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Preoperative risk Pulmonary

Hesham Mostafa Zakaria, Michael Bazydlo, Lonni Schultz, Markian A Pahuta, Jason M Schwalb, Paul Park, Ilyas Aleem, David R Nerenz, Victor Chang
OBJECTIVEThe Michigan Spine Surgery Improvement Collaborative (MSSIC) is a statewide, multicenter quality improvement initiative. Using MSSIC data, the authors sought to identify 90-day adverse events and their associated risk factors (RFs) after cervical spine surgery.METHODSA total of 8236 cervical spine surgery cases were analyzed. Multivariable generalized estimating equation regression models were constructed to identify RFs for adverse events; variables tested included age, sex, diabetes mellitus, disc herniation, foraminal stenosis, central stenosis, American Society of Anesthesiologists Physical Classification System (ASA) class > II, myelopathy, private insurance, anterior versus posterior approach, revision procedures, number of surgical levels, length of procedure, blood loss, preoperative ambulation, ambulation day of surgery, length of hospital stay, and discharge disposition...
February 15, 2019: Journal of Neurosurgery. Spine
C Baillard, M Boubaya, E Statescu, M Collet, A Solis, J Guezennec, V Levy, O Langeron
BACKGROUND: The incidence of hypoxaemia related to airway management is still a matter of concern. Our aim was to determine the factors that contribute to hypoxaemia during induction of anaesthesia after a standardised preoxygenation procedure. METHODS: The study was a multicentre and prospective observational trial. It evaluated the incidence of hypoxaemia at induction of anaesthesia in adult patients. The primary endpoint was the incidence of hypoxaemia defined as pulse oximetry of arterial oxyhaemoglobin saturation (SpO2 ) <95%...
March 2019: British Journal of Anaesthesia
Benjamin Vojnar, Martin Zoremba
With focused transthoracic echocardiography (TTE) we rapidly and non-invasively receive up-to-date information on a patient's hemodynamic status. These can subsequently influence our therapy and thus our risk management. Postoperatively, TTE has proved its worth as an examination method in the recovery room and in the intensive care unit to promptly diagnose life-threatening causes of circulatory depression. Acute pathology such as a pericardial tamponade or fulminant pulmonary artery embolism can be detected quickly and thus possibly time-consuming transport to a CT can be avoided...
February 2019: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Michael L Caparelli, Alexander Shikhman, Abdullah Jalal, Sandra Oppelt, Cari Ogg, Shyam Allamaneni
Postoperative pneumonia increases morbidity, length of stay, and hospital readmission rates. Current data support the use of perioperative chlorhexidine gluconate in elective cardiac surgery patients to prevent postoperative pneumonia. The objectives of this study were to implement a resident-driven quality improvement project and determine the efficacy of an oral care bundle in preventing postoperative pneumonia among noncardiac surgical patients. A retrospective review of postoperative pneumonia occurrences at our hospital captured by the NSQIP database from 2014 to 2016 was conducted...
January 1, 2019: American Surgeon
Douglas J Young, Philip J McCall, Alan Kirk, Alistair Macfie, John Kinsella, Benjamin G Shelley
OBJECTIVES: Following lung resection, there is a decrease in the functional capacity and quality of life, which is not fully explained by changes in pulmonary function. Previous work demonstrates that B-type natriuretic peptide (BNP) is associated with short- and long-term complications following lung resection, leading to the suggestion that cardiac dysfunction may contribute to functional deterioration. Our aim was to investigate any relationship between BNP and subjective and objective indices of functional deterioration following lung resection surgery...
February 8, 2019: Interactive Cardiovascular and Thoracic Surgery
Alexandra M Roch, Thomas K Maatman, Rose A Carr, Cameron L Colgate, Eugene P Ceppa, Michael G House, James Lopes, Attila Nakeeb, C Max Schmidt, Nicholas J Zyromski
BACKGROUND: Necrotizing pancreatitis (NP) is a severe systemic inflammatory process. We have observed a high incidence of venous thromboembolism (VTE) in NP patients. However, remarkably few data exist to document the true incidence of VTE-including splanchnic vein thrombosis (SVT), extremity deep venous thrombosis (eDVT), and pulmonary embolism (PE)-in NP. Therefore, we sought to determine the incidence and risk factors for VTE in NP patients. METHODS: Retrospective review of all NP patients treated at a single academic center between 2005 and 2015...
February 7, 2019: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Jeff S Ehresman, Tomas Garzon-Muvdi, Davis Rogers, Michael Lim, Gary L Gallia, Jon Weingart, Henry Brem, Chetan Bettegowda, Kaisorn L Chaichana
Object  Meningiomas occur in various intracranial locations. Each location is associated with a unique set of surgical nuances and risk profiles. The incidence and risk factors that predispose patients to certain deficits based on tumor locations are unclear. This study aimed to determine which preoperative factors increase the risk of patients having new deficits after surgery based on tumor location for patients undergoing intracranial meningioma surgery. Methods  Adult patients who underwent primary, nonbiopsy resection of a meningioma at a tertiary care institution between 2007 and 2015 were retrospectively reviewed...
February 2019: Journal of Neurological Surgery. Part B, Skull Base
Xiaoyu Chen, Lin Hou, Yuanyuan Zhang, Xiangjing Liu, Bohan Shao, Bo Yuan, Jing Li, Min Li, Hong Cheng, Lei Teng, Mingdi Guo, Zhengqing Wang, Tienan Chen, Jianjun Liu, Yaping Liu, Zhigang Liu, Xiaocheng Liu, Qi Guo
OBJECTIVE: To determine the prophylactic efficacy of short-term intensive preoperative inspiratory muscle training on the incidence of postoperative pulmonary complications in patients scheduled for cardiac surgery. DESIGN: Single-blind, randomized controlled pilot study. SETTING: TEDA International Cardiovascular Hospital, China. SUBJECTS: In total, 197 subjects aged ⩾50 years scheduled for cardiac surgery were selected...
February 6, 2019: Clinical Rehabilitation
Naoya Yoshida, Hiroyuki Yamamoto, Hideo Baba, Hiroaki Miyata, Masayuki Watanabe, Yasushi Toh, Hisahiro Matsubara, Yoshihiro Kakeji, Yasuyuki Seto
OBJECTIVE: We aimed to elucidate whether minimally invasive esophagectomy (MIE) can be safely performed by reviewing the Japanese National Clinical Database. SUMMARY OF BACKGROUND DATA: MIE is being increasingly adopted, even for advanced esophageal cancer that requires various preoperative treatments. However, the superiority of MIE's short-term outcomes compared with those of open esophagectomy (OE) has not been definitively established in general clinical practice...
January 31, 2019: Annals of Surgery
Omair A Shariq, Kristine T Hanson, Nicholas P McKenna, Scott R Kelley, Eric J Dozois, Amy L Lightner, Kellie L Mathis, Elizabeth B Habermann
BACKGROUND: Metabolic syndrome is associated with poorer postoperative outcomes after various abdominal operations. However, the impact of metabolic syndrome on outcomes after colorectal cancer surgery remains poorly described. OBJECTIVE: The purpose of this study was to determine the association between metabolic syndrome and short-term postoperative outcomes in patients undergoing elective colorectal cancer surgery. DESIGN: This was a retrospective cohort study...
January 31, 2019: Diseases of the Colon and Rectum
Tatsuro Tamura, Katsunobu Sakurai, Mikio Nambara, Yuichiro Miki, Takahiro Toyokawa, Naoshi Kubo, Hiroaki Tanaka, Kazuya Muguruma, Masakazu Yashiro, Masaichi Ohira
BACKGROUND: Sarcopenia is known to have an important influence on postoperative complications in several diseases, and on the prognosis of patients with cancer. However, whether sarcopenia is associated with complications and prognosis after gastrectomy in patients with gastric cancer remains controversial. This study evaluated the impact of the preoperative muscle mass on postoperative complications of gastric cancer surgery. MATERIALS AND METHODS: The muscle mass of 153 patients who underwent gastrectomy for gastric cancer from January 2014 to August 2016 was assessed before surgery by a multifrequency bioelectrical impedance analysis (In Body 3...
February 2019: Anticancer Research
P Sh Chomakhidze, N V Mozzhuhina, M G Poltavskaya, V P Sedov, A L Syrkin
PURPOSE OF THE STUDY: Evaluation of the value of the results of the use of cardiac functional examination methods for the stratification of the risk of developing cardiovascular complications in planned abdominal surgical interventions in patients over 65 years of age or with cardiac pathology. MATERIALS AND METHODS: The study included 179 patients over 65 years of age or with a history of heart disease who underwent elective abdominal surgery. The median age was 70 years...
January 28, 2019: Kardiologiia
Christina L Costantino, Abraham D Geller, Cameron D Wright, Harald C Ott, Ashok Muniappan, Douglas J Mathisen, Michael Lanuti
OBJECTIVES: Complete resection of neoplasms involving the carina are technically challenging and have high operative morbidity and mortality. This study examines the last 2 decades of clinical experience at our institution. METHODS: Medical records were retrospectively reviewed between 1997 and 2017 to identify all patients who underwent carinal resection. Primary outcome measures include risk factors for complications and overall survival. RESULTS: In total, 45 carinal resections were performed with a median follow-up of 3...
December 15, 2018: Journal of Thoracic and Cardiovascular Surgery
Shun Takao, Takeshi Masuda, Kakuhiro Yamaguchi, Shinjiro Sakamoto, Yasushi Horimasu, Taku Nakashima, Shintaro Miyamoto, Hiroshi Iwamoto, Kazunori Fujitaka, Hironobu Hamada, Noboru Hattori
Several studies have investigated the incidence of and risk factors for acute exacerbation (AE) in patients with interstitial lung disease (ILD) after lung resection surgery. However, the incidence and risk factors for AE-ILD after non-pulmonary surgery are not known. The aim of this study was to investigate the incidence of and risk factors for AE-ILD after non-pulmonary surgery.Eighty patients who were diagnosed with ILD on preoperative chest computed tomography (CT) imaging and underwent non-pulmonary surgery under general anesthesia at Hiroshima University Hospital between September 2011 and September 2017 were enrolled...
February 2019: Medicine (Baltimore)
Justin A Sobrino, Nhatrang Le, Joseph A Sujka, Leo Andrew Benedict, Rebecca M Rentea, Hanna Alemayehu, Shawn D St Peter
BACKGROUND: Lung biopsy is part of the diagnostic workup for multiple diseases. Although the morbidity of the procedure has decreased with the use of thoracoscopy, lung biopsy still holds substantial risk for patients. Therefore, we evaluated the likelihood of lung biopsies impacting treatment compared to complications. MATERIAL AND METHODS: This was a single-institution, retrospective chart review of patients less than aged 18 y undergoing lung biopsy from 2010 to 2016...
December 10, 2018: Journal of Surgical Research
Laura T Boitano, James C Iannuzzi, Adam Tanious, Jahan Mohebali, Samuel I Schwartz, William Darrin Clouse, Mark F Conrad
BACKGROUND: There are limited data guiding preoperative counseling on the need for discharge to facility after elective open abdominal aortic aneurysm repair (OAR). This study aims to determine the preoperative predictors for nonhome discharge (NHD) following OAR. MATERIALS AND METHODS: The National Surgical Quality Improvement Program Vascular Procedure Targeted database was queried for elective OAR, 2011-2015. The primary endpoint was NHD. Complex surgery was defined as high operative time...
March 2019: Journal of Surgical Research
Bochao Zhao, Jingting Zhang, Jiale Zhang, Shihui Zou, Rui Luo, Huimian Xu, Baojun Huang
OBJECTIVE: In this study, we performed a systematic review and meta-analysis to evaluate the impact of preoperative underweight status on postoperative complications and survival outcome of gastric cancer (GC) patients. METHODS: The related studies were identified by searching PubMed and Embase databases. According to the body mass index (BMI), all patients were classified into underweight group (<18.5 kg/m2 ) and normal weight group (≥18.5 kg/m2 , <25 kg/m2 )...
January 26, 2019: Nutrition and Cancer
Francesco Nappi, Mario Lusini, Sanjeet Singh Avtaar Singh, Orlando Santana, Massimo Chello, Christos G Mihos
BACKGROUND: Mitral valve repair combined with papillary muscle approximation (MVr+PMA) may improve repair durability in severe ischemic mitral regurgitation (MR), when compared with MVr alone. We sought to identify preoperative transthoracic echocardiographic markers associated with MR recurrence after MVr+PMA. METHODS: A post-hoc analysis was performed on patients with severe ischemic MR who underwent coronary artery bypass grafting with MVr+PMA, in the Papillary Muscle Approximation Randomized Trial...
January 23, 2019: Annals of Thoracic Surgery
Wen-Hua Zhang, Yan-Yan Bai, Wei Guo, Ming Li, Gui-Xia Chang, Wei Liu, Yu Mao
OBJECTIVE: This study aims to investigate the accuracy of the preoperative localization of small nodules by computerized tomography (CT)-guided placing wire and intrapleural fibrin glue near the nodules at 3 days before the operation. METHODS: From October 2015 to December 2017, a total of 79 patients, who received preoperative localization of small pulmonary nodules and surgical treatment in the Department of Thoracic Surgery of Hohhot First Hospital, were enrolled into this study...
January 2019: Medicine (Baltimore)
Christopher W Towe, Katherine Wu, Alina Khil, Yaron Perry, Stephanie G Worrell, Vanessa P Ho, Philip A Linden
BACKGROUND: Pulmonary function testing (PFT) is commonly used to risk-stratify patients prior to lung resection. Guidelines recommend that patients with reduced lung function, due to chronic lung conditions such as Chronic Obstructive Pulmonary Disease (COPD), should receive additional physiologic testing to determine fitness for resection. We reviewed our experience with six-minute walk testing (SMWT) to determine the association of test results and post-operative complications. METHODS: Consecutive adult patients undergoing segmentectomy, lobectomy, bilobectomy or pneumonectomy between 1 January, 2007 and 1 January, 2017 were identified in a prospectively maintained database...
January 23, 2019: Healthcare (Basel, Switzerland)
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