Preoperative Optimization of the Liver for Resection

2013 ◽  
pp. 133-137
Author(s):  
J. Belghiti ◽  
D. Fuks
Keyword(s):  
Preoperative Optimization

788 Preoperative Optimization Contributes to Sustained Improvement in Renal Function with LVAD Therapy

2012 ◽  
Vol 31 (4) ◽  
pp. S268-S269
Author(s):  
H.-S. Chiew ◽  
B.S. Edwards ◽  
S.J. Park ◽  
J. Geske ◽  
D.R. Fermin ◽  
...  
Keyword(s):  
Renal Function ◽  
Sustained Improvement ◽  
Preoperative Optimization

The Impact of Surgeon Adherence to Preoperative Optimization of Hernia Repairs

2021 ◽  
Vol 264 ◽  
pp. 8-15
Author(s):  
Lia D. Delaney ◽  
Meera Kattapuram ◽  
Julia Aseel Haidar ◽  
Alyssa S. Chen ◽  
Grecia Quiroga ◽  
...  
Keyword(s):  
Preoperative Optimization ◽  
The Impact

Trends in the Surgical Management and Outcomes of Complicated Peptic Ulcer Disease

2020 ◽  
Vol 86 (7) ◽  
pp. 856-864
Author(s):  
Olubode A. Olufajo ◽  
Amanda Wilson ◽  
Bruke Yehayes ◽  
Ahmad Zeineddin ◽  
Edward E. Cornwell ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Surgical Management ◽  
Postoperative Care ◽  
National Inpatient Sample ◽  
Trend Analyses ◽  
Ulcer Disease ◽  
Preoperative Optimization ◽  
Obstruction Group ◽  
Perforation Group

Background Older data indicate that less patients undergo surgery for complicated peptic ulcer disease (PUD). We evaluated contemporary trends in the surgical management and outcomes of patients with complicated PUD. Methods The National Inpatient Sample (2005-2014) was queried for patients with complicated PUD (hemorrhage, perforation, or obstruction). Trend analyses were used to evaluate changes in management and outcomes. Results There were 1 570 696 admissions for complicated PUD during the study period. Majority (87.0%) presented with hemorrhage, 10.6% presented with perforation, and 2.4% had an obstruction. The average age was 67 years. Overall, admissions with complicated PUD decreased from 180 054 in 2005 to 150 335 in 2014. The proportion of patients managed operatively decreased from 2.5% to 1.9% in the hemorrhage group, 75.0% to 67.4% in the perforation group, and 26.0% to 20.2% in the obstruction group (all P-trend < .05). Overall, among patients managed operatively, the use of acid-reducing procedures decreased from 25.9% to 13.9%, mortality decreased from 11.9% to 9.4% (both P-trend < .001), while complications remained stable (10.4% to 10.3%, P-trend = .830). Conclusions There are fewer admissions with complicated PUD and more patients are treated nonoperatively. Despite subtle improvements, significant proportions of patients still die from complicated PUD indicating the need for improved preoperative optimization and postoperative care among these patients.

scholarly journals Perioperative Neurological Evaluation and Management to Lower the Risk of Acute Stroke in Patients Undergoing Noncardiac, Nonneurological Surgery: A Scientific Statement From the American Heart Association/American Stroke Association

Circulation ◽  
2021 ◽  
Author(s):  
Curtis Benesch ◽  
Laurent G. Glance ◽  
Colin P. Derdeyn ◽  
Lee A. Fleisher ◽  
Robert G. Holloway ◽  
...  
Keyword(s):  
Intravenous Thrombolysis ◽  
Heart Association ◽  
Pressure Control ◽  
Neurological Dysfunction ◽  
Anesthetic Technique ◽  
Perioperative Stroke ◽  
Carotid Revascularization ◽  
Preoperative Optimization ◽  
Scientific Statement

Perioperative stroke is a potentially devastating complication in patients undergoing noncardiac, nonneurological surgery. This scientific statement summarizes established risk factors for perioperative stroke, preoperative and intraoperative strategies to mitigate the risk of stroke, suggestions for postoperative assessments, and treatment approaches for minimizing permanent neurological dysfunction in patients who experience a perioperative stroke. The first section focuses on preoperative optimization, including the role of preoperative carotid revascularization in patients with high-grade carotid stenosis and delaying surgery in patients with recent strokes. The second section reviews intraoperative strategies to reduce the risk of stroke, focusing on blood pressure control, perioperative goal-directed therapy, blood transfusion, and anesthetic technique. Finally, this statement presents strategies for the evaluation and treatment of patients with suspected postoperative strokes and, in particular, highlights the value of rapid recognition of strokes and the early use of intravenous thrombolysis and mechanical embolectomy in appropriate patients.

Preoperative Risk Factors for Nonhome Discharge of Home-Dwelling Geriatric Patients Following Elective Surgery

2020 ◽  
pp. 073346482094469
Author(s):  
John C. Warwick ◽  
Ethan Y. Brovman ◽  
Sascha S. Beutler ◽  
Richard D. Urman
Keyword(s):  
Risk Factors ◽  
Elective Surgery ◽  
Living Alone ◽  
Preoperative Risk ◽  
Improvement Program ◽  
Surgical Quality ◽  
Preoperative Risk Factors ◽  
Preoperative Optimization ◽  
Mobility Aid ◽  
Geriatric Research

To identify patient risk factors for nonhome discharge (NHD) for home-dwelling older patients undergoing surgery, we performed a retrospective cohort study of patients aged ≥65 years undergoing elective surgery between 2014 and 2016 using the geriatric research file from the National Surgical Quality Improvement Program (NSQIP). Multivariable logistic regression examined the association between preoperative demographics, comorbidities, and functional status and NHD to determine which factors are most strongly predictive of NHD. Risk of NHD was higher among those of age >85 years, age 75 to 85 years, Black race, with body mass index (BMI) >30, dyspnea with exertion or at rest, partially or totally dependent in activities of daily living (ADLs), preoperative steroid use, preoperative wound infection, use of a mobility aid, fall within 3 months, or living alone at home without support. NHDs were statistically more likely among orthopedic, neurosurgery, or cardiac surgery interventions. Understanding individual patient’s risks and setting expectations for likely postoperative course is integral to appropriate preoperative counseling and preoperative optimization.

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