scholarly journals Clinical outcomes of early infective endocarditis vegetation extraction with AngioVac sytem

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
E Chang
Keyword(s):  
Infective Endocarditis ◽  
Length Of Stay ◽  
Heart Surgery ◽  
Inflammatory Marker ◽  
Open Heart Surgery ◽  
Right Heart Failure ◽  
Hospital Length Of Stay ◽  
Average Hospital ◽  
Surgical Extraction ◽  
Percutaneous Extraction

Abstract Funding Acknowledgements Type of funding sources: None. Purpose  To describe our institutional experience in right-sided vegetation extraction using a percutaneous system and report our outcomes including mortality, ICU length of stay (LOS), hospital length of stay, decline in inflammatory markers, leukocytosis and bacteremia.  Background Right-sided infective endocarditis (IE) has become increasingly common due to the growing incidence of intravenous drugs use (IVDU). Patients with large vegetations are often considered candidates for surgical extraction. However, high rates of recurrence in IVDU population and high surgical mortality are prohibitive of surgeries. Percutaneous extraction of right-sided masses has become an alternative to open heart surgery and can be performed with lower morbidity and mortality in patients with right sided IE.  Percutaneous vegetation extraction facilitates functional recovery in critical care setting and influence outcomes in patients with elevated perioperative risk or concerns for recurrent IE. Methods A total of 3 patients with right sided IE underwent percutaneous vegetation extraction with AngioVac® system (AngioDynamics Inc., Latham, NY) under combined fluoroscopy and transesophageal echocardiography (TEE) guidance. Results In hospital mortality was 0%,  average ICU LOS was 8 days and average hospital LOS was 4 weeks. There was a decrease in inflammatory marker and white blood cell (WBC) count after AngioVac procedure. Conclusion We report our experience with high risk IE patients. These patients had large vegetations, persistent bacteremia, right heart failure with prohibitive risk profiles during the perioperative period. AngioVac was effective in reducing bacteremia burden and reducing ICU stay. There were no procedure related complications. Overall percutaneous extraction of right-sided masses and vegetations have the potential of improving outcomes, reducing complications and healthcare costs in patients with right-sided IE. Table 1AgeSexVegetation LocationDevice usedMicroorganismPatient intubated for the procedure (y/n)ICU LOSHospital LOSDischarge death or aliveDecrease in WBCDecrease in ESRPatient #122MTVAngioVacMSSAY2 days3 weeksAlive768Patient #2`38MTVAngioVacMSSAY1 day2 weeksAlive229Patient #334FTV, RVOTAngioVacMRSAY20 days8 weeksAlive8Clinical characteristics and outcomes of patients with IE undergoing percutaneous extractions of right-sided vegetationsAbstract Figure. Picture 1

scholarly journals The Effect of Early Mobilization on ICU and Hospital Length of Stay and Its Impact on the Cost of Care in Post-Open Heart Surgery Patients: A Randomized Control Trial (RCT)

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Takroni MA ◽  
Albarrati A ◽  
Akomolafe T ◽  
Al Enazy M
Keyword(s):  
Length Of Stay ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Early Mobilization ◽  
Hospital Length ◽  
Cost Of Care ◽  
Hospital Length Of Stay ◽  
The Past ◽  
Randomized Control ◽  
The Cost

Introduction: Early Mobilization (EM) of patients in Intensive Care Unit (ICU) has received considerable attention in scientific literature over the past several years. It has been reported that EM decrease Hospital Length of Stay (LOS).

30-Day Outcomes for Total Ankle Arthroplasty in Patients With Anemia

2021 ◽  
pp. 107110072110175
Author(s):  
Jordan R. Pollock ◽  
Matt K. Doan ◽  
M. Lane Moore ◽  
Jeffrey D. Hassebrock ◽  
Justin L. Makovicka ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Univariate Analysis ◽  
Hospital Length ◽  
Total Ankle Arthroplasty ◽  
Hospital Length Of Stay ◽  
Preoperative Anemia ◽  
Improvement Project ◽  
Average Hospital ◽  
Ankle Arthroplasty ◽  
Reoperation Rates

Background: While anemia has been associated with poor surgical outcomes in total knee arthroplasty and total hip arthroplasty, the effects of anemia on total ankle arthroplasty remain unknown. This study examines how preoperative anemia affects postoperative outcomes in total ankle arthroplasty. Methods: A retrospective analysis was performed using the American College of Surgeons National Surgery Quality Improvement Project database from 2011 to 2018 for total ankle arthroplasty procedures. Hematocrit (HCT) levels were used to determine preoperative anemia. Results: Of the 1028 patients included in this study, 114 patients were found to be anemic. Univariate analysis demonstrated anemia was significantly associated with an increased average hospital length of stay (2.2 vs 1.8 days, P < .008), increased rate of 30-day readmission (3.5% vs 1.1%, P = .036), increased 30-day reoperation (2.6% vs 0.4%, P = .007), extended length of stay (64% vs 49.9%, P = .004), wound complication (1.75% vs 0.11%, P = .002), and surgical site infection (2.6% vs 0.6%, P = .017). Multivariate logistic regression analysis found anemia to be significantly associated with extended hospital length of stay (odds ratio [OR], 1.62; 95% CI, 1.07-2.45; P = .023) and increased reoperation rates (OR, 5.47; 95% CI, 1.15-26.00; P = .033). Anemia was not found to be a predictor of increased readmission rates (OR, 3.13; 95% CI, 0.93-10.56; P = .066) or postoperative complications (OR, 1.27; 95% CI, 0.35-4.56; P = .71). Conclusion: This study found increasing severity of anemia to be associated with extended hospital length of stay and increased reoperation rates. Providers and patients should be aware of the increased risks of total ankle arthroplasty with preoperative anemia. Level of Evidence: Level III, retrospective comparative study.

scholarly journals Influence of biomarkers level during follow-up when operating under cardiopulmonary bypass

2015 ◽  
Vol 18 (3) ◽  
pp. 39
Author(s):  
Yu. I. Petrishchev ◽  
A. L. Levit ◽  
I. N. Leyderman
Keyword(s):  
Cardiac Surgery ◽  
Length Of Stay ◽  
Plasma Levels ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Cardiac Surgeons ◽  
The Given ◽  
The Relationship

Systemic inflammatory response was first determined in 1980 and cardiac surgeons turned to it in 1996. At present, there are a lot of publications on this issue, however, the extent of operation and duration of CPB are considered in clinical practice as crucial indicators of severity of patient's condition following cardiac surgery. In our study we tried to look at this problem from a different perspective and draw a parallel between the severity of patient's condition resulting from operational trauma and CPB. We included 48 patients who under-went cardiac surgery under CPB. Plasma levels of procalcitonin (PCT), lactate and interleukin-6 were investigated before the operation, after CPB and at 24 hours. Also revealed was the relationship between the plasma levels of IL-6, lactate and PCT (r = 0.53; p = 0.000 in both cases). The level of PCT at the 3rd stage was found to relate to the duration of CPB (r = 0.4; p = 0.005), ALV (r = 0.44; p = 0.001) and length of stay at ICU (r = 0.53; p = 0.000). We didn't manage to find any relationship between the length of stay at ICU and the duration of CPB. Correlation between the PCT plasma level and the duration of intensive care indicates the importance of dynamics of the given biomarker for early prediction of follow-up course after open-heart surgery.

scholarly journals Postcaesarean open-heart surgery for Streptococcus sanguinis infective endocarditis

2013 ◽  
Vol 2013 (nov14 1) ◽  
pp. bcr2013010103-bcr2013010103 ◽  
Author(s):  
K. Kongwattanakul ◽  
S. Tribuddharat ◽  
S. Prathanee ◽  
O. Pachirat
Keyword(s):  
Infective Endocarditis ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Streptococcus Sanguinis

Surgical Site Infection After Pediatric Cardiothoracic Surgery

2016 ◽  
Vol 8 (1) ◽  
pp. 7-12 ◽  
Author(s):  
Anthony A. Sochet ◽  
Alexander M. Cartron ◽  
Aoibhinn Nyhan ◽  
Michael C. Spaeder ◽  
Xiaoyan Song ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Surgical Site Infection ◽  
Heart Surgery ◽  
Hospital Costs ◽  
Congenital Heart Surgery ◽  
Hospital Length ◽  
Cardiothoracic Surgery ◽  
Hospital Length Of Stay ◽  
Published Data ◽  
Site Infection

Background: Surgical site infection (SSI) occurs in 0.25% to 6% of children after cardiothoracic surgery (CTS). There are no published data regarding the financial impact of SSI after pediatric CTS. We sought to determine the attributable hospital cost and length of stay associated with SSI in children after CTS. Methods: We performed a retrospective, matched cohort study in a 26-bed cardiac intensive care unit (CICU) from January 2010 through December 2013. Cases with SSI were identified retrospectively and individually matched to controls 2:1 by age, gender, Risk Adjustment for Congenital Heart Surgery score, Society of Thoracic Surgeons–European Association for Cardiothoracic Surgery category, and primary cardiac diagnosis and procedure. Results: Of the 981 cases performed during the study period, 12 with SSI were identified. There were no differences in demographics, clinical characteristics, or intraoperative data. Median total hospital costs were higher in participants with SSI as compared to controls (US$219,573 vs US$82,623, P < .01). Children with SSI had longer median CICU length of stay (9 vs 3 days, P < .01), hospital length of stay (18 vs 8.5 days, P < .01), and duration of mechanical ventilation (2 vs 1 day, P < .01) and vasoactive administration (4.5 vs 1 day, P < .01). Conclusions: Children with SSI after CTS have an associated increase in hospital costs of US$136,950/case and hospital length of stay of 9.5 days/case. The economic burden posed by SSI stress the importance of infection control surveillance, exhaustive preventative measures, and identification of modifiable risk factors.

scholarly journals 2286. Evaluating the Impact of Ceftolozane/Tazobactam on Clinical Outcomes in Patients with Multi-Drug-resistant Pseudomonas aeruginosa Pneumonia

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S783-S784
Author(s):  
Matthew Mills ◽  
Ashley MacWhinnie ◽  
Timmy Do
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Length Of Stay ◽  
Clinical Cure ◽  
Standard Of Care ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Multi Drug Resistance ◽  
Average Hospital ◽  
Definitive Therapy ◽  
The Impact

Abstract Background Ceftolozane/tazobactam is a novel cephalosporin and β-lactamase inhibitor antibiotic that has shown to have potent activity against Pseudomonas aeruginosa including strains exhibiting multi-drug resistance (MDR). The purpose of this study was to evaluate ceftolozane/tazobactam efficacy in MDR P. aeruginosa pneumonia compared with historical standard of care. Methods This was a retrospective cohort study of patients hospitalized across AdventHealth Central Florida campuses with MDR P. aeruginosa pneumonia from January 1, 2017 through December 31, 2018. This study included patients ≥ 18 years of age with a diagnosis of pneumonia and a positive respiratory culture with MDR P. aeruginosa. The primary outcome of this study was the rate of clinical cure by day 14 of definitive therapy. Secondary outcomes included 30-day readmission rate, average hospital length of stay (LOS), cost of admission, average ICU LOS after initiation of definitive antibiotic, and total days of antibiotic exposure for pneumonia. Data were analyzed with statistical computer software utilizing independent samples t-test and chi square tests of independence as appropriate. Results A total of 115 patients were included in the final analysis, 62 patients treated with ceftolozane/tazobactam and 53 patients treated with historical standard of care. Rate of clinical cure was similar between patients treated with ceftolozane/tazobactam, 72.6% (n = 45), and those treated with historical standard of care, 67.9% (n = 36), {X2 (1) = 0.297, p = 0.683}. Other outcomes assessed were also similar between groups except for average hospital length of stay (42.7 days vs. 30.3 days t(113) = 2.054, p = 0.042), and cost of admission ($78,550 vs. $47,681, t(113) = 2.458, p = 0.016), which were significantly greater in the ceftolozane/tazobactam treatment group. Conclusion In patients diagnosed with MDR P. aeruginosa pneumonia, clinical cure rates were not significantly different between those treated with ceftolozane/tazobactam compared with historical standard of care. Significantly greater hospital length of stay and cost of admission was associated with use of ceftolozane/tazobactam, although many patient factors may have influenced these results. Disclosures All authors: No reported disclosures.

Sign in / Sign up

Export Citation Format

Share Document