scholarly journals Long‐term outcomes and risk factors of recurrent biliary obstruction after permanent endoscopic biliary stenting for choledocholithiasis in high‐risk patients

2020 ◽  
Vol 21 (4) ◽  
pp. 246-251
Author(s):  
Ryo Sugiura ◽  
Hirohito Naruse ◽  
Hiroaki Yamato ◽  
Taiki Kudo ◽  
Yoshiya Yamamoto ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Biliary Obstruction ◽  
Biliary Stenting ◽  
Long Term Outcomes ◽  
Endoscopic Biliary Stenting ◽  
High Risk Patients ◽  
Risk Patients

scholarly journals Surgical treatment of valve endocarditis in high-risk patients and predictors of long-term outcomes

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Giuseppe Nasso ◽  
Giuseppe Santarpino ◽  
Marco Moscarelli ◽  
Ignazio Condello ◽  
Angelo Maria Dell’Aquila ◽  
...  
Keyword(s):  
Risk Factors ◽  
Infective Endocarditis ◽  
High Risk ◽  
Aortic Valve ◽  
Hospital Mortality ◽  
Long Term Outcomes ◽  
High Risk Patients ◽  
Risk Patients

AbstractInfective endocarditis represents a surgical challenge associated with perioperative mortality. The aim of this study is to evaluate the predictors of operative mortality and long-term outcomes in high-risk patients. We retrospectively analyzed 123 patients operated on for infective endocarditis from January 2011 to December 2020. Logistic regression model was used to identify prognostic factors of in-hospital mortality. Long term follow-up was made to asses late prognosis. Preoperative renal failure, an elevation EuroSCORE II and prior aortic valve re-replacement were found to be preoperative risk factors significantly associated with mortality. In-hospital mortality was 27% in patients who had previously undergone aortic valve replacement (n = 4 out of 15 operated, p = 0.01). Patients who were operated on during the active phase of infective endocarditis showed a higher mortality rate than those operated on after the acute phase (16% vs. 0%; p = 0.02). The type of prosthesis used (biological or mechanical) was not associated with mortality, whereas cross-clamp time significantly correlated with mortality (mean cross-clamp time 135 ± 65 min in dead patients vs. 76 ± 32 min in surviving patients; p = 0.0005). Mean follow up was 57.94 ± 30.9 months. Twelve patients died (11.65%). Among the twelve mortalities, five were adjudicated to cardiac causes and seven were non-cardiac (two cancers, one traumatic accident, one cerebral hemorrhage, two bronchopneumonia, one peritonitis). Overall survival probability (freedom from death, all causes) at 3, 5, 7 and 8 years was 98.9% (95% CI 97–100%), 96% (95% CI 92–100%), 85.9% (95% CI 76–97%), and 74% (95% CI 60–91%) respectively. Our study demonstrates that an early surgical approach may represent a valuable treatment option for high-risk patients with infective endocarditis, also in case of prosthetic valve endocarditis. Although several risk factors are associated with higher mortality, no patient subset is inoperable. These findings can be helpful to inform decision-making in heart team discussion.

Laparoscopic Sleeve Gastrectomy for High-Risk Patients in a Monocentric Series: Long-Term Outcomes and Predictors of Success

2019 ◽  
Vol 29 (11) ◽  
pp. 3629-3637 ◽  
Author(s):  
Aurora Gil–Rendo ◽  
José Ramón Muñoz-Rodríguez ◽  
Francisco Domper Bardají ◽  
Bruno Menchén Trujillo ◽  
Fernando Martínez-de Paz ◽  
...  
Keyword(s):  
Sleeve Gastrectomy ◽  
High Risk ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Predictors Of Success ◽  
Long Term Outcomes ◽  
High Risk Patients ◽  
Risk Patients

Tu1414 Long-Term Prognosis After Biliary Stenting for Common Bile Duct Stones in Elderly High-Risk Patients

2017 ◽  
Vol 85 (5) ◽  
pp. AB616
Author(s):  
Yu Akazawa ◽  
Masahiro Ohtani ◽  
Takuto Nosaka ◽  
Yasushi Saito ◽  
Kazuto Takahashi ◽  
...  
Keyword(s):  
High Risk ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Common Bile Duct Stones ◽  
Bile Duct Stones ◽  
Biliary Stenting ◽  
High Risk Patients ◽  
Risk Patients ◽  
Long Term Prognosis

scholarly journals TCT-695 A Gender-Specific Look at MitraClip Therapy in Surgical High-Risk Patients: Acute and Long-Term Outcomes

2013 ◽  
Vol 62 (18) ◽  
pp. B212
Author(s):  
Michael Schlüter ◽  
Daniel Lubs ◽  
Edith Lubos ◽  
Volker Rudolph ◽  
Hendrik Treede ◽  
...  
Keyword(s):  
High Risk ◽  
Long Term Outcomes ◽  
High Risk Patients ◽  
Risk Patients ◽  
Gender Specific ◽  
Mitraclip Therapy

scholarly journals Factors Determining Periprocedural and Long-term Complications of High Risk Carotid Artery Stenting

2015 ◽  
Vol 42 (1) ◽  
pp. 48-54
Author(s):  
Vincent Dinculescu ◽  
Anne C.M. Ritter ◽  
Marlise P. dos Santos ◽  
Ravi M. Mohan ◽  
Betty A. Schwarz ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Large Scale ◽  
High Risk Patient ◽  
Patient Characteristics ◽  
High Risk Patients ◽  
Risk Patients

ABSTRACTBackground and Purpose: Carotid artery stenting (CAS) has been, historically, an alternative to open endarterectomy (CEA) for stroke prevention in high risk patients with carotid atherosclerosis. We sought to determine the rates of periprocedural and long-term stroke or death and the risk factors for complications after CAS in our high risk patient population. Methods: Clinical and treatment variables of consecutive CAS procedures performed between 2002 and 2011 were analyzed. Using univariate and multivariate logistic regression analyses we examined how patient characteristics influenced outcomes and changes in modified Rankin Score (mRS). Results: In 152 patients, the composite total of periprocedural death, stroke, transient ischemic attack (TIA) and myocardial infarction (MI) rate was 3.95% (6/152). Chronic kidney disease (CKD) was strongly associated with periprocedural complications (p<0.001). Coronary artery disease/peripheral vascular disease (CAD/PVD) (p=0.03), dyslipidemia (p=0.02), CKD (p=0.01), and contralateral internal carotid artery stenosis (p=0.02) were non-modifiable risk factors for mRS increase. There were 25 deaths, 8 strokes, 11 TIAs, and 1 MI (mean follow-up 38.4 months, range 0-116 months). The presence of CAD/PVD (p=0.009) and dyslipidemia (p=0.002) were significantly associated with long-term complications. Conclusion: CAS was performed with low periprocedural complications in high-risk patients. Our rates compare very favorably to large-scale trials that have ideal patients. This data encourages the consideration of CAS in patients considered high risk for CEA and provides possible patient characteristics (CKD) to help with periprocedural risk stratification.

scholarly journals RS11. Long-Term Outcomes of EVAR and EVAR With Hypogastric Branch Placement in High Risk Patients

2016 ◽  
Vol 63 (6) ◽  
pp. 144S-145S
Author(s):  
Mohammad Abbasi ◽  
Matthew Eagleton ◽  
Corey Brier
Keyword(s):  
High Risk ◽  
Long Term Outcomes ◽  
High Risk Patients ◽  
Risk Patients

The Role of Peritoneal Lavage and the Prognostic Significance of Mesothelial Cell Area in Preventing Encapsulating Peritoneal Sclerosis

2010 ◽  
Vol 30 (3) ◽  
pp. 343-352 ◽  
Author(s):  
Tadashi Yamamoto ◽  
Kyoko Nagasue ◽  
Senji Okuno ◽  
Tomoyuki Yamakawa
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Risk Ratio ◽  
Peritoneal Lavage ◽  
Prognostic Significance ◽  
Mesothelial Cell ◽  
Cell Area ◽  
High Risk Patients ◽  
Risk Patients

♦ BackgroundSevere peritoneal injury and encapsulating peritoneal sclerosis (EPS) as complications of long-term peritoneal dialysis (PD) are issues of concern. The usefulness of peritoneal lavage after withdrawal of PD and the risk factors for EPS have not been addressed until now. Little is known about mesothelial cell area (MCA) in the effluent as a marker of peritoneal injury. In the present study, we investigated the clinical significance of peritoneal lavage after PD withdrawal and tried to clarify the risk factors related to MCA, with the aim of preventing EPS. We also developed an algorithm for the clinical management of long-term PD patients.♦ MethodsWe assigned 247 PD patients to one of two cohorts after PD withdrawal: a non-lavage group (73 patients) and a lavage group (174 patients). To clarify the risk factors, we studied these potential predictors: PD duration, dialysate-to-plasma ratio of creatinine (D/P Cr) at the time of PD withdrawal, frequency of peritoneal lavage, type of PD or lavage solution, MCA at the time of PD withdrawal (“PD area”), and MCA at the time of peritoneal lavage withdrawal or censoring (“LA area”). Recurrent intestinal obstruction was defined as the main manifestation of EPS. Diagnostic performance and cut-off values were then calculated for the selected risk factors.♦ ResultsThe overall incidence of EPS was significantly lower in the lavage group, at 6.9% (5.2% during lavage and 2.5% after lavage), than in the non-lavage group, at 15.1%. The risk factors and cut-off values were PD area (350 μm2) and PD duration (78 months) for the non-lavage group; and PD area (350 μm2) and LA area (320 μm2) for the lavage group. Patients with a PD duration of 78 months or more and a PD area of 350 μm2or more were defined as high-risk patients in the non-lavage group (risk ratio: 11.14), and patients with a PD area of 350 μm2or more and an LA area of 320 μm2or more were defined as high-risk patients in the lavage group (risk ratio: 10.43).♦ ConclusionsPeritoneal lavage is effective in reducing the incidence of EPS after PD withdrawal. The PD duration and MCA are significant risk factors, and these markers are useful for classifying patients into low- and high-risk groups for the development of EPS.

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