlap)...
August 2016: Prostate
P Kolh, S De Hert, P De Rango
The concept of risk assessment and the identification of surgical unfitness for vascular intervention is a particularly controversial issue today as the minimally invasive surgical population has increased not only in volume but also in complexity (comorbidity profile) and age, requiring an improved pre-operative selection and definition of high risk. A practical step by step (three steps, two points for each) approach for surgical risk assessment is suggested in this review. As a general rule, the identification of a "high risk" patient for vascular surgery follows a step by step process where the risk is clearly defined, quantified (when too "high"?), and thereby stratified based on the procedure, the patient, and the hospital, with the aid of predictive risk scores...
June 2016: European Journal of Vascular and Endovascular Surgery
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: Retrospective review of large, multicenter adult spinal deformity (ASD) database OBJECTIVE.: 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. There exist no predictive model that could potentially aid in the clinical decision making for adult patients undergoing deformity correction...
April 1, 2016: Spine
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"