scholarly journals A Retrospective Review of 589 Percutaneous Tracheostomies in a Canadian Community Teaching Hospital

2021 ◽  
pp. 014556132110257
Author(s):  
Dongho Shin ◽  
Andrew Ma ◽  
Yvonne Chan
Keyword(s):  
Retrospective Study ◽  
Teaching Hospital ◽  
Intraoperative Complications ◽  
Percutaneous Tracheostomy ◽  
Hospital Setting ◽  
Complication Rates ◽  
Safe Alternative ◽  
Neck Extension ◽  
Intraoperative Complication ◽  
Community Teaching

Objective: The primary objective of this study was to review the complication rate of percutaneous tracheostomies performed by a single surgeon in a community teaching hospital. Methods: This retrospective study reviewed the patients who underwent percutaneous tracheostomy with bronchoscopic guidance in a community hospital setting between 2009 and 2017. Patients older than the age of 18 requiring percutaneous tracheostomy were chosen for this retrospective study. Patients who were medically unstable, had no palpable neck landmarks, and inadequate neck extension were excluded. Indications for percutaneous tracheostomy included patients who had failed to wean from mechanical ventilation, required pulmonary toileting, or in whom airway protection was required. Results: Of the 600 patients who received percutaneous tracheostomy, 589 patients were included in the study. Intraoperative complication (2.6%) and postoperative complication rates (11.4%) compared similarly to literature reported rates. The most common intraoperative complications were bleeding, technical difficulties, and accidental extubation. Bleeding, tube obstruction, and infection were the most common postoperative complications. Overall burden of comorbidity, defined by Charlson Comorbidity Index, and coagulopathy were also found to be associated with higher complication rates. The decannulation rate at discharge was 46.3%. Conclusion: Percutaneous tracheostomy is a safe alternative to open tracheostomies in the community setting for appropriately selected patients.

Outpatient Endovascular Tibial Artery Intervention in an Office-Based Setting Is as Safe and Effective as in a Hospital Setting

2018 ◽  
Vol 25 (6) ◽  
pp. 666-672 ◽  
Author(s):  
Steve M. D’Souza ◽  
Christopher L. Stout ◽  
Emilia Krol ◽  
David J. Dexter ◽  
Sadaf Sadie Ahanchi ◽  
...  
Keyword(s):  
Hospital Setting ◽  
Transluminal Angioplasty ◽  
Primary Patency ◽  
Chronic Obstructive ◽  
Complication Rates ◽  
Unplanned Admission ◽  
Safe Alternative ◽  
Admission Rates ◽  
Tibial Artery ◽  
Angiography Suite

Purpose: To compare outcomes of outpatient tibial artery procedures between an office endovascular center and a hospital angiography suite. Methods: A retrospective review was conducted of 204 outpatient tibial interventions performed on 161 patients (mean age 72±11.5 years; 81 men) in either an office (n=100) or hospital (n=104) angiography suite from April 2011 through September 2013. Patients who had an existing ipsilateral bypass that was completely proximal to the tibial trifurcation were eligible, as were patients with prior proximal endovascular interventions. Exclusion criteria included previous ipsilateral bypass involving the infrapopliteal vessels, in-patient status at the time of the procedure, planned admission after the procedure, and infrapopliteal stenting. Treatment included percutaneous transluminal angioplasty (PTA) or PTA with atherectomy. Primary outcomes were unplanned admission, emergency room visits, acute complications, and patency. Results: There were no significant differences in demographics or baseline Rutherford category between patients treated in an office endovascular suite vs a hospital angiography suite. Factors more prevalent in the hospital group included chronic obstructive pulmonary disease (16% vs 8%, p=0.045), renal insufficiency (37% vs 25%, p=0.017), and previous proximal bypass (12% vs 4%, p=0.045). Of the 100 office procedures, 25 involved PTA and 75 were PTA with atherectomy, while in the 104 hospital procedures, PTA was applied in 68 patients and PTA with atherectomy in 36. Thirty-day local complication rates (7% vs 11%, p=0.368), systemic complication rates (4% vs 8%, p=0.263), and mortality (1% vs 2%, p=0.596) in the office vs hospital setting were not statistically different. Unplanned postprocedure hospital admission rates for medical reasons were lower in the office group (2% vs 11%, p=0.01). Kaplan-Meier estimates of the 1-year follow-up data were better in the office group for primary patency (69% vs 53%, p=0.050), assisted primary patency (90% vs 89%, p=0.646), and amputation-free survival (89% vs 83%, p=0.476), but the differences were not statistically significant. Conclusion: Efficacy and safety of outpatient endovascular tibial artery interventions between office and hospital settings were similar, with lower unplanned admission rates and better patency. With appropriate patient selection, the office endovascular suite can be a safe alternative to the hospital angiography suite.

scholarly journals Visual Outcomes and Intraoperative Complication Rates of Phacoemulsification Cataract Surgery by Third Year Ophthalmology Residents in the UP-Philippine General Hospital

2019 ◽  
Vol 53 (4) ◽  
Author(s):  
Richard C. Kho ◽  
Maria Angelica DF. Villano
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
General Hospital ◽  
Intraoperative Complications ◽  
The Philippines ◽  
Complication Rates ◽  
Intraoperative Complication ◽  
Visual Outcomes ◽  
Significant Difference ◽  
Vitreous Loss

Background. Phacoemulsification is the most important cataract surgical procedure performed by ophthalmology residents. There is an increasing and consistent trend in international studies on decreased complication rates and more efficient surgical techniques with more surgeries performed. The data collected from this study can be used to quantitatively assess the cataract surgery training of Ophthalmology residents in the country and can help to improve the quality of cataract surgeries taught and performed in the training programs. Objectives. To analyze outcomes of phacoemulsification cataract surgeries and to determine the intraoperative complication rates of third-year residents of the University of the Philippines - Philippine General Hospital (UP-PGH). Methods. Retrospective chart review of phacoemulsification cases done by eight third-year ophthalmology residents at the UP-PGH from January 1 to December 31, 2017. Outcomes measured included postoperative best corrected visual acuity (BCVA), intraoperative complications (posterior capsular rent and vitreous loss), and adjusted phacoemulsification times (total phacoemulsification time multiplied by phacoemulsification power used). Results. Four hundred ninety-two (492) cases were analyzed. Postoperative mean BCVA was 20/25. There were no significant differences in visual acuity outcomes over the course of training. Intraoperative complications occurred in 33 cases, with fewer cases with posterior capsule rent and vitreous loss later in training after the first 50 cases. There was a downward trend of adjusted phacoemulsification time throughout training, with a significant difference between the first 50 and 100 cases. Conclusion. Good visual outcomes are achievable throughout the resident’s phacoemulsification learning curve. Surgical competency in phacoemulsification, as measured by complication rates and phacoemulsification efficiency, still improves significantly with an increasing number of cases and experience beyond the first 100 cases.

Complications Related to Latarjet Shoulder Stabilization: A Systematic Review

2021 ◽  
pp. 036354652110423
Author(s):  
Chul-Hyun Cho ◽  
Sang Soo Na ◽  
Byung-Chan Choi ◽  
Du-Han Kim
Keyword(s):  
Systematic Review ◽  
Complication Rate ◽  
Shoulder Instability ◽  
Intraoperative Complications ◽  
Cochrane Library ◽  
Anterior Shoulder Instability ◽  
Complication Rates ◽  
Open Approach ◽  
Latarjet Procedure ◽  
Intraoperative Complication

Background: In cases of recurrent anterior shoulder instability with a glenoid defect, Latarjet procedures are widely used for stabilization. Although complications with this procedure have been reported, few studies have comprehensively analyzed issues related to the Latarjet procedure. Purpose: To identify the overall complication rate of the Latarjet procedure used for anterior shoulder instability and to compare the rate of complications between arthroscopic and open approaches. Study Design: Systematic review; Level of evidence, 4. Methods: PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed by using the PubMed, EMBASE, Scopus, and Cochrane Library databases. Data on complications were extracted and classified as intraoperative, postoperative, or instability-related for further analysis. Quality assessments were performed with criteria from the Methodological Index for Nonrandomized Studies (MINORS). A quantitative synthesis of data was conducted to compare the complication rates between arthroscopic and open approaches. Results: A total of 35 articles were included in this analysis. The MINORS score was 11.89. A total 2560 Latarjet procedures (2532 patients) were included. The overall complication rate was 16.1% (n = 412). The intraoperative complication rate was 3.4% (n = 87) and included a 1.9% (n = 48) incidence of nerve injuries and a 1.0% (n = 25) incidence of iatrogenic fractures. Screw problems, vascular injuries, and conversion arthroscopic to open surgery each occurred at a rate of <1%. The postoperative complication rate was 6.5% (n = 166), and the most common complication was nonunion (1.3%; n = 33). The instability-related complication rate was 6.2% (n = 159) and included a 1.5% (n = 38) rate of redislocation, a 2.9% (n = 75) rate of positive apprehension test, and a 1.0% (n = 26) rate of instability. Overall, 2.6% (n = 66) of patients required an unplanned secondary operation after the initial surgery. The arthroscopic approach was associated with a higher rate of intraoperative complications compared with the open approach (5.0% vs 2.9%; P =.020) and a lower rate of instability-related complications (3.1% vs 7.2%; P < .001). Conclusion: The Latarjet procedure for anterior shoulder instability results in an overall complication rate of 16.1% and a reoperation rate of 2.6%. However, serious complications at short-term follow-up appear rare. When the arthroscopic approach was used, the rate of intraoperative complications was higher, although instability-related complications were lower when compared with the open approach.

scholarly journals Complications of Third Molar Extraction: A retrospective study from a tertiary healthcare centre in Oman

2019 ◽  
Vol 19 (3) ◽  
pp. 230 ◽  
Author(s):  
Nabeel Sayed ◽  
Abdulaziz Bakathir ◽  
Mehboob Pasha ◽  
Salim Al-Sudairy
Keyword(s):  
Retrospective Study ◽  
Postoperative Complications ◽  
Intraoperative Complications ◽  
Third Molar ◽  
Complication Rates ◽  
Third Molars ◽  
Healthcare Centre ◽  
Bone Removal ◽  
Dry Socket ◽  
Tertiary Healthcare

Objectives: This retrospective study aimed to investigate complications associated with the extraction of third molars at a tertiary healthcare centre in Oman. Methods: All consecutive patients who underwent extraction of one or more impacted third molars under general anaesthesia at Sultan Qaboos University Hospital, Muscat, Oman, between January 2007 and December 2017 were included. Age, gender, indication for extraction, teeth removed, procedure and complications were recorded. Results: A total of 1,116 third molars (56% mandibular and 44% maxillary) were extracted and the majority (67.7%) were from female patients. The mean age at extraction was 24 ± 5 years and most patients (77.7%) were 20‒29 years old. The intraoperative and postoperative complication rates were 3.7% and 8.3%, respectively. The intraoperative complications included tuberosity fracture (1.2%), root fracture (1.1%), bleeding (0.7%), soft tissue injury (0.5%) and adjacent tooth damage (0.2%). Postoperative complications were sensory nerve injuries (7.2%), swelling/pain/trismus (0.6%) and dry socket (0.5%). Nerve injury was temporary in 41 patients and permanent in four cases. A statistically significant relationship was observed between those aged 30‒39 years and dry socket (P = 0.010) as well as bone removal and all postoperative complications (P = 0.001). Conclusion: Most complications resulting from third molar extractions were minor and within the reported ranges in the scientific literature. However, increased age and bone removal were associated with a higher risk of complications. These findings may help to guide treatment planning, informed consent and patient education.Keywords: Third Molar; Tooth Extraction; Complications; Lingual Nerve; Inferior Alveolar Nerve; Oman.

scholarly journals Substance Use Patterns and Schizophrenia Spectrum Disorders: A Retrospective Study of Inpatients at a Community Teaching Hospital

2020 ◽  
Vol 12 (12) ◽  
pp. 803-808
Author(s):  
Terence Tumenta ◽  
Oluwatoyin Oladeji ◽  
Manpreet Gill ◽  
Basim Ahmed Khan ◽  
Olaniyi Olayinka ◽  
...  
Keyword(s):  
Substance Use ◽  
Retrospective Study ◽  
Teaching Hospital ◽  
Schizophrenia Spectrum Disorders ◽  
Use Patterns ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders ◽  
Community Teaching

scholarly journals Intraoperative complications in pediatric neurosurgery: review of 1807 cases

2016 ◽  
Vol 18 (3) ◽  
pp. 363-371 ◽  
Author(s):  
Erik J. van Lindert ◽  
Sebastian Arts ◽  
Laura M. Blok ◽  
Mark P. Hendriks ◽  
Luc Tielens ◽  
...  
Keyword(s):  
Informed Consent ◽  
Intraoperative Complications ◽  
Pediatric Neurosurgery ◽  
Neurosurgical Procedures ◽  
Complication Rates ◽  
Tumor Surgery ◽  
Neurosurgical Department ◽  
Intraoperative Complication ◽  
Cerebrovascular Complications ◽  
Cerebrovascular Surgery

OBJECTIVE Minimal literature exists on the intraoperative complication rate of pediatric neurosurgical procedures with respect to both surgical and anesthesiological complications. The aim of this study, therefore, was to establish intraoperative complication rates to provide patients and parents with information on which to base their informed consent and to establish a baseline for further targeted improvement of pediatric neurosurgical care. METHODS A clinical complication registration database comprising a consecutive cohort of all pediatric neurosurgical procedures carried out in a general neurosurgical department from January 1, 2004, until July 1, 2012, was analyzed. During the study period, 1807 procedures were performed on patients below the age of 17 years. RESULTS Sixty-four intraoperative complications occurred in 62 patients (3.5% of procedures). Intraoperative mortality was 0.17% (n = 3). Seventy-eight percent of the complications (n = 50) were related to the neurosurgical procedures, whereas 22% (n = 14) were due to anesthesiology. The highest intraoperative complication rates were for cerebrovascular surgery (7.7%) and tumor surgery (7.4%). The most frequently occurring complications were cerebrovascular complications (33%). CONCLUSIONS Intraoperative complications are not exceptional during pediatric neurosurgical procedures. Awareness of these complications is the first step in preventing them.

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