Endoscopic Drainage of Pancreatic Pseudocysts: Long-Term Outcome and Procedural Factors Associated with Safe and Successful Treatment

Aims of our study were to describe the long-term survival in patients surviving an acute tubular necrosis (ATN) episode and determine factors associated with late mortality. We performed a prospective cohort study that evaluated the long-term outcome of 212 patients surviving an ATN episode. Mortality at the end of followup was 24.5%, and the probability of these patients being alive 5 years after discharge was 55%. During the followup, 4.7% of patients needed chronic dialysis. Univariate analysis showed that previous CKD (), cardiovascular disease (), age greater than 60 years (), and higher SCr baseline (), after 12 months () and 36 months (), were predictors of long-term mortality. In multivariate analysis, older age (HR = 6.4, CI 95% = 1.2–34.5, ) and higher SCr after 12 months (HR = 2.1, 95% CI 95% = 1.14–4.1, ) were identified as risk factors associated with late mortality. In conclusion, 55% of patients surviving an ATN episode were still alive, and less than 5% required chronic dialysis 60 months later; older age and increased Scr after 12 months were identified as risk factors associated with late death.

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Long-term outcome of extratemporal epilepsy surgery among 154 adult patients

Journal of Neurosurgery ◽

10.3171/jns/2008/108/4/0676 ◽

2008 ◽

Vol 108 (4) ◽

pp. 676-686 ◽

Cited By ~ 58

Author(s):

Alaa Eldin Elsharkawy ◽

Friedrich Behne ◽

Falk Oppel ◽

Heinz Pannek ◽

Reinhard Schulz ◽

...

Keyword(s):

Epilepsy Surgery ◽

Cox Regression ◽

Adult Patients ◽

Class I ◽

Seizure Outcome ◽

Term Outcome ◽

Long Term Outcome ◽

Factors Associated

Object The goal of this study was to evaluate the long-term outcome of patients who underwent extratemporal epilepsy surgery and to assess preoperative prognostic factors associated with seizure outcome. Methods This retrospective study included 154 consecutive adult patients who underwent epilepsy surgery at Bethel Epilepsy Centre, Bielefeld, Germany between 1991 and 2001. Seizure outcome was categorized based on the modified Engel classification. Survival statistics were calculated using Kaplan–Meier curves, life tables, and Cox regression models to evaluate the risk factors associated with outcomes. Results Sixty-one patients (39.6%) underwent frontal resections, 68 (44.1%) had posterior cortex resections, 15 (9.7%) multilobar resections, 6 (3.9%) parietal resections, and 4 (2.6%) occipital resections. The probability of an Engel Class I outcome for the overall patient group was 55.8% (95% confidence interval [CI] 52–58% at 0.5 years), 54.5% (95% CI 50–58%) at 1 year, and 51.1% (95% CI 48–54%) at 14 years. If a patient was in Class I at 2 years postoperatively, the probability of remaining in Class I for 14 years postoperatively was 88% (95% CI 78–98%). Factors predictive of poor long-term outcome after surgery were previous surgery (p = 0.04), tonic–clonic seizures (p = 0.02), and the presence of an auditory aura (p = 0.03). Factors predictive of good long-term outcome were surgery within 5 years after onset (p = 0.015) and preoperative invasive monitoring (p = 0.002). Conclusions Extratemporal epilepsy surgery is effective according to findings on long-term follow-up. The outcome at the first 2-year follow-up visit is a reliable predictor of long-term Engel Class I postoperative outcome.

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