Dialysis is an independent risk factor for perioperative adverse events, readmission, reoperation, and mortality for patients undergoing elective spine surgery

Abstract Background The prognostic value of perioperative diastolic dysfunction (PDD) in patients undergoing noncardiac surgery remains uncertain, and the current guidelines do not recognize PDD as a perioperative risk factor. This systematic review aimed to investigate whether existing evidence supports PDD as an independent predictor of adverse events after noncardiac surgery. Methods Ovid MEDLINE, PubMed, EMBASE, the Cochrane Library, and Google search engine were searched for English-language citations in April 2015 investigating PDD as a risk factor for perioperative adverse events in adult patients undergoing noncardiac surgery. Two reviewers independently assessed the study risk of bias. Extracted data were verified. Random-effects model was used for meta-analysis, and reviewers’ certainty was graded. Results Seventeen studies met eligibility criteria; however, 13 contributed to evidence synthesis. The entire body of evidence addressing the research question was based on a total of 3,876 patients. PDD was significantly associated with pulmonary edema/congestive heart failure (odds ratio [OR], 3.90; 95% CI, 2.23 to 6.83; 3 studies; 996 patients), myocardial infarction (OR, 1.74; 95% CI, 1.14 to 2.67; 3 studies; 717 patients), and the composite outcome of major adverse cardiovascular events (OR, 2.03; 95% CI, 1.24 to 3.32; 4 studies; 1,814 patients). Evidence addressing other outcomes had low statistical power, but higher long-term cardiovascular mortality was observed in patients undergoing open vascular repair (OR, 3.00; 95% CI, 1.50 to 6.00). Reviewers’ overall certainty of the evidence was moderate. Conclusion Evidence of moderate certainty indicates that PDD is an independent risk factor for adverse cardiovascular outcomes after noncardiac surgery.

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Racial Disparities in Surgical Outcomes After Spine Surgery: An ACS-NSQIP Analysis

Global Spine Journal ◽

10.1177/2192568218811633 ◽

2018 ◽

Vol 9 (6) ◽

pp. 583-590 ◽

Cited By ~ 1

Author(s):

Zachary Sanford ◽

Haley Taylor ◽

Alyson Fiorentino ◽

Andrew Broda ◽

Amina Zaidi ◽

...

Keyword(s):

Risk Factor ◽

Racial Disparities ◽

Spine Surgery ◽

Independent Risk Factor ◽

Lumbar Fusion ◽

Surgical Site Infections ◽

Postoperative Outcomes ◽

Cervical Fusion ◽

Acs Nsqip ◽

Comorbidity Burden

Study Design: Retrospective cohort study. Objectives: Racial disparities in postoperative outcomes are unfortunately common. We present data assessing race as an independent risk factor for postoperative complications after spine surgery for Native American (NA) and African American (AA) patients compared with Caucasians (CA). Methods: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried for spine procedures performed in 2015. Data was subdivided by surgery, demography, comorbidity, and 30-day postoperative outcomes, which were then compared by race. Regression was performed holding race as an independent risk factor. Results: A total of 4803 patients (4106 CA, 522 AA, 175 NA) were included in this analysis. AA patients experienced longer length of stay (LOS) and operative times ( P < .001) excluding lumbar fusion, which was significantly shorter ( P = .035). AA patients demonstrated higher comorbidity burden, specifically for diabetes and hypertension ( P < .005), while NA individuals were higher tobacco consumers ( P < .001). AA race was an independent risk factor associated with longer LOS across all cervical surgeries (β = 1.54, P <.001), lumbar fusion (β = 0.77, P = .009), and decompression laminectomy (β = 1.23, P < .001), longer operative time in cervical fusion (β = 12.21, P = .032), lumbar fusion (β = -24.00, P = .016), and decompression laminectomy (OR = 20.95, P < .001), greater risk for deep vein thrombosis in lumbar fusion (OR = 3.72, P = .017), and increased superficial surgical site infections (OR = 5.22, P = .001) and pulmonary embolism (OR = 5.76, P = .048) in decompression laminectomy. NA race was an independent risk factor for superficial surgical site infections following cervical fusion (OR = 14.58, P = .044) and decompression laminectomy (OR = 4.80, P = .021). Conclusion: AA and NA spine surgery patients exhibit disproportionate comorbidity burden and greater 30-day complications compared with CA patients. AA and NA race were found to independently affect rates of complications, LOS, and operation time.

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Independent Risk Factor Analysis for Major Cardiovascular Adverse Events in Patients with Mild Coronary Stenosis

10.21203/rs.2.14615/v2 ◽

2020 ◽

Author(s):

Wei Luo ◽

Ru Zhao ◽

YanQiu Song ◽

Hui Zhao ◽

WeiJun Ma ◽

...

Keyword(s):

Factor Analysis ◽

Risk Factor ◽

Adverse Events ◽

Coronary Stenosis ◽

Independent Risk Factor ◽

Risk Factor Analysis

Abstract The authors have withdrawn this preprint from Research Square

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Low Body Mass is a Negative Independent Risk Factor in Elective Cervical Spine Surgery

The Spine Journal ◽

10.1016/j.spinee.2016.07.365 ◽

2016 ◽

Vol 16 (10) ◽

pp. S267-S268

Author(s):

Cyrus M. Jalai ◽

Gregory W. Poorman ◽

Breton Line ◽

Shay Bess ◽

Shaleen Vira ◽

...

Keyword(s):

Risk Factor ◽

Cervical Spine ◽

Body Mass ◽

Spine Surgery ◽

Independent Risk Factor ◽

Cervical Spine Surgery

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Plasma von Willebrand Factor Levels Are an Independent Risk Factor for Adverse Events Including Mortality and Major Bleeding in Anticoagulated Atrial Fibrillation Patients

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2010.12.033 ◽

2011 ◽

Vol 57 (25) ◽

pp. 2496-2504 ◽

Cited By ~ 97

Author(s):

Vanessa Roldán ◽

Francisco Marín ◽

Begoña Muiña ◽

Jose Miguel Torregrosa ◽

Diana Hernández-Romero ◽

...

Keyword(s):

Atrial Fibrillation ◽

Risk Factor ◽

Adverse Events ◽

Von Willebrand Factor ◽

Major Bleeding ◽

Independent Risk Factor ◽

Von Willebrand ◽

Willebrand Factor

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Predictive Value of Electromechanical Activation Time for In-Hospital Major Cardiac Adverse Events in Heart Failure Patients

Cardiovascular Therapeutics ◽

10.1155/2020/4532596 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Jing Zhang ◽

Wen-Xian Liu ◽

Shu-Zheng Lyu

Keyword(s):

Heart Failure ◽

Risk Factor ◽

Adverse Events ◽

Roc Curve ◽

Predictive Value ◽

Independent Risk Factor ◽

Left Ventricular Ejection ◽

Activation Time ◽

End Points ◽

Cardiac Adverse Events

Objective. This prospective study aimed to evaluate the value of the cardiac cycle time-corrected electromechanical activation time (EMATc) measured at admission for predicting major cardiac adverse events (MACEs) in hospitalized patients with chronic heart failure (CHF). Methods. CHF patients with a left ventricular ejection fraction (LVEF) lower than 50% N=145 were enrolled in this study. Documented clinical end-points (MACEs) included cardiogenic death, onset of acute HF as assessed with invasive and noninvasive mechanical ventilation, and cardiogenic shock. According to the different clinical end-points, patients were divided into two groups: a MACE group n=22 and a nonMACE group n=123. EMATc, LVEF, and circulating levels of B type natriuretic peptide (BNP) and Troponin I (TnI) were measured. Multivariate logistic regression analysis was used to examine the association between EMATc and MACEs. The parameters adjusted in the multivariable model included EMATc, BNP, and heart rate. The predictive value of EMATc was evaluated by receiver operating characteristic (ROC) curve analysis. Results. Elevated EMATc was an independent risk factor for MACEs (odds ratio [OR] 1.1443, 95% confidence interval [CI] 1.016–1.286, P=0.027). The area under the ROC curve for EMATc was 0.799 (95% CI 0.702–0.896, P<0.001). The optimal cutoff EMATc value was >13.8% with a sensitivity of 81.8% and a specificity of 65.9%. Conclusions. We demonstrated that an elevated EMATc measured at admission is an independent risk factor for MACEs among hospitalized CHF patients. Acoustic cardiography measured at admission may provide a simple, noninvasive method for risk stratification of CHF patients. This trial is registered with ChiCTR1900021470.

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