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Cognitive preoperative prognostication

Aistė Pranckevičienė, Vytautas Jurkuvėnas, Vytenis Pranas Deltuva, Arimantas Tamašauskas, Adomas Bunevičius
This study aimed to evaluate clinical utility of The Hopkins Verbal Learning Test-Revised (HVLT-R) for assessment of preoperative memory function in meningioma patients and to investigate prognostic value of memory assessment in predicting outcomes after meningioma excision surgery. A total of 93 meningioma patients were assessed 2-3 days preoperatively using HVLT-R, and EORTC QLQ-30 and QLQ-BN20. Functional outcome at discharge was evaluated using The Glasgow Outcome Scale. A sample of 95 healthy controls was matched to patients according to age, gender, and education...
April 4, 2018: Applied Neuropsychology. Adult
Young Hak Roh, Young Do Koh, Jong Oh Kim, Kyu Ho Lee, Hyun Sik Gong, Goo Hyun Baek
BACKGROUND: Postoperative pillar pain (deep-seated wrist pain worsened by leaning on the heel of the hand) sometimes occurs after carpal tunnel release (CTR), leading to weakness in the hand and delayed return to work. Increased pain sensitivity has been found to be associated with worse symptoms and poorer treatment response in a number of chronic musculoskeletal conditions, but few studies have investigated the association of pain sensitization with pillar pain after CTR. QUESTIONS/PURPOSES: (1) Is preoperative pain sensitization in patients with carpal tunnel syndrome (CTS) associated with increased severity of pillar pain after open CTR? (2) What other demographic, electrophysiological, or preoperative clinical characteristics are associated with pillar pain after CTR? METHODS: Over a 35-month period, one surgeon performed 162 open carpal tunnel releases...
April 2018: Clinical Orthopaedics and related Research
Jennifer Watt, Andrea C Tricco, Catherine Talbot-Hamon, Ba' Pham, Patricia Rios, Agnes Grudniewicz, Camilla Wong, Douglas Sinclair, Sharon E Straus
BACKGROUND: Elective surgeries can be associated with significant harm to older adults. The present study aimed to identify the prognostic factors associated with the development of postoperative complications among older adults undergoing elective surgery. METHODS: Medline, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and AgeLine were searched for articles published between inception and April 21, 2016. Prospective studies reporting prognostic factors associated with postoperative complications (composite outcome of medical and surgical complications), functional decline, mortality, post-hospitalization discharge destination, and prolonged hospitalization among older adults undergoing elective surgery were included...
January 12, 2018: BMC Medicine
Anouck N Bletterman, Marcella E de Geest-Vrolijk, Johanna E Vriezekolk, Maria W Nijhuis-van der Sanden, Nico Lu van Meeteren, Thomas J Hoogeboom
OBJECTIVE: To evaluate the predictive value of preoperative psychosocial factors on the perceived and observed postoperative patient's functional recovery during the post-hospital phase and up to 12 months after hospital discharge of patients who underwent total knee or total hip arthroplasty. METHODS: A systematic review was performed. MEDLINE, CINAHL, EMBASE and PsychINFO were systematically screened in order to find prospective longitudinal studies. Risk of bias was assessed using a modified version of a 27-item checklist for prognostic studies, as previously used by Veerbeek...
September 1, 2017: Clinical Rehabilitation
Maren Schmidt, Rahel Eckardt, Sarah Altmeppen, Klaus-Dieter Wernecke, Claudia Spies
OBJECTIVE: To investigate the prognostic value of elements of the Geriatric Assessment, in particular the Timed Up and Go (TUG) Test and the Barthel Index of Activities of Daily Living (ADL) for one-year post-operative mortality in elderly patients with cancer. MATERIALS AND METHODS: This prospective cohort study included patients 65years of age or older undergoing elective major surgery for cancer between June 2008 and June 2010. Preoperative functional status was measured by the TUG Test and the Barthel Index of ADL Cognitive state was assessed by the Mini Mental State Examination (MMSE)...
January 2018: Journal of Geriatric Oncology
Taro Nimura, Ken-Ichi Nagamatsu, Tadashi Ando, Arifumi Matsumoto, Kinya Hisanaga, Teiji Tominaga
We retrospectively investigated the effects of subthalamic nucleus stimulation (STN-DBS) on new postoperative onset of cognitive decline and prognostic factors for advanced Parkinson's disease (PD). We studied 39 PD patients who had received bilateral STN-DBS. Clinical symptoms, cognitive function, psychiatric function, and health-related quality of life (HRQOL) were assessed before and six months after surgery. Based on the results of neuropsychological examinations six months after the surgery, the subjects were divided into those with and those without cognitive decline...
October 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
J Blume, M Lange, E Rothenfusser, C Doenitz, U Bogdahn, A Brawanski, J Schlaier
OBJECTIVES: White Matter lesions (WML) are a risk factor for cognitive impairment in Parkinson's disease. There is no clear evidence of reduced general cognitive function after DBS. However, a subgroup of patients develops dementia rapidly after DBS despite careful patient selection processes. The aim of this study was to evaluate the load of WML as a possible risk factor for cognitive decline following STN DBS. PATIENTS AND METHODS: 40 PD-patients receiving bilateral STN-DBS were followed at least three years after surgery to detect dementia...
May 31, 2017: Clinical Neurology and Neurosurgery
Ellen W S Carbo, Arjan Hillebrand, Edwin van Dellen, Prejaas Tewarie, Philip C de Witt Hamer, Johannes C Baayen, Martin Klein, Jeroen J G Geurts, Jaap C Reijneveld, Cornelis J Stam, Linda Douw
Resective neurosurgery carries the risk of postoperative cognitive deterioration. The concept of 'hub (over)load', caused by (over)use of the most important brain regions, has been theoretically postulated in relation to symptomatology and neurological disease course, but lacks experimental confirmation. We investigated functional hub load and postsurgical cognitive deterioration in patients undergoing lesion resection. Patients (n = 28) underwent resting-state magnetoencephalography and neuropsychological assessments preoperatively and 1-year after lesion resection...
February 7, 2017: Scientific Reports
Sebastian Müller, Hatem Al-Fadel Saleh, Marcel Jakob, Nicholas A Beckmann, Bojana Savic, Daniel Rikli, Norbert Suhm
INTRODUCTION: Geriatric hip fracture patients are a highly heterogeneous collective, what distinctly aggravates the best possible treatment. Consequently, it is becoming more important to identify selection criteria that can distinguish those patients who can benefit the most from treatment in a geriatric fracture center. In our pilot study, we assessed the 2007 published Penrod score for its utility as a useful selection tool by prospectively comparing our own patient's outcome with the Penrod study...
August 2016: Archives of Orthopaedic and Trauma Surgery
Bart M G Baekelandt, Marianne J Hjermstad, Tom Nordby, Morten W Fagerland, Elin H Kure, Turid Heiberg, Trond Buanes, Knut J Labori
BACKGROUND: The purpose of this prospective study was to evaluate whether pre-surgery health-related quality of life (HRQoL) and subjectively rated symptom scores are prognostic factors for survival in patients with resectable pancreatic ductal adenocarcinoma (PDAC). METHODS: Patients undergoing pancreatic resection for PDAC completed the Edmonton Symptom Assessment System (ESAS) and the EORTC QLQ-C30 and QLQ-PAN26 questionnaires preoperatively. Patient, tumor and treatment characteristics, recurrence and survival were registered...
March 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Timothy C Ryken, Ian Parney, John Buatti, Steven N Kalkanis, Jeffrey J Olson
QUESTIONS: (1) What is the optimal role of external beam radiotherapy in the management of adult patients with newly diagnosed low-grade glioma (LGG) in terms of improving outcome (i.e., survival, complications, seizure control or other reported outcomes of interest)? (2) Which radiation strategies (dose, timing, fractionation, stereotactic radiation, brachytherapy, chemotherapy) improve outcomes compared to standard external beam radiation therapy in the initial management of low grade gliomas in adults? (3) Do specific factors (e...
December 2015: Journal of Neuro-oncology
Madoka Nakajima, Masakazu Miyajima, Ikuko Ogino, Chihiro Akiba, Hidenori Sugano, Takeshi Hara, Keiko Fusegi, Kostadin Karagiozov, Hajime Arai
The prognosis of cognitive improvement after cerebrospinal fluid (CSF) shunting in idiopathic normal pressure hydrocephalus (iNPH) remains uncertain, with no reports on CSF biomarkers related to long-term cognitive prognosis. We performed a preliminary study of CSF biomarker protein levels for cognitive outcome prognostication of two-year outcomes after shunt treated iNPH in 36 patients (13 women) with a median age of 75years (IQR 69-78). CSF biomarkers included soluble amyloid precursor proteins (sAPP, sAPPα, sAPPβ), amyloid β (Aβ)1-38, Aβ1-42 and phosphorylated tau (p-tau), lipocalin-type prostaglandin D synthase (L-PGDS)/β-trace, and cystatin C...
October 15, 2015: Journal of the Neurological Sciences
Shang-Ming Chiou
BACKGROUND: A few reports have addressed the sex-related efficacy of deep brain stimulation (DBS) in the subthalamic nucleus (STN) to treat advanced Parkinson disease (PD). The present study evaluates the sex-related prognostic factors for STN-DBS outcomes. METHODS: Seventy-two consecutive patients (48 men and 24 women) were reviewed retrospectively. Changes in the Unified PD Rating Scale scores were compared between men and women in the 6-month drug-off/DBS-on state relative to the preoperative drug-off baseline...
October 2015: World Neurosurgery
Shobhit V Minhas, Ian Chow, David S Feldman, Joseph Bosco, Norman Y Otsuka
BACKGROUND: Pediatric scoliosis often requires operative treatment, yet few studies have examined readmission rates in this patient population. The purpose of this study is to examine the incidence, reasons, and independent risk factors for 30-day unplanned readmissions following scoliosis surgery. METHODS: A retrospective analysis of the American College of Surgeons National Surgical Quality Improvement-Pediatric database from 2012 to 2013 was performed. Patients undergoing spinal arthrodesis for progressive infantile scoliosis, idiopathic scoliosis, or scoliosis due to other medical conditions were identified and divided between 2 groups: patients with unplanned 30-day readmissions (Readmitted) and patients with no unplanned readmissions (Non-Readmitted)...
March 2016: Journal of Pediatric Orthopedics
J Hirsch, G DePalma, T T Tsai, L P Sands, J M Leung
INTRODUCTION: Postoperative delirium is common in older patients. Despite its prognostic significance, the pathophysiology is incompletely understood. Although many risk factors have been identified, no reversible factors, particularly ones potentially modifiable by anaesthetic management, have been identified. The goal of this prospective cohort study was to investigate whether intraoperative hypotension was associated with postoperative delirium in older patients undergoing major non-cardiac surgery...
September 2015: British Journal of Anaesthesia
Daegu Lee, Jae Yong Jo, Ji Sun Jung, Sang Jun Kim
OBJECTIVE: To investigate the prognostic factors predicting the recovery of pre-fracture functional mobility, we evaluated this by the use of ambulatory assistive devices in short-term follow-up. METHODS: Five hundred and fifty-three elderly patients who had undergone hip fracture operations from January 2006 to June 2013 were enrolled in this retrospective study. Clinical characteristics and predicted factors affecting functional recovery, such as the delay of rehabilitation after the operation, were reviewed...
December 2014: Annals of Rehabilitation Medicine
Lawrence S Long, Jed T Wolpaw, Jacqueline M Leung
BACKGROUND: Preoperative cognitive impairment is a major risk factor for postoperative delirium. We therefore investigated the prognostic significance and feasibility of administering a brief cognitive screen before surgery. METHODS: Patients > 65 yr of age undergoing hip, knee, or spine surgery were enrolled. A 60-sec cognitive screen, the animal fluency test (AFT), was administered preoperatively. Postoperative delirium was measured using a chart-based tool previously validated using criteria from the Confusion Assessment Method...
June 2015: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Megan A Feng, Daniel T McMillan, Karen Crowell, Hyman Muss, Matthew E Nielsen, Angela B Smith
BACKGROUND: The comprehensive geriatric assessment (CGA) has developed as an important prognostic tool to risk stratify older adults and has recently been applied to the surgical field. In this systematic review, we examined the utility of CGA components as predictors of adverse outcomes among geriatric patients undergoing major oncologic surgery. MATERIALS AND METHODS: MEDLINE, Embase, and the Cochrane Library were searched for prospective studies examining the association of components of the CGA with specific outcomes among geriatric patients undergoing elective oncologic surgery...
January 2015: Journal of Surgical Research
Maren Schmidt, Bruno Neuner, Andrea Kindler, Kathrin Scholtz, Rahel Eckardt, Peter Neuhaus, Claudia Spies
OBJECTIVE: Aim of this study was to evaluate the association between preoperative health-related quality of life (HRQoL) and mortality in a cohort of elderly patients (>65 years) with gastrointestinal, gynecological and genitourinary carcinomas. DESIGN: Prospective cohort pilot study. SETTING: Tertiary university hospital in Germany. PATIENTS: Between June 2008 and July 2010 and after ethical committee approval and written informed consent, 126 patients scheduled for onco-surgery were included...
2014: PloS One
Takeo Uzuka, Kenichiro Asano, Toshio Sasajima, Kaori Sakurada, Toshihiro Kumabe, Takaaki Beppu, Masahiro Ichikawa, Chifumi Kitanaka, Hiroshi Aoki, Kiyoshi Saito, Kuniaki Ogasawara, Teiji Tominaga, Kazuo Mizoi, Hiroki Ohkuma, Yukihiko Fujii, Takamasa Kayama
Age is one of the most important prognostic factors in glioblastoma patients, but no standard treatment has been established for elderly patients with this condition. We therefore conducted a retrospective cohort study to evaluate treatment regimens and outcomes in elderly glioblastoma patients. The study population consisted of 79 glioblastoma patients aged ≥ 76 years (median age 78.0 years; 34 men and 45 women). The median preoperative Karnofsky performance status (KPS) score was 60. Surgical procedures were classified as biopsy (31 patients, 39...
January 2014: Journal of Neuro-oncology
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