scholarly journals Risk factors for perioperative morbidity and mortality after extended hepatectomy for hepatocellular carcinoma

2003 ◽  
Vol 90 (1) ◽  
pp. 33-41 ◽  
Author(s):  
A. C. Wei ◽  
R. Tung-Ping Poon ◽  
S.-T. Fan ◽  
J. Wong
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Morbidity And Mortality ◽  
Extended Hepatectomy ◽  
Perioperative Morbidity

scholarly journals Surgical prehabilitation using mobile health coaching in patients with obesity: A pilot study

2020 ◽  
Vol 48 (5) ◽  
pp. 373-380
Author(s):  
Kasia Kulinski ◽  
Natalie A Smith
Keyword(s):  
Risk Factors ◽  
Mobile Health ◽  
Elective Surgery ◽  
Text Message ◽  
Cost Effective ◽  
Text Messages ◽  
Morbidity And Mortality ◽  
Perioperative Morbidity ◽  
Increased Risk ◽  
Patient Health

Many patients spend months waiting for elective procedures, and many have significant modifiable risk factors that could contribute to an increased risk of perioperative morbidity and mortality. The minimal direct contact that usually occurs with healthcare professionals during this period represents a missed opportunity to improve patient health and surgical outcomes. Patients with obesity comprise a large proportion of the surgical workload but are under-represented in prehabilitation studies. Our study piloted a mobile phone based, multidisciplinary, prehabilitation programme for patients with obesity awaiting elective surgery. A total of 22 participants were recruited via the Wollongong Hospital pre-admissions clinic in New South Wales, Australia, and 18 completed the study. All received the study intervention of four text messages per week for six months. Questionnaires addressing the self-reported outcome measures were performed at the start and completion of the study. Forty percent of participants lost weight and 40% of smokers decreased their cigarette intake over the study. Sixty percent reported an overall improved health score. Over 80% of patients found the programme effective for themselves, and all recommended that it be made available to other patients. The cost was A$1.20 per patient per month. Our study showed improvement in some of the risk factors for perioperative morbidity and mortality. With improved methods to increase enrolment, our overall impression is that text message–based mobile health prehabilitation may be a feasible, cost-effective and worthwhile intervention for patients with obesity.

scholarly journals Perioperative Morbidity and Mortality of Same-day Bilateral TKAs: Incidence and Risk Factors

2013 ◽  
Vol 472 (1) ◽  
pp. 111-120 ◽  
Author(s):  
Lazaros Poultsides ◽  
Stavros Memtsoudis ◽  
Alejandro Gonzalez Della Valle ◽  
Ivan De Martino ◽  
Huong T. Do ◽  
...  
Keyword(s):  
Risk Factors ◽  
Morbidity And Mortality ◽  
Perioperative Morbidity ◽  
Bilateral Tkas

Perioperative morbidity and mortality in patients treated by radical cystectomy: A multi-institutional retrospective study.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 270-270
Author(s):  
N. Takada ◽  
T. Abe ◽  
S. Maruyama ◽  
A. Sazawa ◽  
N. Shinohara ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Stay ◽  
Radical Cystectomy ◽  
Urinary Diversion ◽  
Death Rate ◽  
Operative Time ◽  
Morbidity And Mortality ◽  
Perioperative Outcomes ◽  
Perioperative Morbidity ◽  
Asa Score

270 Background: It is well known that radical cystectomy is associated with comparatively high perioperative morbidity and mortality. In the present study, we collected data of perioperative outcomes from Hokkaido University Graduate School of Medicine and our teaching hospitals and assessed the complications and death rate within 90 days after radical cystectomy. Methods: We collected clinical data of 970 patients undergoing radical cystectomy for nonmetastatic bladder cancer in 21 institutions between 1999 and 2009. We then assessed 90-day complications and death after radical cystectomy. The complications were classified according to the modified Clavien classification. Over 40 variables were included in the analysis, including age, ASA score, BMI, comorbidity, neoadjuvant chemotherapy, clinical stage, type of urinary diversion, operative time, estimated blood loss, transfusion, and hospital stay. Statistical analysis was performed utilizing Student's t-tests, chi-square tests, and logistic regression analysis. Results: The median patient age was 70 (range, 25-91) years old. 62.5% of patients had an ASA score≥2. Regarding the urinary diversion, ileal conduit was performed in 523 (53.6%) patients, neobladder in 178 (18.4%), ureterocutaneostomy in 255 (26.3%). Median operative time was 399 (range, 100-927) minutes. Median hospital stay was 39 (0-364) days. Regarding the complications, 660 (68%) patients experienced at least one complication and death rate within 90 days after surgery was 1.34% (n=13), respectively. Of the complications, 34.1% was classified as grade 1, 41.5% as grade 2, 20.1% as grade 3, 1.1% as grade 4, 1.2% as grade 5. Multivariate analysis identified age≥70 (odds ratio 1.41), urinary diversion utilizing intestine (OR 1.58) and operative time ≥ 400 (OR 1.54) were independent risk factors. Conclusions: Death rate was 1.34%, which was compatible to reports form western high- volume centers. About two-thirds of the patients experienced at least one complication, although they were mostly classified as grade 2 or less. Age, urinary diversion, and operative time were significant risk factors for perioperative complications after radical cystectomy. No significant financial relationships to disclose.

scholarly journals Patient Selection for Day Case-eligible Surgery

2013 ◽  
Vol 119 (6) ◽  
pp. 1310-1321 ◽  
Author(s):  
Michael R. Mathis ◽  
Norah N. Naughton ◽  
Amy M. Shanks ◽  
Robert E. Freundlich ◽  
Christopher J. Pannucci ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Surgical Procedures ◽  
Patient Selection ◽  
Outpatient Surgery ◽  
Morbidity And Mortality ◽  
Day Case ◽  
Surgical Morbidity ◽  
Perioperative Morbidity ◽  
Selection For

Abstract Background: Due to economic pressures and improvements in perioperative care, outpatient surgical procedures have become commonplace. However, risk factors for outpatient surgical morbidity and mortality remain unclear. There are no multicenter clinical data guiding patient selection for outpatient surgery. The authors hypothesize that specific risk factors increase the likelihood of day case-eligible surgical morbidity or mortality. Methods: The authors analyzed adults undergoing common day case-eligible surgical procedures by using the American College of Surgeons’ National Surgical Quality Improvement Program database from 2005 to 2010. Common day case-eligible surgical procedures were identified as the most common outpatient surgical Current Procedural Terminology codes provided by Blue Cross Blue Shield of Michigan and Medicare publications. Study variables included anthropometric data and relevant medical comorbidities. The primary outcome was morbidity or mortality within 72 h. Intraoperative complications included adverse cardiovascular events; postoperative complications included surgical, anesthetic, and medical adverse events. Results: Of 244,397 surgeries studied, 232 (0.1%) experienced early perioperative morbidity or mortality. Seven independent risk factors were identified while controlling for surgical complexity: overweight body mass index, obese body mass index, chronic obstructive pulmonary disease, history of transient ischemic attack/stroke, hypertension, previous cardiac surgical intervention, and prolonged operative time. Conclusions: The demonstrated low rate of perioperative morbidity and mortality confirms the safety of current day case-eligible surgeries. The authors obtained the first prospectively collected data identifying risk factors for morbidity and mortality with day case-eligible surgery. The results of the study provide new data to advance patient-selection processes for outpatient surgery.

Risk factors associated with perioperative morbidity and mortality following isolated tricuspid valve replacement

2018 ◽  
Vol 221 ◽  
pp. 224-231 ◽  
Author(s):  
Jinmiao Chen ◽  
Mieradilijiang Abudupataer ◽  
Kui Hu ◽  
Aikebaier Maimaiti ◽  
Shuyang Lu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Valve Replacement ◽  
Tricuspid Valve ◽  
Morbidity And Mortality ◽  
Tricuspid Valve Replacement ◽  
Perioperative Morbidity ◽  
Factors Associated

Studying the Birth Outcome in Tikrit Teaching Hospital

2018 ◽  
Vol 1 (1) ◽  
pp. 55-57
Author(s):  
Areej Noaman
Keyword(s):  
Risk Factors ◽  
Developing Countries ◽  
Teaching Hospital ◽  
Birth Outcome ◽  
Morbidity And Mortality ◽  
Healthy Baby ◽  
Factors Affecting ◽  
Neonatal Deaths ◽  
Healthy Mother

  Background : A successful birth outcome is defined as the birth of a healthy baby to a healthy mother. While relatively low in industrialized world, maternal and fetal morbidity and mortality and neonatal deaths occur disproportionately in developing countries. Aim of the Study: To assess birth outcome and identify some risk factors affecting it for achieving favorable birth outcome in Tikrit Teaching Hospital

Risk Factors for Hepatic Encephalopathy after Transjugular Intrahepatic Portosystemic Shunt in Patients with Hepatocellular Carcinoma and Portal Hypertension

2015 ◽  
Vol 24 (3) ◽  
pp. 301-307 ◽  
Author(s):  
Jiannan Yao ◽  
Li Zuo ◽  
Guangyu An ◽  
Zhendong Yue ◽  
Hongwei Zhao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Portal Hypertension ◽  
Hepatic Encephalopathy ◽  
Pressure Gradient ◽  
Transjugular Intrahepatic Portosystemic Shunt ◽  
Meld Score ◽  
Portosystemic Shunt ◽  
Portal Flow ◽  
Intrahepatic Portosystemic Shunt

Aims: This study aimed at assessing the risk factors for hepatic encephalopathy (HE) after transjugular intrahepatic portosystemic shunt (TIPS) in patients with hepatocellular carcinoma (HCC) and portal hypertension. Method: Consecutive patients (n=279) with primary HCC who underwent TIPS between January 1997 and March 2012 at a single institution were retrospectively reviewed. Patients were followed up for 2 years. Pre-TIPS, peri-TIPS and post-TIPS clinical variables were reviewed using univariate and multivariate analyses to identify risk factors for HE after TIPS. Results: The overall incidence of HE was 41% (114/279). Multivariate analysis showed an increased odds for HE in patients with: >3 treatments with transcatheter arterial chemoembolization (TACE) and/or trans-arterial embolization (TAE) (odds ratio [OR], 4.078; 95% confidence interval [95%CI], 1.748-9.515); hepatopetal portal flow (OR, 2.362; 95%CI, 1.032-5.404); high portosystemic pressure gradient (OR, 1.198; 95%CI, 1.073-1.336) and high pre-TIPS MELD score (OR, 1.693; 95%CI, 1.390-2.062). Odds for HE were increased 1.693 fold for each 1-point increase in the MELD score, and 1.198 fold for each 1-mmHg decrease in the post-TIPS portosystemic pressure gradient. Conclusion: The identification of clinical variables associated with increased odds of HE may be useful for the selection of appropriate candidates for TIPS. Results suggest that an inappropriate decrease in the portosystemic pressure gradient might be associated with HE after TIPS. In addition, >3 treatments with TACE/TAE, hepatopetal portal flow, and high MELD score were also associated with increased odds of HE after TIPS. Key words:  –  –  – .

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