Hospital and Long-Term Outcome of Trauma Patients with Tracheostomy for Respiratory Failure

2005 ◽  
Vol 71 (2) ◽  
pp. 123-127 ◽  
Author(s):  
Milo Engoren ◽  
Cynthia Arslanian-Engoren
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Outcome Data ◽  
Hospital Length Of Stay ◽  
Trauma Patients ◽  
Term Outcome ◽  
Term Survival ◽  
Long Term Outcome ◽  
Social Security Death Index

Studies of tracheostomy for respiratory failure have suggested a poor prognosis, however, trauma patients may have a better outcome. Data from 113 trauma patients were retrospectively analyzed for comorbidities, laboratory values, and hospital course. Long-term survival was determined from the Social Security Death Index. Trauma patients were young, overwhelmingly male, relatively healthy, and frequently uninsured. Seventy-five per cent of trauma patients were liberated from mechanical ventilation by hospital discharge. Timing of tracheostomy had no effect on days of mechanical ventilation or hospital length of stay. Hospital survival was 98 per cent, and 3-year Kaplan-Meier survival was 80 per cent. Older age and higher admission creatinine levels were predictive of late death. Trauma patients who undergo tracheostomy are likely to survive and be liberated from mechanical ventilation.

scholarly journals LONG-TERM FOLLOW UP AND TREATMENT OUTCOMES OF A 2 YEAR-OLD-BOY WITH METASTATIC TESTOSTERONE-SECRETING ADRENOCORTICAL CARCINOMA

2020 ◽  
Vol 6 (6) ◽  
pp. e300-e304
Author(s):  
Danielle LoGiurato ◽  
Zoltan Antal ◽  
Ping Zhou
Keyword(s):  
Adrenocortical Carcinoma ◽  
Survival Rates ◽  
Disease Status ◽  
Central Precocious Puberty ◽  
Outcome Data ◽  
Term Outcome ◽  
Term Survival ◽  
Long Term Outcome ◽  
Long Term Survival

Objective: Treatment of metastatic adrenocortical carcinoma (ACC) is challenging and long-term survival rates are exceedingly low. Long-term outcome data for pediatric patients who received mitotane is very limited. Methods: We describe the case of a 2-year-old boy with ACC with a lung metastasis. He was treated with surgery, chemotherapy, and mitotane, and remains disease-free 13 years after diagnosis. Results: The key endocrine issues learned from this case include: adrenal-derived sex-steroid and insulin-like growth factor-2 levels are correlated with disease status; very high doses of glucocorticoid and mineralocorticoid are required while on treatment of mitotane; and central precocious puberty needs to be detected and treated in a timely manner to preserve final adult height. Conclusion: We report a case of pediatric ACC with metastasis that was successfully treated with surgery, chemotherapy, and adjuvant therapy with mitotane. Appropriate endocrine testing and management are important for long-term survival and quality of life.

scholarly journals The long term survival of successfully weaned prolonged mechanical ventilation patients

2020 ◽  
Author(s):  
Chienhsiu Huang
Keyword(s):  
Mechanical Ventilation ◽  
End Of Life ◽  
Prolonged Mechanical Ventilation ◽  
Do Not Resuscitate ◽  
Term Outcome ◽  
Term Survival ◽  
Long Term Outcome ◽  
Long Term Survival ◽  
To Receive

Abstract Background Over six years, five hundred and seventy-four patients were admitted to the respiratory care center. Three hundred and ninety-one patients were successfully weaned from the ventilator. How is the long term outcome of these successfully weaned prolonged mechanical ventilation patients? Very few articles were discussing the long term outcome of successfully weaned prolonged mechanical ventilation patients. We will explore this issue in-depth in this article. Methods We analyzed retrospective data from successfully weaned prolonged mechanical ventilation patients to investigate the clinical variables, discharged status, long term survival, the cause of death, end-of-life decisions. Results We can further gather long term follow-up data on 243 patients. The factors between patients who died in the ward and those who survived ≥1 year revealed the poorer survival of patients who died in the ward was due to a higher percentage of end-stage renal disease comorbidity, a higher percentage of malignant comorbidity, higher percentage of ≥ four comorbidities and a higher percentage of signed do-not-resuscitate / do-not-intubate orders. The factors between patients who survived <1 year and those who survived ≥1 year revealed the poorer survival of patients who survived <1 year was due to older age, a higher percentage of signed do-not-resuscitate / do-not-intubate orders. That 81 patients (33.3%) who signed a do-not-resuscitate / do-not-intubate orders, indicates that, at most, 66.7% of survivors were willing to receive mechanical ventilation again. Conclusion The end-of-life decision (signed do-not-resuscitate / do-not-intubate orders) is one of the major influence factors of long term survival of successfully weaned prolonged mechanical ventilation patients. In all, 81 patients (33.3%) in our study signed do-not-resuscitate / do-not-intubate orders, meaning that, at most, 66.7% of survivors were willing to receive mechanical ventilation again.

scholarly journals Non-Surgical and Non-Radioiodine Techniques for Ablation of Benign Thyroid Nodules: Consensus Statement and Recommendation

2020 ◽  
Vol 128 (10) ◽  
pp. 687-692 ◽  
Author(s):  
Joachim Feldkamp ◽  
F. Grünwald ◽  
Markus Luster ◽  
Kerstin Lorenz ◽  
Christian Vorländer ◽  
...  
Keyword(s):  
Thyroid Nodules ◽  
Consensus Statement ◽  
German Society ◽  
Outcome Data ◽  
High Frequency Ultrasound ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Ultrasound Ablation ◽  
General And Visceral Surgery

AbstractThyroid nodules and cysts are frequently diagnosed in Germany with a prevalence of about 20% in young adults reaching up to 70% in older adults. Surgery is the standard treatment of symptomatic nodules, nodules with suspicion of malignancy and thyroid cancer. Radioiodine treatment is applied for autonomously functioning nodules. During the last years new non-surgical and non-radioiodine techniques have been introduced to treat thyroid nodules. These techniques include ethanol/polidocanol treatment, radiofrequency, microwave, and laser ablation, and high frequency ultrasound ablation. A significant reduction in nodule size could be documented for these techniques in several studies, but long-term outcome data are missing. Until now, there is no general consensus regarding the appropriate indications for these methods. For this reason, the Thyroid Section (German Society for Endocrinology), the Thyroid Working Committee (German Society for Nuclear Medicine), and the German Association of Endocrine Surgeons (CAEK) for the German Society of General and Visceral Surgery (DGAV) reviewed the respective literature, discussed the pro and cons and developed a consensus statement and recommendation to help physicians and patients in their decision making.

Long-term outcome of children undergoing surgery for suspected perilymph fistula

2008 ◽  
Vol 123 (3) ◽  
pp. 298-302 ◽  
Author(s):  
R J Sim ◽  
A H Jardine ◽  
E J Beckenham
Keyword(s):  
Hearing Loss ◽  
Case Series ◽  
Outcome Data ◽  
Rank Test ◽  
Short Term ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Signed Rank ◽  
Signed Rank Test

AbstractA number of authors have suggested that surgery for suspected perilymph fistula is effective in preventing deterioration of hearing and in improving hearing in some cases in the short term. We present long-term hearing outcome data from 35 children who underwent exploration for presumed perilymph fistula at The Children's Hospital, Sydney, Australia, between 1985 and 1992.Methods:The pre-operative audiological data (mean of 500, 1000, 2000 and 4000 Hz results) were compared with the most recently available data (range two to 15 years) and the six-month post-operative data.Results:The short-term results showed no significant change in hearing at six months, with a subsequent, statistically significant progression of hearing loss in both operated and non-operated ears (Wilcoxon signed rank test: operated ear, p < 0.017; non-operated ear, p < 0.009).Conclusion:In this case series, exploratory surgery for correction of suspected perilymph fistula did not prevent progression of long-term hearing loss.

Menstrual, Sexual, and Obstetrical Outcomes after Vaginal Replacement for Vaginal Atresia Associated with Anorectal Malformation

2016 ◽  
Vol 27 (06) ◽  
pp. 495-502 ◽  
Author(s):  
Clare Skerritt ◽  
Alejandra Vilanova Sánchez ◽  
Victoria Lane ◽  
Richard Wood ◽  
Geri Hewitt ◽  
...  
Keyword(s):  
Anorectal Malformation ◽  
Outcome Data ◽  
Current Evidence ◽  
Vaginal Agenesis ◽  
Vaginal Reconstruction ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Vaginal Atresia ◽  
Rectovestibular Fistula

Background The authors of this article became aware of significant differences in the management of two females with a rectovestibular fistula and associated vaginal agenesis. In one patient, a sigmoid colovaginoplasty was performed at the time of the posterior sagittal anorectoplasty (PSARP), and the other underwent repair of the rectovestibular fistula with a primary PSARP, but the surgeons elected to delay the timing of vaginal reconstruction. We decided to review the literature, to establish if recommendations could be made to optimize the management of these children based on current evidence. Methods A literature review was conducted to determine the management and long-term outcomes in patients with an anorectal malformation and associated vaginal atresia. Specific gynecological outcomes assessed were menstrual egress and adequacy of the vaginal replacement for penile–vaginal intercourse. Results Eighty-eight cases were included in the review. Age at diagnosis had a bimodal distribution: 0 to 5 years, 56%; >10 years, 37%. Vaginal atresia was recognized before the operation in 45 patients. Types of vaginal atresia encountered were: (a) distal vaginal atresia (n = 17), (b) vaginal agenesis with absent Mullerian development (n = 47), (c) vaginal agenesis with variable Mullerian development (n = 17), and (d) cervico-vaginal agenesis (n = 7). Types of vaginal replacement used were sigmoid colovaginoplasty (n = 26), distal rectal fistula as neovagina (n = 30), terminal ileum (n = 5), vaginal pull-through (n = 9), and others/unknown (n = 8). Two patients followed a perineal dilatation program and nine patients await reconstruction. Median follow-up was 18 months (6 weeks to 31 years). Long-term menstrual outcomes were reported in 18 (21%) patients. Sexual function was reported in 10 (11%) patients. Three pregnancies were reported but none resulted in live births. Conclusion Vaginal atresia is often missed in association with ARMs. Management should be in collaboration with pediatric gynecologists. Due to a lack of long-term outcome data, no definite conclusion can be drawn for the best technique, tissue, or timing of vaginal replacement. The opportunity to perform vaginal replacement in conjunction with the rectal repair may be worth considering because of a shallower pelvis, nonscarred tissue planes, and the excellent surgical exposure.

scholarly journals Chronic Myeloid Leukemia: Long-Term Outcome Data in the Imatinib Era

2018 ◽  
Vol 35 (1) ◽  
pp. 37-42 ◽  
Author(s):  
Prasanth Ganesan ◽  
Trivadi S. Ganesan ◽  
Venkatraman Radhakrishnan ◽  
Tenali Gnana Sagar ◽  
Krishnarathinam Kannan ◽  
...  
Keyword(s):  
Chronic Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Outcome Data ◽  
Term Outcome ◽  
Long Term Outcome

Impact of age on early outcomes and long-term survival of patients undergoing aortic repair with Stanford A dissection

Perfusion ◽  
2018 ◽  
Vol 33 (8) ◽  
pp. 687-695 ◽  
Author(s):  
Julia Merkle ◽  
Anton Sabashnikov ◽  
Carolyn Weber ◽  
Georg Schlachtenberger ◽  
Johanna Maier ◽  
...  
Keyword(s):  
Surgical Repair ◽  
Age Groups ◽  
Term Outcome ◽  
Term Survival ◽  
Long Term Outcome ◽  
Long Term Survival ◽  
Cerebrovascular Events ◽  
Short And Long Term ◽  
Male Patients

Objectives: Stanford A acute aortic dissection (AAD) is a life-threatening emergency, typically occurring in older patients and requiring immediate surgical repair. The aim of this study was to evaluate early outcome and short- and long-term survival of patients under and above 65 years of age. Methods: Two hundred and forty patients with Stanford A AAD underwent aortic surgical repair from January 2006 to April 2015 in our center. After statistical analysis and logistic regression analysis, Kaplan-Meier survival estimation was performed, with up to 9-year follow-up, comprising patients under and above 65 years of age. Results: The proportion of patients above 65 years of age suffering from Stanford A AAD was 50% (n=120). The group of patients above 65 years of age compared to the group under 65 years of age showed statistically significant differences in terms of higher odds ratios (OR) for hypertension (p=0.012), peripheral vascular disease (p=0.026) and tachyarrhythmia absoluta (p=0.004). Patients over 65 years of age also showed significantly poorer short- and long-term survival. Our subgroup analysis revealed that male patients (Breslow p=0.001, Log-Rank p=0.001) and patients suffering with hypertension (Breslow p=0.003, Log-Rank p=0.001) were reasonable for these results whereas younger and older female patients showed similar short- and long-term outcome (Breslow p=0.926, Log-Rank p=0.724). After stratifying all patients into 4 age groups (<45; 55-65; 65-75; >75years), short-term survival of the patients appeared to be significantly poorer with increasing age (Breslow p=0.026, Log-Rank p=0.008) whereas long-term survival of patients free from cerebrovascular events (Breslow p=0.0494, Log-Rank p=0.489) remained similar. Conclusions: All patients referred to our hospital for repair of Stanford A AAD with higher age had poorer short- and long-term survival, caused by male patients and patients suffering from hypertension, whereas survival of women and survival free from cerebrovascular events of the entire patient cohort was similar, irrespective of age.

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