Administrative data measured surgical site infection probability within 30 days of surgery in elderly patients

2016 ◽  
Vol 77 ◽  
pp. 112-117 ◽  
Author(s):  
Carl van Walraven ◽  
Timothy D. Jackson ◽  
Nick Daneman
2010 ◽  
Vol 47 (2) ◽  
pp. 178-183 ◽  
Author(s):  
José Eduardo de Aguilar-Nascimento ◽  
Alberto Bicudo Salomão ◽  
Cervantes Caporossi ◽  
Breno Nadaf Diniz

CONTEXT: Multimodal protocol of perioperative care may enhance recovery after surgery. Based on evidence these new routines of perioperative care changed conventional prescriptions in surgery. OBJECTIVE: To evaluate the results of a multimodal protocol (ACERTO protocol) in elderly patients. METHODS: Non-randomized historical cohort study was performed at the surgical ward of a tertiary university hospital. One hundred seventeen patients aged 60 and older were submitted to elective abdominal operations under either conventional (n = 42; conventional group, January 2004-June 2005) or a fast-track perioperative protocol named ACERTO (n = 75; ACERTO group, July 2005-December 2007). Main endpoints were preoperative fasting time, postoperative day of re-feeding, volume of intravenous fluids, length of hospital stay and morbidity. RESULTS: The implantation of the ACERTO protocol was followed by a decrease in both preoperative fasting (15 [8-20] vs 4 [2-20] hours, P<0.001) and postoperative day of refeeding (1st [1st-10th] vs 0 [0-5th] PO day; P<0.01), and intravenous fluids (10.7 [2.5-57.5] vs 2.5 [0.5-82] L, P<0.001). The changing of protocols reduced the mean length of hospital stay by 4 days (6[1-43] vs 2[1-97] days; P = 0.002) and surgical site infection rate by 85.7% (19%; 8/42 vs 2.7%; 2/75, P<0.001; relative risk = 1.20; 95% confidence interval = 1.03-1.39). Per-protocol analysis showed that hospital stay in major operations diminished only in patients who completed the protocol (P<0.01). CONCLUSION: The implementation of multidisciplinary routines of the ACERTO protocol diminished both hospitalization and surgical site infection in elderly patients submitted to abdominal operations.


2018 ◽  
Author(s):  
Mostafa Shahrezaee ◽  
Mohammad Ali Okhovatpour ◽  
Mohammad Banasiri ◽  
Seyyed Reza Sharifzadeh

Various therapeutic methods are available to treat patients with intertrochantric fracture, which is usually caused by falling down. This complication is usually observed among the elderly, particularly old women. The choice of the proper therapeutic method depends on many factors including patient’s condition, type of fracture, and the amount of movement. Hip arthroplasty is one of these therapeutic methods, which have certain advantages and disadvantages. Immediate resumption of walking with the ability of weight toleration and absence of complications such as aseptic necrosis are some advantages of this method. Sixtyeight elderly patients with pertrochanteric fracture who had resorted to Iranian Army’s hospitals and had undergone arthroplasty. These cases were examined with due comparison with historical and external controls. Variables such a type of operation, age, post-operation pain, the pace of resuming walking ability, embolism, surgical site infection, bedsore and DVT were studied and compared against standard operation. The results achieved through assessment of variables showed a significant difference with standard operation in terms of variables such as post-operative movement ability, pain scale in various times, surgical complications, embolism, surgical site infection, bedsore, and DVT. Post-operative pain within the first 3 months following it are some complications with not much attention is paid to them, but they are important complications which can cause many negative and influential effects on patients. Arthroplasty is more expensive than standard operation and the patient may initially feel more pain.


2011 ◽  
Vol 11 (Suppl 1) ◽  
pp. A37
Author(s):  
M Minutolo ◽  
G Blandino ◽  
R Lanteri ◽  
S Puleo ◽  
V Minutolo

2021 ◽  
pp. 219256822199965
Author(s):  
Barry Ting Sheen Kweh ◽  
Hui Qing Lee ◽  
Terence Tan ◽  
Kim Siong Tew ◽  
Ronald Leong ◽  
...  

Study Design: Retrospective cohort. Objectives: To validate the 11-item modified Frailty Index (mFI) as a perioperative risk stratification tool in elderly patients undergoing spine surgery. Methods: All consecutive cases of spine surgery in patients aged 65 years or older between July 2016 and June 2018 at a state-wide trauma center were retrospectively reviewed. The primary outcome was post-operative major complication rate (Clavien-Dindo Classification ≥ III). Secondary outcome measures included the rate of all complications, 6-month mortality and surgical site infection. Results: A total of 348 cases were identified. The major complication rate was significantly lower in patients with an mFI of 0 compared to ≥ 0.45 (18.3% versus 42.5%, P = .049). As the mFI increased from 0 to ≥ 0.45 there was a stepwise increase in risk of major complications ( P < .001). Additionally, 6-month mortality rate was considerably lower when the mFI was 0 rather than ≥ 0.27 (4.2% versus 20.4%, P = .007). Multivariate analysis demonstrated an mFI ≥ 0.27 was significantly associated with an increased incidence of major complication (OR 2.80, 95% CI 1.46-5.35, P = .002), all complication (OR 2.93, 95% CI 1.70-15.11, P < .001), 6-month mortality (OR 7.39, 95% CI 2.55-21.43, P < .001) and surgical site infection (OR 4.43, 95% CI 1.71-11.51, P = .002). The American Society of Anesthesiologists’ (ASA) index did not share a stepwise relationship with any outcome. Conclusion: The mFI is significantly associated in a gradated fashion with increased morbidity and mortality. Patients with an mFI ≥ 0.27 are at greater risk of major complications, all-complications, 6-monthy mortality, and surgical site infection.


2015 ◽  
Vol 24 (10) ◽  
pp. 441-445 ◽  
Author(s):  
A. Kadar ◽  
G. Eisenberg ◽  
E. Yahav ◽  
M. Drexler ◽  
M. Salai ◽  
...  

2010 ◽  
Vol 27 (3) ◽  
pp. 224-231 ◽  
Author(s):  
Ting-Shuo Huang ◽  
Fu-Chang Hu ◽  
Chung-Wei Fan ◽  
Chun-Hui Lee ◽  
Shyh-Chuan Jwo ◽  
...  

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