scholarly journals Perioperative Evaluation of Patient Outcomes after Severe Acid Corrosive Injury

2015 ◽  
Vol 2015 ◽  
pp. 1-6
Author(s):  
Ming-Ho Wu ◽  
Han-Yun Wu
Keyword(s):  
Risk Factors ◽  
Ph Value ◽  
Gastric Perforation ◽  
Laboratory Data ◽  
Length Of Hospital Stay ◽  
Female Gender ◽  
Class Iii ◽  
Visceral Injury ◽  
Corrosive Injury ◽  
Preoperative Risk Factors

We reviewed 64 patients with perforation or full-thickness injury of the alimentary tract after acid ingestion. Based on our classification of laparotomy findings, there were class I (n=15); class II (n=13); class III (n=16); and class IV (n=20). Study parameters were preoperative laboratory data, gastric perforation, associated visceral injury, and extension of the injury. End points of the study were the patients’ mortality and length of hospital stay. All these patients underwent esophagogastrectomy with (n=16) or without (n=24) concomitant resection, esophagogastroduodenojejunectomy with (n=4) or without (n=13) concomitant resection, and laparotomy only (n=7). Concomitant resections were performed on the spleen (n=10), colon (n=2), pancreas (n=1), gall bladder (n=1), skipped areas of jejunum (n=4), and the first portion of the duodenum (n=4). The study demonstrates five preoperative risk factors, female gender, shock status, shock index, pH value, and base deficit, and four intraoperative risk factors, gastric perforation, associated visceral injury, injury beyond the pylorus, and continuous involvement of the jejunum over a length of 50 cm. The overall mortality rate was 45.3%, which increased significantly with advancing class of corrosive injury.

Risk Factors and Prevention Measures for Postoperative Sternomediastinitis (Literature Review)

2021 ◽  
Vol 90 (4) ◽  
pp. 86-90
Author(s):  
A.A. Shevchenko ◽  
◽  
N.G. Zhila ◽  
E.A. Kashkarov ◽  
K.S. Shevchenko ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiac Surgery ◽  
Median Sternotomy ◽  
Length Of Hospital Stay ◽  
Prevention Measures ◽  
Preoperative Risk ◽  
Technical Errors ◽  
Preoperative Risk Factors ◽  
Postoperative Risk ◽  
Cardiac Surgeons

Median sternotomy remains the most common access in cardiac surgery, while postoperative sternomediastinitis is one of the most severe complications of the transsternal approach. The article analyzes the preoperative risk factors for the development of this complication, including concomitant pathology, constitutional features, bad habits, length of hospital stay, and the urgency of the operation. It was also noted that intraoperative risk factors consist of technical errors in the performance of the operation, intraoperative features of the course of surgery, the nature of the choice of the shunt during myocardial vascularization and the final stage of the operation. Postoperative risk factors include the specific management of the postoperative period in cardiac surgery patients, which can lead to the development of sternomediastinitis. The analysis of measures taken by cardiac surgeons to prevent the development of this complication was carried out

scholarly journals Risk factors of thrombosis in chinese subjects with acute promyelocytic leukemia

2021 ◽  
Author(s):  
Xueya Zhang ◽  
Xizhe Guo
Keyword(s):  
Risk Factors ◽  
Acute Promyelocytic Leukemia ◽  
Detection Rate ◽  
Disease Risk ◽  
Laboratory Data ◽  
Female Gender ◽  
Promyelocytic Leukemia ◽  
Rare Manifestation ◽  
Chinese Subjects ◽  
Pai 1

Abstract Acute promyelocytic leukemia (APL) is a kind of malignant hematologic disease. Thrombosis is a rare manifestation of APL. However, the risk factors of thrombosis related to chinese APL patients are not fully understood. Clinical and laboratory data of 44 consecutively chinese APL patients were collected and analyzed. 1 arterial and 6 venous thrombosis occurred in 44 patients, including 22 males and 22 females, with a median age of 44 years (range 18–74 years). The ratio of male and female gender (P = 0.68), age (P = 0.823), white blood cell count (P = 0.077), hemoglobin (P = 0.409), platelets (P = 0.334), disease risk stratification (P = 0.475), CD2 (P = 0.737), khorana score (P = 0.52), differentiation syndrome (DS) (P = 0.562) and gene mutation related to prognosis of APL, including DNMT3A (P = 0.44), TET2 (P = 0.43), IDH1 (P = 0.6), IDH2 (P = 0.66), NRAS (P = 0.66), ASXL1(P = 0.9) in the two groups with and without thrombosis were not statistically significant. The detection rate of PAI-1 genotype 4G4G was 71.4% (5/7) in 7 patients with thrombosis, while the detection rate of PAI-1 genotype 4G4G in 37 patients without thrombosis was 8.1% (3/37). The differences between the two groups in WT-1 (P = 0.01), PAI-1 4G4G (P = 0.0009), bcr3 (P = 0.027), CD15 (P = 0.005), and FLT3-ITD mutation (P = 0.0008) were statistically significant. The results suggested the PAI-1 gene 4G4G type, PML/RARa (bcr3), CD15, WT-1 and FLT3-ITD mutations excluding DNMT3A, TET2, IDH1/2, NRAS and ASXL1 are risk factors of thrombotic events in chinese APL patients.

scholarly journals Independent Patient Risk Factors Associated With Increased Length of Hospital Stay, Unplanned Return to Operating Room, and 30-Day Readmission Rates After Posterior Cervical Fusion for Cervical Spondylotic Myelopathy

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Aladine A Elsamadicy ◽  
Fouad Chouairi ◽  
Megan Lee ◽  
Andrew B Koo ◽  
Adam Kundishora ◽  
...  
Keyword(s):  
Risk Factors ◽  
Operating Room ◽  
Operative Time ◽  
Significant Risk ◽  
Length Of Hospital Stay ◽  
Female Gender ◽  
Cervical Fusion ◽  
Improvement Program ◽  
Factors Associated ◽  
Posterior Cervical Fusion

Abstract INTRODUCTION The aim of this study was to determine risk factors associated with readmissions, reoperation, and extended length of stay (LOS) following posterior cervical fusion (PCF) for spondylotic myelopathy. METHODS The National Surgical Quality Improvement Program from 2011 to 2016 was queried for all patients undergoing PCF with a diagnosis of spondylotic myelopathy. The inclusion criteria for this project were defined by the CPT code 22600 for PCF. Patients with a history of trauma, malignancy, and those with nonelective surgery were excluded. Patients without ICD9 (721.1) or ICD10 (M47.12) codes for myelopathy were also excluded. For analysis, patients were classified into 2 cohorts: patients who were readmitted, and those who were not readmitted. Patient demographics, comorbidities, intraoperative variables, and number of levels involved in surgery were collected. RESULTS A total of 893 patients with PCF for spondylotic myelopathy were identified, of which 816 (91.4%) were not readmitted and 77 (8.6%) were readmitted.The readmitted cohort was significantly older (No Readmission: 62.6 +/–10.8 vs Readmission: 65.5 +/– 10.8, P = .029). The readmitted population had a significantly higher proportion of dyspnea on exertion (No Readmission: 8.1% vs Readmission: 15.6%, P = .026) and COPD (No Readmission: 6.9% vs Readmission: 14.3%, P = .018). There were no differences in operative time (P = .762) or multilevel surgeries (P = .453) between the 2 cohorts. LOS was similar between readmitted and nonreadmitted patients (P = .640). Upon logistic regression controlling for demographics, comorbidities, surgery level, and operative time, multiple risk factors predicted extended LOS, including female gender, black race, noninsulin-dependent diabetes, chronic steroid use, and length of surgery. BMI and CHF predicted an unplanned return to the operating room. Age [OR: 1.03,95% CI (1.004-1.06), P = .025] was the single predictor of readmission. CONCLUSION Our study suggests that while there are a host of risk factors for both reoperation and extended LOS, increased age is likely the most significant risk factor for readmission following PCF.

scholarly journals Risk factors of thrombosis in Chinese subjects with acute promyelocytic leukemia

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Xueya Zhang ◽  
Xizhe Guo
Keyword(s):  
Risk Factors ◽  
Venous Thrombosis ◽  
Acute Promyelocytic Leukemia ◽  
Detection Rate ◽  
Disease Risk ◽  
Laboratory Data ◽  
Female Gender ◽  
Promyelocytic Leukemia ◽  
Increased Risk ◽  
Pai 1

Abstract Background Acute promyelocytic leukemia (APL) is a special type of acute myeloid leukemia Thrombosis is at increased risk complication in patients with this disease. However, the risk factors of thrombosis related to Chinese APL patients are not fully understood. Methods In this study, clinical and laboratory data of 44 consecutively Chinese APL patients were collected and analyzed. Results One arterial and 6 venous thrombosis occurred in 44 patients, including 22 males and 22 females, with a median age of 44 years (range from 18 to 74 years). The ratio of male and female gender, age, white blood cell count, hemoglobin, platelets, disease risk stratification, CD2, Khorana score, differentiation syndrome (DS) and gene mutation related to prognosis of APL, including DNMT3A, TET2, IDH1, IDH2, NRAS and ASXL1 in the two groups with and without thrombosis were not statistically significant. The detection rate of PAI-1 genotype 4G4G was 71.4% (5/7) in 7 patients with thrombosis, while the detection rate of PAI-1 genotype 4G4G in 37 patients without thrombosis was 8.1% (3/37). The differences between the two groups in WT-1 (P = 0.01), PAI-1 4G4G (P = 0.0009), bcr3 (P = 0.027), CD15 (P = 0.005), and FLT3-ITD mutation (P = 0.0008) were statistically significant. Using multivariate analysis, the risk factors of venous thrombosis in APL were CD15 (P = 0.043), PAI-1 4G4G (P = 0.009), WT-1 (P = 0.043) and FLT3/ITD (P = 0.013), respectively. Conclusion Our results suggested the PAI-1 gene 4G4G type, CD15, WT-1 and FLT3-ITD mutations excluding DNMT3A, TET2, IDH1/2, NRAS and ASXL1 are risk factors of thrombotic events in Chinese APL patients.

Incidence and Preoperative Risk Factors for Major Complications After Capsulectomy: Analysis of 3,048 Patients

2022 ◽  
Author(s):  
Ashkan Afshari ◽  
Lyly Nguyen ◽  
Gabriella E Glassman ◽  
Galen Perdikis ◽  
James C Grotting ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cosmetic Surgery ◽  
Breast Implant ◽  
Major Complication ◽  
Implant Removal ◽  
Class Iii ◽  
Public Attention ◽  
Preoperative Risk Factors ◽  
Major Complications ◽  
Insurance Database

Abstract Background While there are many indications for periprosthetic breast capsulectomy, heightened public attention surrounding breast implant illness has resulted in increased rates of capsulectomy. Objectives This study aims to identify the incidence of major complications and risk factors associated with capsulectomy. Methods Using a prospectively enrolled cosmetic surgery insurance database, CosmetAssure (Birmingham, AL, USA), patients undergoing capsulectomy between January 2, 2017 and July 31, 2019 were identified. Outcomes measured included the occurrence of and risk factors for major complication(s) necessitating an emergency department visit, hospitalization, or reoperation within 45 postoperative days. Results Among 76,128 patients evaluated, 3048 (4.0%) underwent capsulectomy. There was a significant increase in number of capsulectomies following January 6, 2019 (2.7/day vs 5.2/day, p<0.05). Capsulectomy patients had more likely to have any complication and specifically hematoma than those undergoing breast implant removal or replacement without capsulectomy (2.8% vs 1.9% and 1.6% vs 0.9%, respectively, p<0.05). Eighty-four (2.8%) developed at least one complication. The most common complications included hematoma (1.6%) followed by infection (0.5%). ASA class III/IV was an independent risk factor for any complication and BMI ≥30 and office-based surgical suites were risk factors for infection. Conclusions There is a growing number of capsulectomies being performed. The most common major complication is hematoma. Patients undergoing capsulectomy confer a higher complication rate compared to those undergoing breast implant removal or replacement without capsulectomy. Patients should be counseled regarding the potential for major complications.

Indications and practice of enteral nutrition

2014 ◽  
Vol 155 (51) ◽  
pp. 2028-2033 ◽  
Author(s):  
Judit Hallay ◽  
Dániel Nagy ◽  
Béla Fülesdi
Keyword(s):  
Risk Factors ◽  
Treatment Outcome ◽  
Enteral Nutrition ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Nutrition Therapy ◽  
Present Review ◽  
Hospitalised Patients ◽  
Impact On Treatment ◽  
Efficacy Of Treatment

Malnutrition in hospitalised patients has a significant and disadvantageous impact on treatment outcome. If possible, enteral nutrition with an energy/protein-balanced nutrient should be preferred depending on the patient’s condition, type of illness and risk factors. The aim of the nutrition therapy is to increase the efficacy of treatment and shorten the length of hospital stay in order to ensure rapid rehabilitation. In the present review the authors summarize the most important clinical and practical aspects of enteral nutrition therapy. Orv. Hetil., 2014, 155(51), 2028–2033.

Stress, anxiety, depression and burnout in frontline health care workers during COVID-19 pandemic: a brief systematic review and new data from Russia

2021 ◽  
Author(s):  
Ekaterina Mosolova ◽  
Dmitry Sosin ◽  
Sergey Mosolov
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Female Gender ◽  
Assessment Tools ◽  
Care Workers ◽  
Younger Age ◽  
Wide Range ◽  
Associated Risk Factors ◽  
Anxiety Depression ◽  
The Impact

During the COVID-19 pandemic, healthcare workers (HCWs) have been subject to increased workload while also exposed to many psychosocial stressors. In a systematic review we analyze the impact that the pandemic has had on HCWs mental state and associated risk factors. Most studies reported high levels of depression and anxiety among HCWs worldwide, however, due to a wide range of assessment tools, cut-off scores, and number of frontline participants in the studies, results were difficult to compare. Our study is based on two online surveys of 2195 HCWs from different regions of Russia during spring and autumn epidemic outbreaks revealed the rates of anxiety, stress, depression, emotional exhaustion and depersonalization and perceived stress as 32.3%, 31.1%, 45.5%, 74.2%, 37.7% ,67.8%, respectively. Moreover, 2.4% of HCWs reported suicidal thoughts. The most common risk factors include: female gender, nurse as an occupation, younger age, working for over 6 months, chronic diseases, smoking, high working demands, lack of personal protective equipment, low salary, lack of social support, isolation from families, the fear of relatives getting infected. These results demonstrate the need for urgent supportive programs for HCWs fighting COVID-19 that fall into higher risk factors groups.

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