Abstract 156: Capnographic Differences in Out-of-hospital Overdose-related, Respiratory, and Cardiac Arrests

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_4) ◽  
Author(s):  
Robyn McDannold ◽  
Chengcheng Hu ◽  
Daniel W Spaite ◽  
Annemarie E Silver ◽  
Margaret Mullins ◽  
...  
Keyword(s):  
Blood Flow ◽  
Continuous Variables ◽  
Exact Test ◽  
Future Studies ◽  
First Report ◽  
Chi Squared ◽  
Co2 Level ◽  
The Mean ◽  
Full Waveforms ◽  
Very High

Background: Little is known about the ventilatory aspects of overdose-related OHCA (OD-OHCA). We compared maximum ETCO2 (mETCO2; each patient’s highest CO2 level) and mean for each recorded minute of CPR in OD-OHCA to that of respiratory (R-OHCA) and cardiac (C-OHCA) arrests. Methods: Continuous CO2 data (Zoll E/X series monitors) were obtained from 3 Arizona EMS agencies. Cases had at least 3 min of recorded CO2 during CPR. Arrests were classified as OD-OHCA by EMS and/or hospital documentation. Any drug OD was included (e.g., opioids, mixed). C-OHCA and R-OHCA cases were randomly chosen for comparison. The groups were compared using Fisher’s exact test or Chi-squared for categorical and Kruskal-Wallis for continuous variables. Results: Included were 263 subjects (37 OD-OHCA, 157 C-OHCA and 69 R-OHCA; median age 61, 64% male, 1/10-12/18) with 10,271 min of data [median resuscitation interval 37 min (IQR 29, 47)]. Mean ETCO2 (SD): OD-OHCA [41 mmHg (24)]; R-OHCA [40 (23)], C-OHCA [30 (13); p<0.01]. Median mETCO2: OD-OHCA [57 mmHg (95CI: 50, 77)]; R-OHCA [61 (50, 73)], C-OHCA [48 (44, 50); p<0.001; Fig 1]. While mean ETCO2 and mETCO2 were similar for OD-OHCA and R-OHCA, they were both significantly higher than C-OHCA (p<0.01 for all comparisons). ETCO2 waveforms in OD-OHCA resembled the very high, full waveforms typical of R-OHCA while those in C-OHCA tended to be low and blunted. Conclusions: We believe this is the first report of continuous capnography during resuscitation of OD-OHCA. The mean ETCO2 and median of mETCO2 of OD-OHCA and R-OHCA imply similar physiology (hypoventilation and hypercapnia leading to arrest). Both etiologies had much higher ETCO2 values compared to C-OHCA, where low blood flow delivers minimal CO2 to the lungs and yields low, and morphologically different, waveforms. Future studies assessing OD arrest physiology and various approaches to resuscitation and pharmacological reversal are needed.

scholarly journals A multidisciplinary pulmonary embolism response team (PERT)—experience from a national multicenter consortium

2019 ◽  
Vol 9 (3) ◽  
pp. 204589401882456 ◽  
Author(s):  
Jacob Schultz ◽  
Nicholas Giordano ◽  
Hui Zheng ◽  
Blair A. Parry ◽  
Geoffrey D. Barnes ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Patient Characteristics ◽  
Risk Groups ◽  
The United States ◽  
Categorical Variables ◽  
P Value ◽  
Continuous Variables ◽  
Exact Test ◽  
Advanced Therapy ◽  
Chi Squared

Background We provide the first multicenter analysis of patients cared for by eight Pulmonary Embolism Response Teams (PERTs) in the United States (US); describing the frequency of team activation, patient characteristics, pulmonary embolism (PE) severity, treatments delivered, and outcomes. Methods We enrolled patients from the National PERT Consortium™ multicenter registry with a PERT activation between 18 October 2016 and 17 October 2017. Data are presented combined and by PERT institution. Differences between institutions were analyzed using chi-squared test or Fisher's exact test for categorical variables, and ANOVA or Kruskal-Wallis test for continuous variables, with a two-sided P value < 0.05 considered statistically significant. Results There were 475 unique PERT activations across the Consortium, with acute PE confirmed in 416 (88%). The number of activations at each institution ranged from 3 to 13 activations/month/1000 beds with the majority originating from the emergency department (281/475; 59.3%). The largest percentage of patients were at intermediate–low (141/416, 34%) and intermediate–high (146/416, 35%) risk of early mortality, while fewer were at high-risk (51/416, 12%) and low-risk (78/416, 19%). The distribution of risk groups varied significantly between institutions ( P = 0.002). Anticoagulation alone was the most common therapy, delivered to 289/416 (70%) patients with confirmed PE. The proportion of patients receiving any advanced therapy varied between institutions ( P = 0.0003), ranging from 16% to 46%. The 30-day mortality was 16% (53/338), ranging from 9% to 44%. Conclusions The frequency of team activation, PE severity, treatments delivered, and 30-day mortality varies between US PERTs. Further research should investigate the sources of this variability.

scholarly journals Correlation of plasma fibrinogen and mean platelet volume in patients of sepsis to the severity of sepsis and its outcome

2020 ◽  
Vol 7 (12) ◽  
pp. 1830
Author(s):  
Ketan Chalodiya ◽  
Arun Bahulikar ◽  
Vrushali Khadke ◽  
Deepak Phalgune
Keyword(s):  
Septic Shock ◽  
Mean Platelet Volume ◽  
Fibrinogen Level ◽  
Prognostic Indicator ◽  
Plasma Fibrinogen ◽  
Apache Ii Score ◽  
Continuous Variables ◽  
Platelet Volume ◽  
Exact Test ◽  
The Mean

Background: The prognostic value of mean platelet volume (MPV) and plasma fibrinogen level in terms of survival in patients with sepsis and septic shock is still incompletely documented. The aim of the present study was to find a correlation between MPV and plasma fibrinogen with the severity of sepsis and mortality.Methods: Three hundred eleven patients having quick sequential organ failure assessment score 2/3, systolic blood pressure ≤100 mmHg, respiratory rate ≥22/minute and altered mentation <15 (Glasgow coma scale) were included for this prospective observational study. Acute physiology and chronic health evaluation (APACHE) II score, MPV on days one and four, fibrinogen on days one and seven were tested. The number of days of intensive care unit (ICU), and hospital stay, in-hospital mortality was recorded. Categorical and continuous variables were tested using the chi-square test/Fisher’s exact test and analysis of variance/Kruskal-Wallis H test respectively.Results: The mean plasma fibrinogen at day one and day seven was significantly higher in patients who had septic shock and in expired patients. The mean MPV at day four was significantly higher in patients who expired compared to those who survived. The mean MPV on day four was significantly higher compared to the mean MPV at day one in patients who expired.Conclusions: Fibrinogen level at admission is the predictor of mortality in patients with sepsis or septic shock. An increase in MPV was strongly correlated with mortality and can be used as a prognostic indicator.

scholarly journals Bacterial Profile, Multi-Drug Resistance and Seasonality Following Lower Limb Orthopaedic Surgery in Tropical and Subtropical Australian Hospitals: An Epidemiological Cohort Study

2020 ◽  
Vol 17 (2) ◽  
pp. 657
Author(s):  
Mark L. Vickers ◽  
Emma L. Ballard ◽  
Patrick N. A. Harris ◽  
Luke D. Knibbs ◽  
Anjali Jaiprakash ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Lower Limb ◽  
Orthopaedic Surgery ◽  
Categorical Variables ◽  
Multi Drug Resistance ◽  
Continuous Variables ◽  
Exact Test ◽  
Chi Squared ◽  
The Relationship ◽  
Epidemiological Cohort

We aimed to describe the epidemiology, multi-drug resistance and seasonal distribution of bacteria cultured within 12 months following lower limb orthopaedic surgery in tropical and subtropical Australian hospitals between 2010 and 2017. We collected data from four tropical and two subtropical hospitals. Categorical variables were examined using the Pearson Chi-squared test or Fisher’s Exact test, and continuous variables with the Student t-test or Mann–Whitney U test. A Poisson regression model was used to examine the relationship between season, weather and the incidence of Staphylococcus and nonfermentative species. We found that at tropical sites, nonfermenters (Pseudomonas aeruginosa and Acinetobacter baumannii) were more common (28.7% vs. 21.6%, p = 0.018), and patients were more likely to culture multi-drug-resistant (MDR) nonfermenters (11.4% vs. 1.3%, p = 0.009) and MDR Staphylococcus aureus (35.9% vs. 24.6%, p = 0.006). At tropical sites, patients were more likely to be younger (65.9 years vs. 72.0, p = < 0.001), male (57.7% vs. 47.8%, p = 0.005), having knee surgery (45.3% vs. 34.5%, p = 0.002) and undergoing primary procedures (85.0% vs. 73.0%, p = < 0.001). Species were similar between seasons in both tropical and subtropical hospitals. Overall, we found that following lower limb orthopaedic surgery in tropical compared with subtropical Australia, patients were more likely to culture nonfermenters and some MDR species.

scholarly journals Clinical Characteristics and Outcomes of Hematologic Malignancy Patients with Clostridium difficile Toxin EIA vs. PCR Positive Test Results

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S396-S396
Author(s):  
Matthew Ziegler ◽  
Daniel Landsburg ◽  
David Pegues ◽  
Kevin Alby ◽  
Cheryl Gilmar ◽  
...  
Keyword(s):  
Hematologic Malignancy ◽  
Tertiary Care ◽  
Positive Test ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Test Results ◽  
Exact Test ◽  
Academic Center ◽  
Chi Squared ◽  
Record Review

Abstract Background C. difficile infection is common in patients with hematologic malignancy. There is increasing recognition that molecular (polymerase chain reaction, PCR) based testing lacks specificity for infection, while detecting patients with colonization. The objective of our study was to evaluate characteristics of patients with toxin enzyme immunoassay (EIA) vs. PCR positive C. difficile test results. Methods A retrospective review of inpatients at a tertiary care academic center with hematologic malignancy and a positive C. difficile test from 1/2015 to 1/2016 was performed. Data on demographics, comorbidities, clinical features, and outcomes were collected using medical record review. Characteristics were compared between patients with EIA vs. PCR positive test results using chi-squared or Fisher’s exact test for categorical variables and Wilcoxon rank-sum test for continuous variables. Results A total of 130 patients were included: 51% and 49% had a PCR positive and EIA positive result, respectively. Diagnoses included AML (42%), multiple myeloma (22%), and Non-Hodgkin’s lymphoma (13%). Antibiotic exposure was similar, with a median of 4 days of anti-pseudomonal antibiotics received in the prior 30 days. There was no difference in history of a positive C. difficile test in the prior year (12% in the EIA group, 10% in the PCR group, P = 0.71). Patients with EIA positive results were more likely to have a WBC ≥15/mm3 (18% vs. 6%, P = 0.02). However, there were no differences in presence of fever, stool frequency, or imaging evidence of colitis at the time of testing. Medications in the prior 72 hours were similar, including the use of proton pump inhibitors of ~40% and of laxatives of 28%. Clinical outcomes were also similar between patients with EIA vs. PCR positive tests: all-cause death (22% vs. 20%), recurrent CDI (9% vs. 13%), colectomy (1% vs. 4%), and megacolon (0% vs. 3%). Most patients received treatment with oral vancomycin for a median duration of 14 days. Conclusion In patients with hematologic malignancy, those with EIA vs. PCR positive C. difficile test results were clinically similar. These findings suggest that algorithms for testing and treatment of C. difficile in hematologic malignancy patients will need to be specifically targeted towards this immunocompromised population. Disclosures All authors: No reported disclosures.

scholarly journals Transurethral endoscopic approach for large bladder diverticula: Evaluation of a large series

2019 ◽  
Vol 91 (3) ◽  
Author(s):  
Mauro Pacella ◽  
Nicolo' Testino ◽  
Guglielmo Mantica ◽  
Matteo Valcalda ◽  
Rafaela Malinaric ◽  
...  
Keyword(s):  
Endoscopic Approach ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Significance Level ◽  
Exact Test ◽  
Nonparametric Distribution ◽  
Bipolar Energy ◽  
Bladder Diverticula ◽  
Male Patients ◽  
The Mean

Objective: To present the results of the largest series of patients with bladder diverticula > 4 cm managed with an endoscopic approach and give tips about the execution of the procedure. Materials and methods: Data of male patients undergone the endoscopic approach for an acquired bladder diverticula > 4 cm from December 2004 to August 2018 were prospectively collected and retrospectively analyzed. The description of the monopolar and bipolar techniques are provided. The success of the procedure was defined as the reduction of the diverticula for more of the 80% of its initial diameter documented at the 3- months follow-up imaging. Continuous variables with nonparametric distribution were compared using the Mann-Whitney test, while frequencies of categorical variables were compared between groups by Fisher’s exact test with significance level set at 0.05. Results: Thirty-nine patients with a mean (+/- SD) age at surgery of 69.4 ± 8.8 years were enrolled, for an equal number of diverticula managed. The mean diverticular size was 75.1 ± 24.5 millimeters. The mean operative time was 65 ± 21.9 minutes including the prostate surgery. Twelve patients (30.8%) were managed with bipolar energy, the others with monopolar. The success of the procedure was achieved in 30 patients (76.9% - 7 bipolar and 23 monopolar - p = 0.66). Conclusions: The endoscopic approach might be considered as a useful option for patients with a large bladder diverticulum who are at risk for major or laparoscopic procedure.

scholarly journals CMV seropositivity does not increase the risk of death among elderly nursing home residents

2020 ◽  
Vol 19 (4) ◽  
pp. 216-220
Author(s):  
Dorota Pytka ◽  
Bożena Czarkowska-Pączek ◽  
Aleksandra Wyczałkowska-Tomasik
Keyword(s):  
Nursing Home ◽  
Antibody Titre ◽  
Genetic Material ◽  
Nursing Home Residents ◽  
Cmv Infection ◽  
Exact Test ◽  
Risk Of Death ◽  
Chi Squared ◽  
The Mean ◽  
The Impact

AbstractAim. The aim of this study was to assess the anti-CMV antibody titre, the presence of genetic material of the virus in the plasma of elderly residents of nursing homes and the impact of the CMV infection on the risk of death.Material and methods. The number of 202 residents of a nursing home in Warsaw, aged 65 and over, were observed for 1095 days (3 years) between 2015 and 2018. During this period 126 (62.4%) residents died. Plasma CMV DNA levels were assessed using real-time PCR. Anti-CMV antibody titre was measured with the use of commercially available ARCHITECT CMV test.Results. No genetic material of the CMV was found in the studied group of the residents. The mean IgG titre did not differ between those who survived and those who deceased (p=1). Pearson’s Chi-squared test and Fisher’s exact test did not reveal any differences in the rate of deaths among the groups of seronegative, seropositive < 250 IgG [Au/ml], and seropositive > 250 IgG [Au/ml] residents. Kaplan-Meyers survival curves confirmed these results.Conclusions. We did not demonstrate that CMV infection or the anti-CMV antibody titer have any effect on the risk of death in the study group.

scholarly journals 470. The Effects of Arrival Quarantine on Subsequent COVID-19 Testing in a Cohort of Military Basic Trainees

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S301-S301
Author(s):  
Joseph E Marcus ◽  
Dianne Frankel ◽  
Mary Pawlak ◽  
Theresa Casey ◽  
Erin Enriquez ◽  
...  
Keyword(s):  
San Antonio ◽  
Military Training ◽  
Symptomatic Patient ◽  
Continuous Variables ◽  
Exact Test ◽  
Medical Testing ◽  
Presenting Symptoms ◽  
Us Air Force ◽  
The Us ◽  
Chi Squared

Abstract Background The COVID-19 pandemic has been associated with significant spread in congregate settings and various forms of non-pharmaceutical interventions (NPI) have been implemented to prevent spread. Basic Military Training at Joint Base-San Antonio is the entrance to the US Air Force and has been associated with respiratory outbreaks in the past. A two-week arrival quarantine was implemented in March 2020. Effects on subsequent testing for COVID-19 after an arrival quarantine is unknown. Methods The first four weekly cohorts of trainees who underwent an arrival quarantine between March 16-April 13 were monitored during their 7 week training for COVID-19 symptoms. Symptoms, medical testing, and days removed from training were collected on every patient with possible COVID-19 symptoms including cough, shortness of breath, or fever. Testing during the two-week arrival quarantine were compared to the subsequent five weeks of training. Nominal variables were compared by chi squared or Fisher’s exact test as appropriate. Continuous variables were compared by Mann-Whitney U Test. Results A total of 2,573 started training during study period, 89 (3.4%) had symptoms concerning for COVID-19 and were tested. 5 (6%) patients tested positive, all of whom in the arrival quarantine. Compared to patients who completed quarantine (n=29), patients in the arrival quarantine who tested negative for COVID-19 (n=54) were tested more often (26 trainees a week vs. 5.8 later in training, p=&lt; 0.0001), and received more rapid flu tests (74% vs. 38%, p=0.001) and multiplex respiratory PCR (15% vs. 0%, p=0.05). Trainees in quarantine were isolated longer for symptoms than patients who completed quarantine (median 3 vs. 2, p=0.01). There was no difference in presenting symptoms for trainees in quarantine or after quarantine. Conclusion Arrival quarantine appears to be an effective NPI, which in conjunction with other interventions prevented any COVID-19 transmission after quarantine completion. For those who went through arrival quarantine, there was more intense initial testing and initial longer symptomatic patient isolation, this was balanced by fewer symptomatic patients, less testing, and shorter isolations later in training. Disclosures All Authors: No reported disclosures

scholarly journals Comparison of Functional and MRI Outcomes of Microfracture with and without BioCartilage for Osteochondral Lesions of the Talus

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0038
Author(s):  
Yoshiharu Shimozono ◽  
Hao Huang ◽  
Timothy Deyer ◽  
John G Kennedy
Keyword(s):  
Treatment Strategy ◽  
Cartilage Regeneration ◽  
Cartilage Tissue ◽  
Categorical Variables ◽  
Osteochondral Lesions ◽  
Fisher Exact Test ◽  
Continuous Variables ◽  
Exact Test ◽  
The Mean

Category: Ankle, Arthroscopy, Sports Introduction/Purpose: Microfracture (MF) remains a dominant treatment strategy for symptomatic osteochondral lesions of the talus (OLT). Micronized cartilage allograft (BioCartilage) is a biologic scaffold and is utilized for MF augmentation to improve the quality for cartilage regeneration. However, there is still lack of evidence on efficacy of BioCartilage as an adjunct to MF, as no comparative studies have been reported to date. The purpose of this study is to clarify the effectiveness of BioCartilage as an adjuvant to MF compared to MF alone in the treatment of OLT. Methods: A retrospective cohort study comparing patients treated with MF with BioCartilage and MF alone between 2014 and 2017 was undertaken. Patients with a minimum follow-up time of 12 months were included. All patients received concentrated bone marrow aspirate injection at the time of surgery. Clinical outcome was evaluated with the Foot and Ankle Outcome Score (FAOS) pre- and postoperatively. Postoperative MRIs were evaluated using a modified Magnetic Resonance Observation of Cartilage Tissue (MOCART) score. Comparisons between groups were made with the Man-Whitney U test for continuous variables and the Chi-squared test or Fisher exact test for categorical variables. Results: Twenty-four patients underwent MF with BioCartilage (MF-BC group) and 24 patients underwent MF alone (MF group). The mean age was 40.8 years in MF-BC group and 47.8 years in MF group (p=0.068). The mean follow-up time was 19.2 months in MF-BC group and 24.5 months in MF group (p=0.042). Both groups showed significant improvements in all FAOS subscales. No significant differences between groups were found in postoperative FAOS subscales including symptoms, pain, daily activities, sports activities and quality of life (MF-BC; 72.8, 77.8, 87.4, 60.8, 56.6, MF; 73.3, 79.3, 86.0, 60.9, 60.6, respectively, p>0.05). The mean MOCART score in MF-BC group was higher (73.2vs64.1), but not statistically significant (p=0.315). When assessing each MOCART parameter individually, MF-BC group had significant better infill in the defect (p=0.028). Conclusion: MF with BioCartilage is an effective treatment strategy for the treatment of OLT and results in similar functional outcomes compared with MF alone in the short-term. However, MF with BioCartilage provides better cartilage infill in the defect on MRI. This finding suggests that the repair seen in a cartilage defect treated with BioCartilage augmentation may be superior to treatment with MF alone. Further long-term follow-up studies are warranted.

scholarly journals Patient and in vitro fertilization (IVF) cycle characteristics associated with variable blastulation rates: a retrospective study from the Duke Fertility Center (2013–2017)

2019 ◽  
Vol 24 (1) ◽  
Author(s):  
Carrie A. Jones ◽  
Kelly S. Acharya ◽  
Chaitanya R. Acharya ◽  
Douglas Raburn ◽  
Suheil J. Muasher
Keyword(s):  
Statistical Significance ◽  
Categorical Variables ◽  
Continuous Variables ◽  
High Quality ◽  
Vitro Fertilization ◽  
Oocyte Yield ◽  
Chi Squared ◽  
The Mean ◽  
Blastulation Rate

Abstract Background To evaluate the association of patient and IVF cycle characteristics with blastulation rate and formation of high-quality blastocysts Results We analyzed autologous blastocyst cycles from 2013 to 2017. Cycles were subdivided into low (< 33%), intermediate (33–66%), and high (> 66%) blastulation rates. Embryo quality was assigned by embryologists using Gardner Criteria. R statistical package was used, and the blastulation groups were compared using analysis of variance (ANOVA) for continuous variables and chi-squared tests for categorical variables. The Bonferroni correction was used to adjust for multiple comparisons. One hundred seventeen IVF cycles met our inclusion criteria. Of these, 20 (17.1%) had low, 74 (63.2%) had intermediate, and 23 (19.7%) had high blastulation rates. Low blastulation rate was associated with a lower number of blastocysts, including fewer high-quality blastocysts. The mean number of oocytes retrieved was highest (18.1) in the group with the lowest blastulation rate, and lowest (13.4) in those with the highest blastulation rate, although this did not reach statistical significance. There were no significant differences between blastulation rates and age, gravidity, prior live birth, anti-mullerian hormone, estradiol and progesterone levels on the day of ovulation trigger, follicle-stimulating hormone dose, or fertility diagnosis. Conclusions High blastulation rate is associated with a greater number of blastocysts, including a greater number of high-quality blastocysts. Higher oocyte yield, however, is not associated with improved blastulation rates. Blastulation rates, blastocyst number, and quality remain difficult to predict based on cycle characteristics alone, and oocyte yield may not be an accurate predictor of either outcome.

PS01.242: HIATAL HERNIA AFTER MINIMALLY INVASIVE ESOPHAGECTOMY

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 118-118
Author(s):  
Benedetto Mungo ◽  
Ana Gleisner ◽  
Lorena Rincon-Cruz ◽  
Loree Thornton ◽  
Martin Mccarter
Keyword(s):  
Conflicts Of Interest ◽  
Surgical Complication ◽  
Minimally Invasive Esophagectomy ◽  
Time Frame ◽  
Continuous Variables ◽  
Exact Test ◽  
Invasive Esophagectomy ◽  
Abdominal Organs ◽  
Chi Squared ◽  
Prior Surgery

Abstract Background Hiatal hernias (HH) are a known, yet poorly studied, post-surgical complication of esophagectomy. The aim of this study was to analyze in a retrospective fashion the MIE experience at our institution, in order to individuate factors associated with post-surgical HH development. Methods We reviewed data from MIE performed at University of Colorado from July 2013 to July 2017. Our most common approach of choice is Ivor Lewis MIE with circular stapled end to side anastomosis. We divided our patient population in two groups: those who developed a HH at any time post operatively and those who did not. We compared pre-, intra- and post-operative clinical variables of interest in the two groups using Pearson chi-squared and Fisher's exact test for binomial variables and Two-sample Wilcoxon rank-sum (Mann-Whitney) test for continuous variables. Results 91 patients underwent MIE in the study period: 11 developed HH in a time frame ranging from one week to two years post operatively. 8 patients had a HH involving one or more intra-abdominal organs other than the stomach; 3 patients had a HH interesting mostly the tubulized stomach. 7 patients required a reoperation. There were no statistically significant differences in the prevalence of pre-operative comorbidities between the two groups. Patient who developed a HH were significantly less likely to have had prior abdominal or thoracic surgery (Pr = 0.039). As expected, they were also significantly more likely to require a reoperation (Pr = 0.000). There were no statistically significant differences in intra-operative variables between the two groups, including operative time and anastomotic technique, nor where there differences in incidence of post operative complications other than HH. We did observe a trend towards higher rate of preoperative chemotherapy and radiation in the HH group. Of note, we did attempt to prevent HH by means of tacking abdominal organs to the abdominal wall, however this did not prove to significantly decrease HH incidence. Conclusion HH occurs in a non-negligible percentage of patients undergoing MIE. Lack of prior surgery appears to be significantly associated with HH, perhaps due to lesser adhesion burden acting as a mean of organ fixation. Disclosure All authors have declared no conflicts of interest.

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