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thromboembolism icu

Jia-Xuan Xu, Jun Dong, Hong Ren, Xiao-Jie Chen, Yong Yang, Ren-Xiong Chen, Guo-Dong Wang, Hong-Zhi Wang
PURPOSE: The occurrence of venous thromboembolism (VTE) in Chinese cancer patients admitted to intensive care unit (ICU) for postoperative care is poorly characterized. This study was designed to investigate the incidence of VTE in this polulation and to evaluate the utility of the Caprini score in risk stratification. METHODS: We conducted a retrospective cohort study of 2127 consecutive adult patients admitted to a 10-bed surgical ICU in a tertiary care academic hospital during a 4-year period (January 1,2013 to December 31,2016)...
January 2018: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
Dafne Braga Diamante Leiderman, Nelson Wolosker, Marcos Vieira de Melo Oliveira, Heitor Andrei Miranda de Carvalho, Felipe Trajano de Freitas Barão, Antonio Eduardo Zerati, Nelson De Luccia, Pedro Puech-Leão
BACKGROUND: Transient paraplegia of the lower limbs is a rare condition and when has a vascular etiology is usually associated with thromboembolic events, aortic dissection, aortic aneurysms, or as a complication of the surgical correction of those deseases. There is no case reported of acute paraplegia caused by a segmental thrombotic subocclusion of the descending thoracic aorta. CASE REPORT: We report a not yet described clinical situation of a young patient (51 years) admitted to the emergency care department for treatment of systemic arterial hypertension of difficult control with 4 antihypertensive medication classes...
March 5, 2018: Annals of Vascular Surgery
Christopher R Daigle, Stacy A Brethauer, Chao Tu, Anthony T Petrick, John M Morton, Philip R Schauer, Ali Aminian
BACKGROUND: National quality programs have been implemented to decrease the burden of adverse events on key outcomes in bariatric surgery. However, it is not well understood which complications have the most impact on patient health. OBJECTIVE: To quantify the impact of specific bariatric surgery complications on key clinical outcomes. SETTING: The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database...
January 12, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Azra Bihorac, Tezcan Ozrazgat-Baslanti, Ashkan Ebadi, Amir Motaei, Mohcine Madkour, Panagote M Pardalos, Gloria Lipori, William R Hogan, Philip A Efron, Frederick Moore, Lyle L Moldawer, Daisy Zhe Wang, Charles E Hobson, Parisa Rashidi, Xiaolin Li, Petar Momcilovic
MINI: In a single-center cohort of 51,457 adult surgical patients, we have developed and validated an automated machine-learning algorithm that uses existing clinical data in electronic health records to forecast the risk for major complications and death after any type of surgery with high sensitivity and high specificity. OBJECTIVE: To accurately calculate the risk for postoperative complications and death after surgery in the preoperative period using machine-learning modeling of clinical data...
February 27, 2018: Annals of Surgery
Aryana Sepassi, Francine Chingcuanco, Ronald Gordon, Angela Meier, Victoria Divino, Mitch DeKoven, Rami Ben-Joseph
AIMS: To assess incremental charges of patients experiencing venous thromboembolisms (VTE) across various types of elective inpatient surgical procedures with administration of general anesthesia in the United States. METHODS: We performed a retrospective study utilizing data from a nationwide hospital operational records database from July 2014 through June 2015 to compare a group of inpatients experiencing a VTE event postoperatively to a propensity score matched group of inpatients who did not experience a VTE...
February 24, 2018: Journal of Medical Economics
Riten Kumar, Joseph Stanek, Susan Creary, Amy Dunn, Sarah H O'Brien
A hypercoagulable state resulting in increased venous thromboembolism (VTE) has been described in adults with sickle cell disease (SCD), but similar data for children are lacking. The objective of this retrospective cohort study was to describe the rate of VTE and risk factors associated with VTE in children with SCD across tertiary-care children's hospitals in the United States between the years 2009 and 2015. We used the Pediatric Health Information System database to investigate all pediatric patients with SCD admitted to 1 of 48 participating institutions between 1 January 2009 and 30 September 2015...
February 13, 2018: Blood Advances
Rukhmi Bhat, Riten Kumar, Soyang Kwon, Karna Murthy, Robert I Liem
OBJECTIVE: To identify risk factors associated with venous and arterial thrombosis in sick neonates admitted to the neonatal intensive care unit. STUDY DESIGN: A case-control study was conducted at 2 centers between January 2010 and March 2014 using the Children's Hospital Neonatal Database dataset. Cases were neonates diagnosed with either arterial or venous thrombosis during their neonatal intensive care unit stay; controls were matched in a 1:4 ratio by gestational age and presence or absence of central access devices...
February 2, 2018: Journal of Pediatrics
Navpreet K Dhillon, Eric J T Smith, Emma Gillette, Russell Mason, Galinos Barmparas, Bruce L Gewertz, Eric J Ley
BACKGROUND: Adequate venous thromboembolism (VTE) prophylaxis is essential after trauma, especially in patients with lower extremity and/or pelvic fractures. We sought to investigate if prophylactic enoxaparin dosed by anti-Xa trough levels could reduce clinically evident VTE in trauma patients with lower extremity or pelvic injury. METHODS: Prospective data was collected on trauma patients admitted for at least two days with any lower extremity and/or pelvic fracture and who received enoxaparin for VTE prophylaxis between October 2013 and January 2016...
January 20, 2018: International Journal of Surgery
Rachel Van Dusen
INTRODUCTION: Life-threatening bleeding is the most feared complication of warfarin therapy. Rapid anticoagulant reversal via replacement of vitamin K dependent clotting factors is essential for hemostasis. METHODS: A retrospective cohort study of warfarin-treated patients experiencing a life-threatening bleed treated with a warfarin reversal protocol comprised of 4F PCC (post-implementation group) and those who received the prior reversal protocol of 3F PCC and rFVIIa (pre-implementation group) was performed...
January 5, 2018: American Journal of Surgery
Ron C Li, Trit Garg, Tony Cun, Lisa Shieh, Gomathi Krishnan, Daniel Fang, Jonathan H Chen
Objective: Problem-based charting (PBC) is a method for clinician documentation in commercially available electronic medical record systems that integrates note writing and problem list management. We report the effect of PBC on problem list utilization and accuracy at an academic intensive care unit (ICU). Materials and Methods: An interrupted time series design was used to assess the effect of PBC on problem list utilization, which is defined as the number of new problems added to the problem list by clinicians per patient encounter, and of problem list accuracy, which was determined by calculating the recall and precision of the problem list in capturing 5 common ICU diagnoses...
January 18, 2018: Journal of the American Medical Informatics Association: JAMIA
Cassie A Barton, Marissa Hom, Nathan B Johnson, Jon Case, Ran Ran, Martin Schreiber
INTRODUCTION: Life-threatening bleeding can complicate warfarin therapy. Rapid anticoagulant reversal via replacement of vitamin-K dependent clotting factors is essential for hemostasis. We compare two methods of rapid factor replacement for warfarin reversal. METHODS: A retrospective cohort study of warfarin-treated patients experiencing life-threatening bleeding who received a reversal protocol comprised of 4F PCC or 3F PCC and rFVIIa was performed. Demographic, clinical and anticoagulant reversal information, and all adverse events attributed to warfarin reversal were recorded...
January 5, 2018: American Journal of Surgery
Erik R Dong, David G Ng, Danny Ramzy, Joshua S Chung, Oren Friedman, Alain Combes, Francisco A Arabia, Michael Nurok
A retrospective review of three patients with acute respiratory distress syndrome (ARDS) and normal baseline right ventricular function admitted to the Cardiac Surgery Intensive Care Unit whom developed acute cor pulmonale while on veno-venous extracorporeal membrane oxygenation. These patients were diagnosed with ARDS using Berlin Criteria definitions and cannulated with a dual lumen (Avalon) cannula. Despite variations in history, presentation, and course, findings of acute cor pulmonale were encountered 4 to 6 weeks after extracorporeal membrane oxygenation cannulation...
January 10, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Smita Sihag, Bao Le, Alison S Witkin, Josanna M Rodriguez-Lopez, Mauricio A Villavicencio, Gus J Vlahakes, Richard N Channick, Cameron D Wright
BACKGROUND: Pulmonary thromboendarterectomy (PTE) is an effective treatment for chronic thromboembolic pulmonary hypertension (CTEPH), but is a technically challenging operation for cardiothoracic surgeons. Starting a new program allows an opportunity to define a learning curve for PTE. METHODS: A retrospective case review was performed of 134 consecutive PTEs performed from 1998 to 2016 at a single institution. Outcomes were compared using either a two-tailed t-test for continuous variables or a chi-squared test for categorical variables according to experience of the program by terciles (T)...
December 28, 2017: Journal of Cardiothoracic Surgery
Hee Eun Lee, Eunhee S Yi, Jeffrey T Rabatin, J Kyle Bohman, Anja C Roden
BACKGROUND: The outcome of extracorporeal membrane oxygenation (ECMO) might be influenced by its complications. Only limited information is available regarding the pathologic consequences of ECMO especially in the era of modern ECMO technology. METHODS: We studied the histopathologic findings in autopsy lungs of patients treated with ECMO as compared to those without ECMO. Autopsy files were queried for cases with ECMO. An age and gender-matched control group, comprised of patients who died in the Intensive Care Unit without acute respiratory distress syndrome, pneumonia, or ECMO, was compared with patients with ECMO for cardiac reason...
December 20, 2017: Chest
Navpreet K Dhillon, Eric J T Smith, Ara Ko, Megan Y Harada, Audrey R Yang, Kavita A Patel, Galinos Barmparas, Eric J Ley
BACKGROUND: Massive transfusion protocols (MTPs) are necessary for hemodynamically unstable trauma patients with active bleeding. Thrombotic events have been associated with blood transfusion; however, the risk factors for the development of venous thromboembolism (VTE) in trauma patients receiving MTP are unknown. METHODS: A retrospective review was conducted by reviewing the electronic medical records of all trauma patients admitted to a Level I trauma center who received MTP from 2011 to 2016...
February 2018: Journal of Surgical Research
Harm P Ebben, Max V van Burink, Vincent Jongkind, Diane E Mouwen, Jan Udding, Willem Wisselink, Jur K Kievit, Arno M Wiersema, Kakkhee Yeung
BACKGROUND: Acute peripheral arterial occlusions threaten life and limb. Thrombolysis is an established, minimally invasive alternative treatment for surgical thromboembolectomy. Yet, there is no consensus regarding an optimal thrombolysis protocol, and current knowledge is largely based on studies from the 1990s. This study reviews a contemporary cohort of patients treated with thrombolysis and aims to evaluate the treatment results and to identify possible predictors for outcome and (bleeding) complications...
December 6, 2017: Annals of Vascular Surgery
Minh Tran, Steven L Shein, Xinge Ji, Sanjay P Ahuja
BACKGROUND: The incidence of venous thromboembolism (VTE) is rising among inpatients in US hospitals, especially among kids with central venous catheters (CVCs) in the pediatric intensive care unit (PICU). OBJECTIVES: To identify a sub-group of "VTE-rich" population among PICU children, and to assess the effect of VTE on morbidity and mortality. METHODS: Data was extracted from a multicenter Virtual PICU Database, or VPS, for children with a CVC and presence of a VTE...
January 2018: Thrombosis Research
Julie Jaffray, Arash Mahajerin, Guy Young, Neil Goldenberg, Lingyun Ji, Richard Sposto, Amy Stillings, Emily Krava, Brian Branchford
BACKGROUND: Pediatric hospital-acquired venous thromboembolism (HA-VTE) rates have increased dramatically. To achieve generalizable knowledge in the derivation and validation of HA-VTE risk factors and risk prediction models and inform future risk-stratified prevention strategies, multi-institutional studies are needed. OBJECTIVES: This paper presents an investigator-initiated, multicenter pediatric case-cohort study designed to identify risk factors for HA-VTE to create a HA-VTE risk prediction model...
January 2018: Thrombosis Research
Gina H Sun, Visal Patel, Ingrid Moreno-Duarte, Farhad Zahedi, Eric Ursprung, Greg Couper, Fred Y Chen, Ian J Welsby, Raymond Comenzo, Grace Kao, Frederick C Cobey
OBJECTIVE: Assessing the efficacy of intraoperative 4-factor prothrombin complex concentrate (4F-PCC) use in blood product utilization, time to chest closure, intensive care unit (ICU) and hospital length of stay (LOS), thromboembolic complications, renal injury and mortality in left ventricular assist device (LVAD) patients on home anticoagulation therapy with warfarin, undergoing orthotopic heart transplantation (OHT). DESIGN: Retrospective analysis of OHT patients at Tufts Medical Center from May 2013 to October 2016...
February 2018: Journal of Cardiothoracic and Vascular Anesthesia
Charles A Karcutskie, Arjuna Dharmaraja, Jaimin Patel, Sarah A Eidelson, Arch G Martin, Edward B Lineen, Nicholas Namias, Carl I Schulman, Kenneth G Proctor
BACKGROUND: No previous studies have established the optimal antifactor Xa (anti-Xa) level to guide thromboprophylaxis (TPX) dosing with enoxaparin in trauma patients. We hypothesize that achieving 0.2-0.4 IU/mL anti-Xa will decrease venous thromboembolism (VTE) rates after trauma. METHODS: This was a retrospective review of 194 intensive care unit patients sustaining blunt or penetrating trauma from January 2015 to March 2017. All received initial enoxaparin (30 mg BID subcutaneous) and mechanical devices for TPX...
December 2017: Journal of Trauma and Acute Care Surgery
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