scholarly journals Different strategies, equivalent treatment approaches in terms of mortality in four university hospitals: a retrospective multicenter study of gastroschisis in Finland

2021 ◽  
Author(s):  
Asta Tauriainen ◽  
Anna Hyvärinen ◽  
Arimatias Raitio ◽  
Ulla Sankilampi ◽  
Mikko Gärding ◽  
...  
Keyword(s):  
Central Line ◽  
University Hospitals ◽  
Level Of Evidence ◽  
Hospital Variation ◽  
Abdominal Operations ◽  
Short And Long Term ◽  
Initial Hospitalization ◽  
Long Term Mortality

Abstract Purpose Optimal treatment of gastroschisis is not determined. The aim of the present study was to investigate treatment methods of gastroschisis in four university hospitals in Finland. Methods The data of neonates with gastroschisis born between 1993 and 2015 were collected. The primary outcomes were short and long-term mortality and the length of stay (LOS). Statistical analyses consisted of uni- and multivariate models. Results Total of 154 patients were included (range from 31 to 52 in each hospital). There were no statistically significant differences in mortality or LOS between centers. Significant differences were observed between the hospitals in the duration of mechanical ventilation (p = 0.046), time to full enteral nutrition (p = 0.043), delay until full defect closure (p = 0.003), central line sepsis (p = 0.025), abdominal compartment syndrome (p = 0.018), number of abdominal operations during initial hospitalization (p = 0.000) and follow-up (p = 0.000), and ventral hernia at follow-up (p = 0.000). In a Cox multivariate analysis, the treating hospital was not associated with mortality. Conclusion There were no differences in short or long-term mortality between four university hospitals in Finland. However, some inter-hospital variation in postoperative outcomes was present. Level of evidence Level III.

Abstract 19771: Persistent Thrombocytopenia after Myocardial Infarction is Associated with Increased Short- and Long-Term Mortality

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Anirudh Kumar ◽  
Salim Virani ◽  
Scott Bassett ◽  
Mahboob Alam ◽  
Ravi Hira ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Bleeding Complications ◽  
Group Differences ◽  
Long Term Outcomes ◽  
Post Discharge ◽  
Short And Long Term ◽  
The Impact ◽  
Long Term Mortality

Background: Thrombocytopenia (TCP) occurs commonly in patients hospitalized with acute myocardial infarction (AMI). It is unclear whether persistent TCP after discharge among AMI survivors is associated with worse outcomes. Methods: We examined the impact of persistent post-discharge TCP on outcomes in a registry of consecutive AMI patients hospitalized between January 2004 and December 2007. In-hospital (IH) TCP was defined by a nadir platelet count < 150 x 109/L. Resolved TCP was defined as IH TCP which resolved within 3 months after discharge while persistent TCP was defined as IH TCP which did not resolve within 3 months. Results: Of 842 patients hospitalized for a first AMI, we examined data on 617 hospital survivors who had follow-up within 3 months of discharge and documented long-term outcomes. Of those, 474 (76.8%) patients did not experience IH TCP while 42 (6.8%) and 101 (16.4%) had persistent and resolved TCP, respectively (Table). Patients with persistent TCP were older, had worse comorbidities, and were more likely to have TCP at baseline and discharge. There were no inter-group differences in infarct size, major bleeding complications, revascularization, or ejection fraction at discharge. Mortality following discharge was higher at all time-points among AMI patients with persistent TCP compared to patients with resolved or without IH TCP (Figure). Patients with resolved TCP had comparable mortality to those without IH TCP. Conclusion: Persistent TCP within 3 months after hospital discharge for AMI is associated with significantly increased short- and long-term mortality compared to patients with recovered TCP or without IH TCP.

scholarly journals Comparison of surgical indications and short- and long-term complications in 56 cats undergoing perineal, transpelvic or prepubic urethrostomy

2020 ◽  
pp. 1098612X2095903
Author(s):  
Maheeka Seneviratne ◽  
Polina Stamenova ◽  
Karla Lee
Keyword(s):  
Short Term ◽  
Short Term Mortality ◽  
Short And Long Term ◽  
Urethral Lesion ◽  
Urethral Rupture ◽  
Complications And Mortality ◽  
Long Term Mortality

Objectives The aim of this study was to compare indications, complications and mortality rates for perineal urethrostomy (PU), transpelvic urethrostomy (TPU) and prepubic urethrostomy (PPU). Methods A retrospective review of, and follow-up owner questionnaire for, cats undergoing urethrostomy between 2008 and 2018, at a single referral hospital, were performed. Results Fifty-six cats underwent urethrostomy (PU, n = 37; TPU, n = 8; PPU, n = 11). The presenting problem was significantly associated with urethrostomy technique ( P <0.001). For PU cats, feline idiopathic cystitis (FIC; n = 21 [56.7%]) was the most common problem, whereas for PPU cats, trauma (n = 9 [81.8%]) was most common ( P <0.001). Urethrostomy technique was associated with imaging diagnosis ( P <0.001) of the urethral lesion. Most PU cats had no diagnostic imaging lesion (n = 15 [40.5%]) or obstructive calculi or clots (n = 10 [27.0%]), and all PPU cats had urethral rupture. Ten (90.9%) PPU cats had a pelvic lesion, while 21 (56.7%) PU cats had a penile lesion. TPU cats had a range of presenting problems and imaging diagnoses. Short- and long-term complications were reported in 33/55 (60.0%) and 11/30 (36.7%) cats, respectively. The number of cats with long-term complications was greater among PPU cats ( P = 0.02). Short-term dermatitis ( P = 0.019) and long-term incontinence ( P = 0.01) were associated with PPU. Short-term mortality was 5.6% and long-term mortality was 13.3%; both were independent of urethrostomy technique. Quality of life post-urethrostomy, across all techniques, was graded as good by 93% of owners. Conclusions and relevance In this study, PU was the most common feline urethrostomy technique indicated for FIC. Short-term urethrostomy complications are common, irrespective of urethrostomy technique. Long-term complications are less frequent but more common with PPU.

scholarly journals Predictions and outcomes of atrial fibrillation in the patients with acute myocardial infarction

Open Medicine ◽  
2017 ◽  
Vol 12 (1) ◽  
pp. 115-124 ◽  
Author(s):  
Mihailo Vukmirović ◽  
Aneta Bošković ◽  
Irena Tomašević Vukmirović ◽  
Radoje Vujadinovic ◽  
Nikola Fatić ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Atrial Fibrillation ◽  
Acute Myocardial Infarction ◽  
Odds Ratio ◽  
Logistic Regression Model ◽  
Epidemiological Studies ◽  
Short And Long Term ◽  
Long Term Mortality

AbstractThe large epidemiological studies demonstrated that atrial fibrillation is correlated with high mortality and adverse events in patients with acute myocardial infarction. The aim of this study was to determinate predictors of atrial fibrillation develop during the hospital period in patients with acute myocardial infarction as well as short- and long-term mortality depending on the atrial fibrillation presentation. The 600 patients with an acute myocardial infarction were included in the study and follow-up 84 months. Atrial fibrillation develops during the hospital period was registered in 48 patients (8%). After adjustment by logistic regression model the strongest predictor of atrial fibrillation develop during the hospital period was older age, particularly more than 70 years (odds ratio 2.37, CI 1.23-4.58, p=0.010), followed by increased of Body Mass Index (odds ratio 1.17, CI 1.04-1.33, p=0.012), enlarged diameter of left atrium (LA) (odds ratio 1,18, CI 1,03-1,33, p=0,015) presentation of mitral regurgitation (odds ratio 3.56, CI 1.25-10.32, p=0.018) and B-type natriuretic peptide (odds ratio 2.12, CI 1.24-3.33, p=0.048).Patients with atrial fibrillation develop during the hospital period had a higher mortality during the hospital course (10.4% vs. 5.6%) p=0.179. as well as follow-up period of 84 months than patients without it (64.6% vs. 39.1%) p=0.569, than patients without it, but without statistically significance. Patients with AF develop during the hospital period had higher mortality during the hospital course as well as follow up period of 84 months than patients without it, but without statistically significance.

P5734The outcome of intra-aortic balloon pumping support for acute myocardial infarction with extracorporeal membrane oxygenation therapy

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
H Kida ◽  
S Hikoso ◽  
D Nakatani ◽  
S Suna ◽  
T Dohi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Extracorporeal Membrane Oxygenation ◽  
Coronary Insufficiency ◽  
Membrane Oxygenation ◽  
Iabp Support ◽  
Short And Long Term ◽  
Long Term Mortality

Abstract Background It has been reported that intra-aortic balloon pumping (IABP) support for acute myocardial infarction (AMI) with cardiogenic shock did not reduce short and long-term mortality. However, the significance of IABP support for AMI patients with extracorporeal membrane oxygenation (ECMO) therapy remains unclear. The aim of this study was to investigate the effect of IABP support for the short and long-term outcome in AMI patients who received ECMO. Methods Using the database of the Osaka Acute Coronary Insufficiency Study (OACIS), 12,093 consecutive AMI patients were enrolled in this analysis. Among these, we analyzed 520 patients with ECMO. We classified the patients into two groups, patients who received IABP support [IABP group (n=460)] and patients who did not [no IABP group (n=60)]. Primary outcome was all-cause death. Results Study patients had following baseline clinical characteristics, age: 66.8±12.0 year old, male: 78.3%, diabetes mellitus: 41.0%, Killip class≥II: 66.2%, multi-vessel disease: 72.3%, peak creatine phosphokinase >3000IU/L: 68.1%. During a mean follow-up period of 349±625 days, Kaplan-Meier analysis revealed that the all-cause death was significantly lower in IABP group than no IABP group for 30-day (45.5% vs 72.7%, log-rank p<0.001) and long-term (66.2% vs 78.4%, Log rank p=0.005) follow-up period. Cox multivariate analysis revealed that IABP support was significantly associated with a reduced risk of mortality (Hazard ratio 0.445, 95% confidence interval 0.289 to 0.687, p<0.001). Conclusions IABP support for AMI patients with ECMO was significantly associated with reduced risks of the short and long-term mortality, suggesting that IABP support might contribute to improvement of the survival in AMI patients with ECMO.

scholarly journals 99 New onset atrial fibrillation in STEMI patients: main prognostic factors and clinical outcome

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Beatrice Dal Zotto ◽  
Lucia Barbieri ◽  
Gabriele Tumminello ◽  
Massimo Saviano ◽  
Domitilla Gentile ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Hospital Mortality ◽  
Independent Predictor ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Short And Long Term ◽  
Long Term Mortality ◽  
New Onset

Abstract The treatment of patients with known atrial fibrillation (AF) undergoing percutaneous coronary intervention has clear indications in the actual guidelines. Remarkable lack of evidence regarding new-onset AF (NOAF) in particular during STEMI is the reason for this study. We retrospectively analysed 1455 consecutive STEMI patients. The primary outcomes are in-hospital, 1-year and long-term follow-up mortality. Cerebral ischaemic events and major bleedings were considered clinical endpoints at 1 year. NOAF was detected in 102 subjects, 62.7% males, mean age 74.8 ± 10.6 years. Mean left ventricular ejection fraction (LVEF) was 43.5 ± 12.1% and left atrial enlargement (58 ± 20.9 ml) was observed. Anterior STEMI accounted for the majority (46%). NOAF has been predominantly recorded in the acute phase (mean duration of 8.1 ± 12.5 h). CHA2DS2-VASc score &gt;2 was recorded in 83% of cases, while HAS-BLED score of 2 or 3 was the most represented. All patients acutely received enoxaparin, but only 21.6% were discharged on oral anticoagulation (OAC). In-hospital mortality was 14.2%, while 1-year and long-term mortality were 17.2% and 32.1%, respectively. We identified age as an independent predictor of short- and long-term mortality, while LVEF was the only other independent predictor for in-hospital mortality and arrhythmia duration for 1-year mortality. After 1-year of follow-up we recorded three ischaemic events and no major bleeding. In conclusion, STEMI patients who present NOAF are a very high-risk population with increased short- and long-term mortality. Our data suggest that the indication for OAC should be always driven by CHA2DS2-VASC and HAS-BLEED score, even in patients with a single episode indeed. 99 Figure 1Kaplan-Meier curve representing the long-term survival of the entire population from hospital admission up to the maximum follow-up time was performed

P2877The incidence, predictors, and long-term outcomes of new-onset ventricular tachycardia after cardiac surgery

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K.-J Choi ◽  
M S Cho ◽  
U Do ◽  
J Kim ◽  
G B Nam ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Ventricular Tachycardia ◽  
Hospital Mortality ◽  
Index Hospitalization ◽  
Long Term Outcomes ◽  
Short And Long Term ◽  
Long Term Mortality ◽  
New Onset

Abstract Background Incidence and outcomes of new-onset ventricular tachycardia (VT) after cardiac surgery are not fully evaluated. Purpose We retrospectively analyzed the occurrence of new-onset VTs after cardiac surgery, and their implications on short and long-term mortality. Methods Data of 11,004 adult patients who underwent cardiac surgery at our center from 2006 to 2016 were analyzed. VT was diagnosed when 3 or more consecutive wide QRS complexes (>100 bpm) were documented on ECG. The major study outcomes were in-hospital and 5-years overall mortality rates. Results During index hospitalization for cardiac surgery, clinical VTs were documented in 184 patients (1.7%), which included 74 sustained VTs (SusVT, ≥30 seconds) and 110 non-sustained VTs (NSVT). Those patients with SusVT and NSVT showed higher in-hospital mortality compared to those without VTs (31.1% vs. 24.5% vs. 2.0% for SusVT, NSVT, and no VT, respectively, P<0.001). During follow-up after discharge from index hospitalization, patients with SusVT showed higher 5-years mortality than those without VTs, while patients with NSVT did not showed significant differences (22.0% vs. 11.7% vs. 9.2%, P<0.001). In the subgroup of patients with sustained VT who were discharged from index hospitalization (n=51), those with recurrent VTs (>24 hours apart from initial episode) were at higher 5-years mortality rate compared to those without (40.7% vs. 15.8%, P=0.018). Conclusion Patients with SusVT and NSVT were at higher risk of in-hospital mortality, and patients with SusVT were associated with higher risk of long-term mortality. The mortality risk was even higher in those with recurrent episodes of VTs. Acknowledgement/Funding None

Short- and Long-Term Results of Total vs Subtotal Thyroid- ectomies in the Surgical Treatment of Graves' Disease

Swiss Surgery ◽  
2001 ◽  
Vol 7 (1) ◽  
pp. 20-24 ◽  
Author(s):  
Robert ◽  
Mariéthoz ◽  
Pache ◽  
Bertin ◽  
Caulfield ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Nerve Palsy ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Laryngeal Nerve ◽  
Long Term Results ◽  
Graves Disease ◽  
Laryngeal Nerve Palsy ◽  
Short And Long Term

Objective: Approximately one out of five patients with Graves' disease (GD) undergoes a thyroidectomy after a mean period of 18 months of medical treatment. This retrospective and non-randomized study from a teaching hospital compares short- and long-term results of total (TT) and subtotal thyroidectomies (ST) for this disease. Methods: From 1987 to 1997, 94 patients were operated for GD. Thirty-three patients underwent a TT (mostly since 1993) and 61 a ST (keeping 4 to 8 grams of thyroid tissue - mean 6 g). All patients had received propylthiouracil and/or neo-mercazole and were in a euthyroid state at the time of surgery; they also took potassium iodide (lugol) for ten days before surgery. Results: There were no deaths. Transient hypocalcemia (< 3 months) occurred in 32 patients (15 TT and 17 ST) and persistent hypocalcemia in 8 having had TT. Two patients developed transient recurrent laryngeal nerve palsy after ST (< 3 months). After a median follow-up period of seven years (1-15) with five patients lost to follow-up, 41 patients having had a ST are in a hypothyroid state (73%), thirteen are euthyroid (23%), and two suffered recurrent hyperthyroidism, requiring completion of thyroidectomy. All 33 patients having had TT - with follow-ups averaging two years (0.5-8) - are receiving thyroxin substitution. Conclusions: There were no instances of persistent recurrent laryngeal nerve palsy in either group, but persistent hypoparathyroidism occurred more frequently after TT. Long after ST, hypothyroidism developed in nearly three of four cases, whereas euthyroidy was maintained in only one-fourth; recurrent hyperthyroidy was rare.

scholarly journals Minimum 10-Year Clinical Outcome of Lateral Collagen Meniscal Implants for the Replacement of Partial Lateral Meniscal Defects: Further Results From a Prospective Multicenter Study

2021 ◽  
Vol 9 (5) ◽  
pp. 232596712199491
Author(s):  
Alberto Grassi ◽  
Gian Andrea Lucidi ◽  
Giuseppe Filardo ◽  
Piero Agostinone ◽  
Luca Macchiarola ◽  
...  
Keyword(s):  
Survival Rate ◽  
Case Series ◽  
Final Analysis ◽  
Activity Level ◽  
Long Term Results ◽  
Level Of Evidence ◽  
Unicompartmental Knee Arthroplasties ◽  
Tegner Score

Background: The collagen meniscal implant (CMI) is a biologic scaffold aimed at replacing partial meniscal defects. The long-term results of lateral meniscal replacement have never been investigated. Purpose: To document the clinical outcomes and failures of lateral CMI implantation for partial lateral meniscal defect at a minimum 10-year follow-up. Study Design: Case series; Level of evidence, 4, Methods: This study included 24 consecutive patients who underwent lateral CMI implantation for partial lateral meniscal defects between April 2006 and September 2009 and who were part of a previous study with a 2-year follow-up. Outcome measures at the latest follow-up included the Lysholm score, Knee injury and Osteoarthritis Outcome Score, visual analog scale (VAS) for pain, Tegner activity level, and EuroQol 5-Dimensions score. Data regarding complications and failures were collected, and patients were asked about their satisfaction with the procedure. Results: Included in the final analysis were 19 patients (16 male, 3 female) with a mean age at surgery of 37.1 ± 12.6 years and a mean follow-up of 12.4 ± 1.5 years (range, 10-14 years). Five failures (26%) were reported: 1 CMI removal because of implant breakage and 4 joint replacements (2 unicompartmental knee arthroplasties and 2 total knee arthroplasties). The implant survival rate was 96% at 2 years, 85% at 5 years, 85% at 10 years, 77% at 12 years, and 64% at 14 years. Lysholm scores at the final follow-up were rated as “excellent” in 36% (5 of 14 nonfailures), “good” in 43% (6 of 14), and “fair” in 21% (3 of 14). The VAS score was 3.1 ± 3.1, with only 16% (3 of 19 patients) reporting that they were pain-free; the median Tegner score was 3 (interquartile range, 2-5). All clinical scores decreased from the 2-year follow-up; however, with the exception of the Tegner score, they remained significantly higher compared with the preoperative status. Overall, 79% of patients were willing to undergo the same procedure. Conclusion: Lateral CMI implantation for partial lateral meniscal defects provided good long-term results, with a 10-year survival rate of 85% and a 14-year survival rate of 64%. At the final follow-up, 58% of the patients had “good” or “excellent” Lysholm scores. However, there was a general decrease in outcome scores between the short- and the long-term follow-up.

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