Does conversion during minimally invasive rectal surgery for cancer have an impact on short-term and oncologic outcomes? Results of a retrospective cohort study

2021 ◽  
Author(s):  
Solafah Abdalla ◽  
Renato M. Lupinacci ◽  
Pietro Genova ◽  
Olivier Oberlin ◽  
Nicolas Goasguen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Minimally Invasive ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Rectal Surgery ◽  
Oncologic Outcomes ◽  
Short Term

Pulmonary thromboendarterectomy is a curative resolution for chronic thromboembolic pulmonary hypertension associated with antiphospholipid syndrome: a retrospective cohort study

Lupus ◽  
2018 ◽  
Vol 27 (14) ◽  
pp. 2206-2214 ◽  
Author(s):  
C Li ◽  
J Zhao ◽  
S Liu ◽  
W Song ◽  
J Zhu ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Cohort Study ◽  
Cardiac Function ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Short Term ◽  
Pulmonary Thromboendarterectomy ◽  
Thromboembolic Pulmonary Hypertension

Background Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare and life-threatening condition with poor prognosis in patients with antiphospholipid syndrome (APS). Pulmonary thromboendarterectomy (PTE) is the optimal surgical option for CTEPH. Objectives This retrospective cohort study aimed to evaluate the efficacy and risk of PTE in patients with APS-associated CTEPH. Methods Consecutive patients with APS-associated CTEPH diagnosed between January 2012 and September 2017 at Peking Union Medical College Hospital were retrospectively evaluated. Demographics, clinical manifestations, antiphospholipid antibody (aPL) profiles, and pulmonary arterial hypertension–targeted medications were collected. Deterioration of cardiac function and death were chosen as the endpoints, in order to assess the effect of PTE on short-term and long-term prognoses (evaluated by the change of cardiac function after treatment and cardiac deterioration or death in the follow-up, respectively). Results A total of 20 patients with APS-associated CTEPH were enrolled, and eight patients underwent PTE. Chi-square test ( p = 0.01) and Kaplan–Meier curves (log rank test, p = 0.04) showed that there were statistically significant differences in both short-term and long-term prognoses between patients with and without PTE. Conclusion These results provide strong evidence that PTE is a curative resolution in patients with APS-associated CTEPH. Following a full specialized and multidisciplinary risk-benefit evaluation to limit the risk of thrombosis or bleeding and to manage possible thrombocytopenia, PTE is at least a temporal curative resolution for CTEPH complicated with APS.

scholarly journals Abdominal Obesity and Short-term Mortality in Critically Ill Patients with Sepsis: A Retrospective Cohort Study Based on the MIMIC-IV Database

2021 ◽  
Author(s):  
Zhou Lv ◽  
Minglu Gu ◽  
Miao Zhou ◽  
Yanfei Mao ◽  
Lai Jiang
Keyword(s):  
Metabolic Syndrome ◽  
Cohort Study ◽  
Intensive Care ◽  
Abdominal Obesity ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Obese Patients ◽  
Short Term ◽  
Icu Admission ◽  
Short Term Mortality

Abstract Purpose: Multiple studies have demonstrated an obesity paradox such that obese septic patients have a lower mortality rate and a relatively favorable prognosis. However, less is known on the association between abdominal obesity and short-term mortality in patients with sepsis. We conducted this study to determine whether the obesity-related survival benefit remains among abdominal obese patients.Methods: A retrospective cohort study was conducted using data derived from the Medical Information Mart for Intensive Care IV database. Septic patients (≥18 years) with or without abdominal obesity of first intensive care units (ICU) admission in the database were enrolled. The primary outcome was mortality within 28 days of ICU admission and multivariable logistic regression analyses were employed to assess any association between abdominal obesity and the outcome variable.Results: A total of 21534 patients were enrolled finally, the crude 28-day mortality benefit after ICU admission was not observed in patients with abdominal obesity (15.8% vs. 15.3%, p=0.32). In the extended multivariable logistic models, the odds ratio (OR) of abdominal obesity was significantly inversed after incorporating metabolic variables into the logistic model (OR range 1.094-2.872, p = 0.02). The subgroup analysis showed interaction effects in impaired fasting blood glucose/diabetes and metabolic syndrome subgroups (P = 0.001 and <0.001, respectively). In the subgroups of blood pressure, high-density lipoprotein cholesterol, and triglyceride level, no interaction was detected in the association between abdominal obesity and mortality. After propensity score matching, 6523 pairs of patients were selected. The mortality significantly higher in the abdominal obesity group (17.0% vs. 14.8%, p = 0.015). Notably, the non-abdominal obese patients were weaned off vasopressors and mechanical ventilation more quickly than those in the abdominal obesity group (vasopressor‑free days on day 28 of 27.0 vs. 26.8, p < 0.001; ventilation-free days on day 28 of 26.7 vs. 25.6, p < 0.001).Conclusion: Abdominal obesity was associated with increased risk of adjusted sepsis-related mortality within 28 days after ICU admission and was partially mediated through metabolic syndrome components.

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