A scoring system to predict postoperative medical complications in high-risk patients undergoing elective thoracic and lumbar arthrodesis

2016 ◽  
Vol 16 (6) ◽  
pp. 694-699 ◽  
Author(s):  
Jacqueline L. Munch ◽  
Natalie L. Zusman ◽  
Elizabeth G. Lieberman ◽  
Ryland S. Stucke ◽  
Courtney Bell ◽  
...  
Keyword(s):  
High Risk ◽  
Scoring System ◽  
Medical Complications ◽  
High Risk Patients ◽  
Risk Patients ◽  
Lumbar Arthrodesis

scholarly journals MIPSS70+ v2.0 predicts long-term survival in myelofibrosis after allogeneic HCT with the Flu/Mel conditioning regimen

2019 ◽  
Vol 3 (1) ◽  
pp. 83-95 ◽  
Author(s):  
Haris Ali ◽  
Ibrahim Aldoss ◽  
Dongyun Yang ◽  
Sally Mokhtari ◽  
Samer Khaled ◽  
...  
Keyword(s):  
Molecular Markers ◽  
High Risk ◽  
Scoring System ◽  
Conditioning Regimen ◽  
International Prognostic Scoring System ◽  
Intermediate Risk ◽  
High Risk Patients ◽  
Risk Patients ◽  
Transplantation Outcomes ◽  
Very High

Abstract Although allogeneic hematopoietic cell transplantation (allo-HCT) is the only curative treatment for myelofibrosis (MF), data are limited on how molecular markers predict transplantation outcomes. We retrospectively evaluated transplantation outcomes of 110 consecutive MF patients who underwent allo-HCT with a fludarabine/melphalan (Flu/Mel) conditioning regimen at our center and assessed the impact of molecular markers on outcomes based on a 72-gene next-generation sequencing panel and Mutation-Enhanced International Prognostic Scoring System 70+ v2.0 (MIPSS70+ v2.0). With a median follow-up of 63.7 months, the 5-year overall survival (OS) rate was 65% and the nonrelapse mortality (NRM) rate was 17%. In mutational analysis, JAK2 V617F and ASXL1 mutations were the most common. By univariable analysis, higher Dynamic International Prognostic Scoring System scores, unrelated donor type, and very-high-risk cytogenetics were significantly associated with lower OS. Only CBL mutations were significantly associated with lower OS (hazard ratio [HR], 2.64; P = .032) and increased NRM (HR, 3.68; P = .004) after allo-HCT, but CALR, ASXL1, and IDH mutations did not have an impact on transplantation outcomes. Patient classification per MIPSS70 showed worse OS for high-risk (HR, 0.49; P = .039) compared with intermediate-risk patients. Classification per MIPSS70+ v2.0 demonstrated better OS when intermediate-risk patients were compared with high-risk patients (HR, 0.291) and much lower OS when very-high-risk patients were compared with high-risk patients (HR, 5.05; P ≤ .001). In summary, we present one of the largest single-center experiences of Flu/Mel-based allo-HCT, demonstrating that revised cytogenetic changes and MIPSS70+ v2.0 score predict transplantation outcomes, and thus can better inform physicians and patients in making decisions about allo-HCT.

6070 POSTER Non Elective Colon Cancer Resections in the Dutch Surgical Colorectal Audit, a Scoring System to Identify High Risk Patients

2011 ◽  
Vol 47 ◽  
pp. S412
Author(s):  
N. Kolfschoten ◽  
M.W.J.M. Wouters ◽  
G.A. Gooiker ◽  
E.H. Eddes ◽  
J. Kievit ◽  
...  
Keyword(s):  
Colon Cancer ◽  
High Risk ◽  
Scoring System ◽  
High Risk Patients ◽  
Risk Patients ◽  
Elective Colon

scholarly journals APACHE IV system helps to determine cholecystostomy role in elderly patients with acute cholecystitis

2020 ◽  
Author(s):  
Hua Jiang ◽  
Guo Guo ◽  
Zhimin Yao ◽  
Yuehua Wang
Keyword(s):  
High Risk ◽  
Acute Cholecystitis ◽  
Therapeutic Effect ◽  
Scoring System ◽  
Scoring Systems ◽  
Percutaneous Cholecystostomy ◽  
High Risk Patients ◽  
Before And After ◽  
Risk Patients ◽  
Apache Iv

Abstract Background Cholecystostomy offers an alternative method for patients unfit to undergo immediate cholecystectomy. Nevertheless, the role of cholecystostomy in the clinical management of high-risk surgical patients remains unclear. One of the main problems concerning the therapeutic effect in critically ill patients with acute cholecystitis is the lack of validated, well-established scoring systems to stratify the severity of patient disease states. APACHE IV scoring system was useful to estimate the hospital mortality for high-risk patients. We try to evaluate the performance of the APACHE IV scoring system in patients over 65 years of age with acute cholecystitis and the therapeutic effect of percutaneous cholecystostomy. Methods 597 patients over 65 years of age with acute cholecystitis between January 2011 and December 2018 were retrospectively analyzed with the APACHE IV scores. Results Among the 597 patients, 52 successfully underwent cholecystectomy (2 died, 3.85%), 65 underwent percutaneous cholecystostomy (1 died, 1.54%), and 480 received conservative therapy (27 died, 5.63%). The fitness of the APACHE IV score prediction is good with the area under the ROC curve of 0.894. The APACHE IV models were well-calibrated (with the Hosmer-Lemeshow statistic). Using the method of binary regression analysis, for the patients whose estimated mortality rate was more than 10%, cholecystostomy was an important factor for prognosis (P = 0.048). The estimated mortality of PC patients before and after operation was compared, which indicated that the estimated mortality after puncture was significantly decreased, either in the whole patient group (P = 0.004) or in the group with an estimated mortality greater than 10% (P = 0.008). Conclusion The APACHE IV scoring system showed that cholecystostomy was a safe and effective treatment for elderly high-risk patients with acute cholecystitis.

scholarly journals APACHE IV system helps to determine role of cholecystostomy in elderly patients with acute cholecystitis

2021 ◽  
Vol 49 (11) ◽  
pp. 030006052110592
Author(s):  
Hua Jiang ◽  
Guo Guo ◽  
Zhimin Yao ◽  
Yuehua Wang
Keyword(s):  
High Risk ◽  
Acute Cholecystitis ◽  
Scoring System ◽  
Characteristic Curve ◽  
Chi Square ◽  
High Risk Patients ◽  
Before And After ◽  
Risk Patients ◽  
Apache Iv

Objective Cholecystostomy is a palliative treatment for patients unfit to undergo immediate cholecystectomy. Nevertheless, the role of cholecystostomy in the clinical management of such patients remains unclear. The Acute Physiology and Chronic Health Evaluation IV (APACHE IV) scoring system is useful for estimating the hospital mortality of high-risk patients. We evaluated the therapeutic effect of cholecystostomy by the APACHE IV scoring system in patients aged >65 years with acute cholecystitis. Methods In total, 597 patients aged >65 years with acute cholecystitis were retrospectively analyzed using APACHE IV scores. Results The fitness of the APACHE IV score prediction was good, with an area under the receiver operating characteristic curve of 0.894. The chi square independence test indicated that compared with conservative treatment, cholecystostomy may have different effects on mortality for patients whose estimated mortality rate was >10%. Comparison of the estimated mortality of patients before and after cholecystostomy indicated that the estimated mortality was significantly lower after than before puncture, both in the whole patient group and in the group with an estimated mortality of >10%. Conclusion The APACHE IV scoring system showed that cholecystostomy is a safe and effective treatment for elderly high-risk patients with acute cholecystitis.

Validation of the Apfel scoring system for identification of High-risk patients for PONV

2015 ◽  
Vol 1 (3) ◽  
pp. 115 ◽  
Author(s):  
Lulu Sherif ◽  
Radhesh Hegde ◽  
Mallikajaya Mariswami ◽  
Anjali Ollapally
Keyword(s):  
High Risk ◽  
Scoring System ◽  
High Risk Patients ◽  
Risk Patients

Validate Glasgow Blatchford Scoring System for Detecting High Risk Patients With Non Variceal Upper Gastrointestinal Bleed

2011 ◽  
Vol 140 (5) ◽  
pp. S-741
Author(s):  
Ashish Zalawadia ◽  
Ravish Parekh ◽  
Bassam Yaghmour ◽  
George Yaghmour ◽  
Gregory Buran
Keyword(s):  
High Risk ◽  
Scoring System ◽  
High Risk Patients ◽  
Gastrointestinal Bleed ◽  
Upper Gastrointestinal Bleed ◽  
Risk Patients ◽  
Upper Gastrointestinal

Scoring system for the selection of high-risk patients in the intensive care unit

2006 ◽  
Vol 34 (4) ◽  
pp. 1039-1043 ◽  
Author(s):  
Gaetano Iapichino ◽  
Giovanni Mistraletti ◽  
Davide Corbella ◽  
Gabriele Bassi ◽  
Erika Borotto ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
High Risk ◽  
Scoring System ◽  
High Risk Patients ◽  
Risk Patients ◽  
Selection Of

CHA2DS2-VASc scoring system as an initial method for screening high-risk patients in acute myocardial infarction

2014 ◽  
Vol 174 (3) ◽  
pp. 777-780 ◽  
Author(s):  
Young Wook Jeong ◽  
Myung Ho Jeong ◽  
Sung Soo Kim ◽  
Shi Hyun Rhew ◽  
Youngkeun Ahn ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
High Risk ◽  
Scoring System ◽  
High Risk Patients ◽  
Risk Patients ◽  
Initial Method

scholarly journals Development and Validation of a Post-Operative Non-Union Risk Score for Subtrochanteric Femur Fractures

2021 ◽  
Vol 10 (23) ◽  
pp. 5632
Author(s):  
Michalis Panteli ◽  
James S. H. Vun ◽  
Robert M. West ◽  
Anthony J. Howard ◽  
Ippokratis Pountos ◽  
...  
Keyword(s):  
Logistic Regression ◽  
High Risk ◽  
Risk Score ◽  
Scoring System ◽  
Subtrochanteric Fracture ◽  
Non Union ◽  
High Risk Patients ◽  
Femur Fractures ◽  
Post Operative Period ◽  
Risk Patients

Background: Our objective was to develop and validate a predictive model for non-union following a subtrochanteric fracture of the femur. Methods: Following institutional board approval, 316 consecutive patients presenting to our institution (84 non-unions) who fulfilled the inclusion criteria were retrospectively identified. To identify potential unadjusted associations with progression to non-union, simple logistic regression models were used, followed by a revised adjusted model of multiple logistic regression. Results: Having established the risk factors for non-union, the coefficients were used to produce a risk score for predicting non-union. To identify the high-risk patients in the early post-operative period, self-dynamisation was excluded. The revised scoring system was the sum of the following: diabetes (6); deep wound infection (35); simple or severe comminution (13); presence of an atypical fracture (14); lateral cortex gap size ≥5 mm (11), varus malreduction (5–10 degrees) (9); varus malreduction (>10 degrees) (20). On the ROC (receiver operating characteristic) curve, the area under the curve (0.790) demonstrated very good discriminatory capability of the scoring system, with good calibration (Hosmer–Lemeshow test; p = 0.291). Moreover, 5-fold cross validation confirmed good fit of the model and internal validity (accuracy 0.806; Kappa 0.416). The cut-point determined by Youden’s formula was calculated as 18. Conclusion: This study demonstrates that the risk of non-union can be reliably estimated in patients presenting with a subtrochanteric fracture, from the immediate post-operative period. The resulting non-union risk score can be used not only to identify the high-risk patients early, offering them appropriate consultation and in some cases surgical intervention, but also informs surgeons of the modifiable surgery related factors that contribute to this risk.

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