Ultrasonographic‐based predictive factors influencing successful return to racing after superficial digital flexor tendon injuries in flat racehorses: A retrospective cohort study in 469 Thoroughbred racehorses in Hong Kong

Abstract Aim Flexor tendon repairs are commonly performed under general/regional anaesthesia. Wide-awake local anaesthetic no tourniquet (WALANT) has potential advantages including the ability to test the repair intra-operatively; removal of the risks of general anaesthesia; no aerosol generation, thus reducing COVID-19 transmission risk. An ongoing systematic review identified no comparative studies. This study aimed to compare the functional outcomes and complications of flexor tendon repairs under WALANT and general/regional anaesthetic. Method A single-centre, retrospective cohort study was undertaken (July 2019-August 2020). Consecutive adult patients undergoing flexor tendon repair were included. Exclusion criteria were ≥ 3 injured fingers; concurrent hand fracture; revascularisation; replantation. Data were collected on demographics, injuries, operative technique, and outcomes. Results Overall, 139 patients with 165 injured digits were included. Most (60%) were repaired under general anaesthesia. Local anaesthetic (was used for 46 patients (21 with tourniquet, 25 WALANT). Only 30% (42/139) patients had range of motion data at 6-weeks, dropping to 19% (26/139) at 12-weeks. WALANT patients had fewer ruptures (8% vs 14%), fewer adhesions requiring tenolysis (0% vs 4%) and less complications overall than the general/regional anaesthesia group. The results were not found to be statistically significant. Conclusions The lack of data due to patients not attending follow-up, makes meaningful research on flexor tendon injuries very challenging. This study suggests WALANT may reduce complications but is limited by the inherent bias of a retrospective, non-randomised study, and small numbers. Adequately designed and powered studies are recommended in future to further investigate the potential benefits of wide-awake surgery.

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A Retrospective Cohort Study to Determine Predictive Factors for Abdominal Wound Disruption Following Colorectal Surgery

Wound Management & Prevention ◽

10.25270/owm.2018.4.2229 ◽

2018 ◽

Vol 64 (4) ◽

pp. 22-29

Author(s):

Mahir Gachabayov ◽

Karen You ◽

Ryan Sullivan ◽

Roberto Bergamaschi

Keyword(s):

Cohort Study ◽

Colorectal Surgery ◽

Predictive Factors ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Abdominal Wound

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Predictive factors for success of awake proning in hypoxemic respiratory failure secondary to COVID-19: A retrospective cohort study

Respiratory Medicine ◽

10.1016/j.rmed.2021.106379 ◽

2021 ◽

Vol 181 ◽

pp. 106379

Author(s):

Sujith V. Cherian ◽

Chang Li ◽

Brad Roche ◽

Stephan A. Reyes ◽

Siddharth Karanth ◽

...

Keyword(s):

Cohort Study ◽

Respiratory Failure ◽

Predictive Factors ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Hypoxemic Respiratory Failure

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Predictive Factors for Successful Vaginal Delivery after a Trial of External Cephalic Version: A Retrospective Cohort Study of 946 Women

American Journal of Perinatology ◽

10.1055/s-0041-1739505 ◽

2021 ◽

Author(s):

Asaf Bilgory ◽

Olena Minich ◽

Maria Shvaikovsky ◽

Genady Gurevich ◽

Joseph B. Lessing ◽

...

Keyword(s):

Cohort Study ◽

Vaginal Delivery ◽

Predictive Factors ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Goodness Of Fit ◽

External Cephalic Version ◽

Nulliparous Women ◽

Tertiary Center ◽

Vertex Presentation

Objective Our aim was to find the factors which predict a vertex presentation of vaginal delivery (VD) in women who are admitted for a trial of external cephalic version (ECV). Study Design This is a retrospective cohort study of women who underwent a trial of ECV and delivered between November 2011 and December 2018 in a single tertiary center. The main outcome measure was successful VD of a fetus in the vertex presentation. Women who achieved VD in the vertex presentation or underwent cesarean delivery were compared on the basis of variety of predictive factors. Adverse neonatal and maternal outcomes were reported. Logistic regression was used for the multivariate analysis. Results A total of 946 women were included; 717 (75.8%) women had a successful ECV and 663 (70.1%) women had a VD in the vertex presentation. Parous women had 79.3% VD rate (570/719) and nulliparous women had 41.0% VD rate (93/227). Women with an amniotic fluid index (AFI) of 50 to 79, 80 to 200, and >200 mm had 34.8, 71.0, and 83.1% VD rate, respectively. Parous versus nulliparous women had an adjusted odds ratio (aOR) of 5.42 (95% confidence interval [CI] 3.90–7.52, p < 0.001), women with AFI 50 to 79 mm compared with AFI 80 to 200 mm had an aOR of 0.21 (95% CI 0.12–0.37, p < 0.001), and women with an AFI >200 mm compared with AFI 80 to 200 mm had an aOR of 1.74 (95% CI 1.03–2.92, p = 0.037) to achieve VD. The final prediction model for the chances of a VD based on data on admission for ECV was reported. The Hosmer-Lemeshow test was used to evaluate the goodness of fit of the model (p = 0.836). Conclusion Being parous and having an AFI >200 mm are positive independent predictive factors for achieving VD of a vertex presenting fetus after ECV. Whereas AFI 50 to 79 mm is a negative independent predictive factor. Key Points

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