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preoperative evaluation noncardiac surgery

https://read.qxmd.com/read/38527923/preoperative-risk-prediction-models-for-acute-kidney-injury-after-noncardiac-surgery-an-independent-external-validation-cohort-study
#1
JOURNAL ARTICLE
Xiao-Yu Zhuo, Shao-Hui Lei, Lan Sun, Ya-Wen Bai, Jiao Wu, Yong-Jia Zheng, Ke-Xuan Liu, Wei-Feng Liu, Bing-Cheng Zhao
BACKGROUND: Numerous models have been developed to predict acute kidney injury (AKI) after noncardiac surgery, yet there is a lack of independent validation and comparison among them. METHODS: We conducted a systematic literature search to review published risk prediction models for AKI after noncardiac surgery. An independent external validation was performed using a retrospective surgical cohort at a large Chinese hospital from January 2019 to October 2022. The cohort included patients undergoing a wide range of noncardiac surgeries with perioperative creatinine measurements...
March 24, 2024: British Journal of Anaesthesia
https://read.qxmd.com/read/38449953/the-significance-of-equipment-availability-and-anesthesia-educational-conferences-to-decision-making-for-ekg-lead-v5-abnormalities
#2
JOURNAL ARTICLE
Kimberly L Skidmore, Joseph Drinkard, Henson M Randall, Giustino Varrassi, Sahar Shekoohi, Alan D Kaye
Introduction To predict postoperative myocardial infarction rates in patients who undergo noncardiac surgery, the Canadian Cardiovascular Society Guidelines on Perioperative Cardiac Risk Assessment and Management recommends assessment of brain natriuretic peptide (BNP) in certain patients. Serial troponins are measured if the BNP level is elevated. In certain cases, Revised Cardiac Risk Index (RCRI) alone does not perform well, for example, during vascular surgery. Cardiac events occur in 20% of all vascular surgery patients...
February 2024: Curēus
https://read.qxmd.com/read/38445452/development-of-interpretable-machine-learning-models-for-prediction-of-acute-kidney-injury-after-noncardiac-surgery-a-retrospective-cohort-study
#3
JOURNAL ARTICLE
Rao Sun, Shiyong Li, Yuna Wei, Liu Hu, Qiaoqiao Xu, Gaofeng Zhan, Xu Yan, Yuqin He, Yao Wang, Xinhua Li, Ailin Luo, Zhiqiang Zhou
BACKGROUND: Early identification of patients at high risk of postoperative acute kidney injury (AKI) can facilitate the development of preventive approaches. This study aimed to develop prediction models for postoperative AKI in noncardiac surgery using machine learning algorithms. We also evaluated the predictive performance of models that included only preoperative variables or only important predictors. MATERIALS AND METHODS: Adult patients undergoing noncardiac surgery were retrospectively included in the study (76,457 patients in the discovery cohort and 11,910 patients in the validation cohort)...
March 4, 2024: International Journal of Surgery
https://read.qxmd.com/read/38416481/outcomes-of-women-undergoing-noncardiac-surgery-in-veterans-affairs-compared-with-non-veterans-affairs-care-settings
#4
JOURNAL ARTICLE
Elizabeth L George, Michael A Jacobs, Katherine M Reitz, Nader N Massarweh, Ada O Youk, Shipra Arya, Daniel E Hall
IMPORTANCE: Recent legislation facilitates veterans' ability to receive non-Veterans Affairs (VA) surgical care. Although veterans are predominantly male, the number of women receiving care within the VA has nearly doubled to 10% over the past decade and recent data comparing the surgical care of women in VA and non-VA care settings are lacking. OBJECTIVE: To compare postoperative outcomes among women treated in VA hospitals vs private-sector hospitals. DESIGN, SETTING, AND PARTICIPANTS: This coarsened exact-matched cohort study across 9 noncardiac specialties in the Veterans Affairs Surgical Quality Improvement Program (VASQIP) and American College of Surgeons National Surgical Quality Improvement Program (NSQIP) took place from January 1, 2016, to December 31, 2019...
February 28, 2024: JAMA Surgery
https://read.qxmd.com/read/38407141/postoperative-length-of-stay-in-patients-with-stress-hyperglycemia-compared-to-patients-with-diabetic-hyperglycemia-a-retrospective-cohort-study
#5
JOURNAL ARTICLE
Jason Shiffermiller, Matthew Anderson, Rachel Thompson
BACKGROUND: Postoperative hospital length of stay (LOS) is longer in patients with diabetes than in patients without diabetes. Stress hyperglycemia (SH) in patients without a history of diabetes has been associated with adverse postoperative outcomes. The effect of SH on postoperative LOS is uncertain. The aim of this study is to compare postoperative LOS in patients with SH to patients with diabetic hyperglycemia (DH) following noncardiac surgery. METHODS: We carried out a retrospective cohort study of inpatients with at least two glucose measurements ≥180 mg/dL...
February 26, 2024: Journal of Diabetes Science and Technology
https://read.qxmd.com/read/38404717/how-long-after-coronary-artery-bypass-surgery-can-patients-have-elective-safer-non-cardiac-surgery
#6
JOURNAL ARTICLE
Li-Chin Sung, Chuen-Chau Chang, Chun-Chieh Yeh, Yih-Giun Cherng, Ta-Liang Chen, Chien-Chang Liao
OBJECTIVE: To evaluate the complications and mortality after noncardiac surgeries in patients who underwent previous coronary artery bypass grafting (CABG). METHODS: We used insurance data and identified patients aged ≥20 years undergoing noncardiac surgeries between 2010 and 2017 in Taiwan. Based on propensity-score matching, we selected an adequate number of patients with a previous history of CABG (within preoperative 24 months) and those who did not have a CABG history, and both groups had balanced baseline characteristics...
2024: Journal of Multidisciplinary Healthcare
https://read.qxmd.com/read/38311886/comparison-of-effects-of-telmisartan-versus-valsartan-on-post-induction-hypotension-during-noncardiac-surgery-a-prospective-observational-study
#7
JOURNAL ARTICLE
Chung-Sik Oh, Jun Young Park, Seong-Hyop Kim
BACKGROUND: Telmisartan is considered more potent than valsartan. Hemodynamic response during anesthesia induction may be influenced by anti-hypertension (HTN) medication. The present study compared the effect of anti-HTN medications on post-induction hypotension during noncardiac surgeries. METHODS: This observational study standardized the anesthetic regimen across patients, with hypotension defined as mean blood pressure (BP) of less than 65 mmHg. The hemodynamic changes within 5 min before and after endotracheal intubation, and within 10 min before and after surgical incision were measured...
February 5, 2024: Korean Journal of Anesthesiology
https://read.qxmd.com/read/38309132/transfusion-targets-and-adverse-events-in-pediatric-perioperative-acute-anemia
#8
JOURNAL ARTICLE
Lindsay L Warner, Leanne Thalji, Lindsay R Hunter Guevara, Matthew A Warner, Daryl J Kor, David O Warner, Andrew C Hanson, Michael E Nemergut
STUDY OBJECTIVE: To evaluate the association between pretransfusion and posttransfusion hemoglobin concentrations and the outcomes of children undergoing noncardiac surgery. DESIGN: Retrospective review of patient records. We focused on initial postoperative hemoglobin concentrations, which may provide a more useful representation of transfusion adequacy than pretransfusion hemoglobin triggers (the latter often cannot be obtained during acute surgical hemorrhage)...
February 2, 2024: Journal of Clinical Anesthesia
https://read.qxmd.com/read/38305444/the-effect-of-frailty-on-independent-living-after-surgery-a-population-based-retrospective-cohort-study
#9
JOURNAL ARTICLE
A Garland, T Mutter, O Ekuma, C Papadimitropolous
BACKGROUND: Most people value quality of life over mere duration. At least 50% of people are extremely averse to ever living in a nursing home (NH). OBJECTIVES: Assess whether pre-operative frailty is associated with new, post-operative NH placement. DESIGN, SETTING: Retrospective, population-based cohort study in the Canadian province of Manitoba, 2000-2017. PARTICIPANTS: 7408 persons ≥65 years undergoing any of 16 specific, elective, noncardiac surgeries of varying Operative Surgical Stress (OSS)...
2024: Journal of Frailty & Aging
https://read.qxmd.com/read/38153742/intraoperative-blood-management-strategies-for-patients-undergoing-noncardiac-surgery-the-ottawa-intraoperative-transfusion-consensus
#10
JOURNAL ARTICLE
Tori Lenet, Daniel I McIsaac, Julie H Hallet, Angela Jerath, Manoj M Lalu, Stuart G Nicholls, Justin Presseau, Alan Tinmouth, Michael Verret, Christopher G Wherrett, Dean A Fergusson, Guillaume Martel
IMPORTANCE: There is marked variability in red blood cell (RBC) transfusion during the intraoperative period. The development and implementation of existing clinical practice guidelines have been ineffective in reducing this variability. OBJECTIVE: To develop an internationally endorsed consensus statement about intraoperative transfusion in major noncardiac surgery. EVIDENCE REVIEW: A Delphi consensus survey technique with an anonymous 3-round iterative rating and feedback process was used...
December 1, 2023: JAMA Network Open
https://read.qxmd.com/read/38149366/effect-of-the-gupta-score-on-pre-operative-cardiology-consultation-requests-in-noncardiac-nonvascular-surgery
#11
JOURNAL ARTICLE
Funda Atar, Fatma Özkan Sipahioğlu, Gülsen Keskin, Aslı Dönmez
OBJECTIVE: Cardiologists are the most frequently consulted specialists during pre-operative evaluations. However, unnecessary cardiology consultations (CC) can increase cardiologists' workload without impacting anaesthesia practice, resulting in delayed surgeries and additional financial burdens. We hypothesize that using Gupta during the preoperative period can reduce these adverse effects. METHODS: This prospective study included patients scheduled for elective noncardiac, nonvascular surgeries who underwent pre-operative assessment...
December 27, 2023: Turkish Journal of Anaesthesiology and Reanimation
https://read.qxmd.com/read/38105637/management-of-patients-with-ischemic-heart-disease-in-spine-surgery
#12
JOURNAL ARTICLE
Myung-Geun Song, Chang-Won Kim, Sang-Youn Song, Han-Gyul Kim, Dong-Hee Kim
In ischemic heart disease (IHD), the myocardium does not receive enough blood and oxygen. Although the IHD-related mortality rate is decreasing, the risk remains and is a major predictor of cardiac complications following noncardiac surgery. Given the increase in the older population, the number of patients with spinal diseases requiring surgery is increasing. Among these patients, those with underlying IHD or a high risk of cardiac complications before and after surgery are also increasing. Given that cardiac complications following spinal surgery are associated with delayed patient recovery and even death, spinal surgeons should be knowledgeable about overall patient management, including medication therapy in those at high risk of developing perioperative cardiac complications for successful patient care...
December 18, 2023: Asian Spine Journal
https://read.qxmd.com/read/38063866/-the-role-of-cardiac-biomarkers-in-perioperative-risk-evaluation-of-noncardiac-surgery-patients-a-summary-of-the-esaic-guidelines-2023
#13
REVIEW
René M'Pembele, Sebastian Roth, Giovanna Lurati Buse
BACKGROUND: The recently published ESAIC guidelines highlight the clinical value of cardiac troponins (cTn) and B‑type natriuretic peptides (BNP) for risk assessment in patients undergoing noncardiac surgery. OBJECTIVE: Summary of the ESAIC guideline recommendations. MATERIAL AND METHODS: The evidence for the recommendations was extracted from studies that investigated the perioperative role of cTn and BNP as prognostic factors, for risk prediction and for therapeutic guidance...
December 8, 2023: Anaesthesiologie
https://read.qxmd.com/read/38056847/-perioperative-management-for-patients-with-cardiovascular-diseases-in-general-thoracic-surgery
#14
JOURNAL ARTICLE
Terumoto Koike, Masanori Tsuchida
For general thoracic surgeons, perioperative management for the prevention of cardiac complications is important because patients undergoing general thoracic surgery often have risk factors for cardiac diseases. Some risk-scoring systems can estimate a patient's risk of perioperative cardiac complication. Surgery-specific risk for intrathoracic surgery is intermediate. Preoperative evaluation for coronary artery disease should be considered only in high-risk patients based on the risk-scoring system and surgery- specific risk...
September 2023: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://read.qxmd.com/read/38039068/survey-of-the-impact-of-decision-support-in-preoperative-management-of-anemia-i-anemia-survey-study
#15
JOURNAL ARTICLE
Gaëtan Mignanelli, Richard Boyer, Nicolas Bonifas, Emmanuel Rineau, Yassine Moussali, Morgan Le Guen
BACKGROUND: Major surgery on patients with anemia has demonstrated an increased risk of perioperative blood transfusions and postoperative morbidity and mortality. Recent studies have shown that integrating preoperative anemia treatment as a component of perioperative blood management may reduce blood product utilization and improve outcomes in both cardiac and noncardiac surgery. However, outpatient management of anemia falls outside of daily practice for most anesthesiologists and is probably weakly understood...
December 1, 2023: JMIR perioperative medicine
https://read.qxmd.com/read/37984177/development-and-validation-of-delirium-prediction-models-for-noncardiac-surgery-patients
#16
JOURNAL ARTICLE
Julian Rössler, Karan Shah, Sara Medellin, Alparslan Turan, Kurt Ruetzler, Mriganka Singh, Daniel I Sessler, Kamal Maheshwari
STUDY OBJECTIVE: Postoperative delirium is associated with morbidity and mortality, and its incidence varies widely. Using known predisposing and precipitating factors, we sought to develop postoperative delirium prediction models for noncardiac surgical patients. DESIGN: Retrospective prediction model study. SETTING: Major quaternary medical center. PATIENTS: Our January 2016 to June 2020 training dataset included 51,677 patients of whom 2795 patients had delirium...
November 18, 2023: Journal of Clinical Anesthesia
https://read.qxmd.com/read/37946773/case-of-takotsubo-cardiomyopathy-after-surgical-treatment-of-liver-hydatid-cyst-a-case-report
#17
Yakup Altaş, Ülfet Abdullayeva
BACKGROUND: Takotsubo cardiomyopathy, also called apical ballooning syndrome, is a disease that is often triggered by stress factors in postmenopausal women and mimics acute coronary syndrome. The aim of this article is to draw attention to takotsubo cardiomyopathy after surgical treatment of liver hydatid cyst. CASE SUMMARY: A 50-year-old diabetic and hypertensive female patient was evaluated preoperatively before general surgery for liver hydatid cyst, and no cardiac problems were found...
October 16, 2023: World Journal of Clinical Cases
https://read.qxmd.com/read/37930697/automated-electronic-frailty-index-identified-frailty-status-and-associated-postsurgical-adverse-events
#18
JOURNAL ARTICLE
Ashish K Khanna, Vida Motamedi, Bethany Bouldin, Timothy Harwood, Nicholas M Pajewski, Amit K Saha, Scott Segal
IMPORTANCE: Electronic frailty index (eFI) is an automated electronic health record (EHR)-based tool that uses a combination of clinical encounters, diagnosis codes, laboratory workups, medications, and Medicare annual wellness visit data as markers of frailty status. The association of eFI with postanesthesia adverse outcomes has not been evaluated. OBJECTIVE: To examine the association of frailty, calculated as eFI at the time of the surgical procedure and categorized as fit, prefrail, or frail, with adverse events after elective noncardiac surgery...
November 1, 2023: JAMA Network Open
https://read.qxmd.com/read/37884977/the-impact-of-preoperative-malnutrition-on-postoperative-delirium-a-systematic-review-and-meta-analysis
#19
REVIEW
Bo Dong, Jing Wang, Pan Li, Jianli Li, Meinv Liu, Huanhuan Zhang
BACKGROUND: Postoperative delirium (POD) is a common postoperative complication, characterized by disturbance of attention, perception, and consciousness within 1 week after surgery, and linked to cognitive decline, increased mortality, and other serious surgical outcomes. Early identification and treatment of risk factors for POD could reduce the occurrence of delirium and the related poor outcomes. Malnutrition as a possible precipitating factor, defined as the poor anthropometric, functional, and clinical outcomes of nutrient deficiency, has been investigated...
October 26, 2023: Perioperative Medicine
https://read.qxmd.com/read/37853279/troponin-elevation-as-a-marker-of-short-deterioration-and-one-year-death-in-a-high-risk-surgical-patient-cohort-in-a-low-and-middle-income-country-setting-a-postoperative-approach-to-increase-surveillance
#20
JOURNAL ARTICLE
Adriene Stahlschmidt, Sávio C Passos, Debora D Dornelles, Carisi Polanczyk, Claudia S Gutierrez, Rosangela R Minuzzi, Stela M J Castro, Luciana C Stefani
PURPOSE: Myocardial injury after noncardiac surgery is common and mostly asymptomatic. The ideal target population that will benefit from routine troponin measurements in low and middle income countries (LMICs) is unclear. This study aims to evaluate the clinical outcomes of a cohort of high-risk surgical patients according to high-sensitivity troponin T (hsTnT) in an LMIC setting. METHODS: We conducted a prospective cohort study of 442 high-risk patients undergoing noncardiac surgery at a Brazilian hospital between February 2019 and March 2020...
November 2023: Canadian Journal of Anaesthesia
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