Thoracic surgery mortality and morbidity in a university hospital

2012 ◽  
Vol 20 (2) ◽  
pp. 182-187 ◽  
Author(s):  
Sirilak Suksompong ◽  
Sarawut Thamtanavit ◽  
Benno von Bormann ◽  
Punnaruk Thongcharoen
Keyword(s):  
Thoracic Surgery ◽  
University Hospital ◽  
Mortality And Morbidity ◽  
Surgery Mortality

scholarly journals Thoracic surgery in the COVID-19 era: an Italian university hospital experience

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Riccardo Taje ◽  
Stefano Elia ◽  
Benedetto Cristino ◽  
Federico Tacconi ◽  
Gianluca Natali ◽  
...  
Keyword(s):  
Thoracic Surgery ◽  
Surgical Care ◽  
Primary Outcome Measure ◽  
University Hospital ◽  
Mortality And Morbidity ◽  
Number Of Patients ◽  
Study Results ◽  
Group A ◽  
Advanced Stages ◽  
Free Rate

Abstract Background Aims of this study were to assess the results of anti-COVID19 measures applied to maintain thoracic surgery activity at an Italian University institution through a 12-month period and to assess the results as compared with an equivalent non-pandemic time span. Methods Data and results of 646 patients operated on at the department of Thoracic Surgery of the Tor Vergata University Policlinic in Rome between February 2019 and March 2021 were retrospectively analyzed. Patients were divided in 2 groups: one operated on during the COVID-19 pandemic (pandemic group) and another during the previous non-pandemic 12 months (non-pandemic group). Primary outcome measure was COVID-19 infection-free rate. Results Three patients developed mild COVID-19 infection early after surgery resulting in an estimated COVID-19 infection-free rate of 98%. At intergroup comparisons (non-pandemic vs. pandemic group), a greater number of patients was operated before the pandemic (352 vs. 294, p = 0.0013). In addition, a significant greater thoracoscopy/thoracotomy procedures rate was found in the pandemic group (97/151 vs. 82/81, p = 0.02) and the total number of chest drainages (104 vs. 131, p = 0.0001) was higher in the same group. At surgery, tumor size was larger (19.5 ± 13 vs. 28.2 ± 21; p < 0.001) and T3-T4/T1-T2 ratio was higher (16/97 vs. 30/56; p < 0.001) during the pandemic with no difference in mortality and morbidity. In addition, the number of patients lost before treatment was higher in the pandemic group (8 vs. 15; p = 0.01). Finally, in 7 patients admitted for COVID-19 pneumonia, incidental lung (N = 5) or mediastinal (N = 2) tumors were discovered at the chest computed tomography. Conclusions Estimated COVID-19 infection free rate was 98% in the COVID-19 pandemic group; there were less surgical procedures, and operated lung tumors had larger size and more advanced stages than in the non-pandemic group. Nonetheless, hospital stay was reduced with comparable mortality and morbidity. Our study results may help implement efficacy of the everyday surgical care.

scholarly journals Preliminary study of the prevalence of hypotrophy and fetal alcohol syndrome in Antananarivo, Madagascar

2020 ◽  
Vol 7 (7) ◽  
pp. 1496
Author(s):  
Mbolanirina L. Rakotomahefa Narison ◽  
Arthur B. A. Ratsimbazafy ◽  
Zo L. Andrianadison ◽  
Honore S. Raobijaona
Keyword(s):  
Fetal Alcohol Syndrome ◽  
University Hospital ◽  
Fetal Alcohol ◽  
Mortality And Morbidity ◽  
Underdeveloped Countries ◽  
Determining Factors ◽  
Associated Malformations ◽  
Preliminary Study ◽  
Familial Alcoholism ◽  
The Relationship

Background: Hypotrophy is a major contributor to neonatal mortality and morbidity in underdeveloped countries. In Madagascar, efforts have been made to improve this situation, particularly with regard to prevention and early treatment. This prevention is mainly focused on the search for determining factors. Fetal Alcohol Syndrome (FAS) is not yet mentioned in Madagascar although more than 9% of Tananarivian women drink alcohol. A study was conducted in our department to determine the relationship between maternal alcohol intake and hypotrophy.Methods: The prospective study was carried out in the pediatrics department of the Joseph Raseta Befelatanana University Hospital Centre, on hospitalized hypotrophic newborns (below the 10th percentile) over a period of 3 months from December 1, 2018 to February 31, 2019. In the newborn, authors studied facial features, neurological abnormalities and associated malformations. For the mother, alcohol consumption, pregnancy information was analyzed. The character of FAS could thus be classified.Results: Author counted 21 hypotrophs among the 128 newborns hospitalized during this period. The facial abnormalities observed were: upper lip thickness abnormality (9.5%) and retrognathism (4.7%). Neurological signs described were: difficulty sucking (76.1%), hypotonia (66.6%), restlessness (9.5%), hyper-responsiveness (9.5%), hypertonia (9.5%) and tremor (4.7%). Two organ malformations (9.5%) were seen: cardiac and biliary tract malformations. Only one mother (4.7%) admitted having taken alcohol during pregnancy. Seven cases of familial alcoholism were reported. At the end of this study, we were able to identify only one case of doubtful FAS (4.7%), 2 cases of suspected FAS (9.5%) and 1 case of confirmed FAS (4.7%).Conclusions: This syndrome remains under-diagnosed in Madagascar due to the lack of staff training on FAS and the non-systematization of the search for its signs during systematic visits.

scholarly journals Clinical study of the hospital mortality and morbidity after thoracic surgery.

2001 ◽  
Vol 15 (2) ◽  
pp. 71-77 ◽  
Author(s):  
Mitsuo Kawamura ◽  
Yasuhiro Takahashi ◽  
Kimito Orino ◽  
Yoshirou Sazawa
Keyword(s):  
Clinical Study ◽  
Thoracic Surgery ◽  
Hospital Mortality ◽  
Mortality And Morbidity

scholarly journals Early and Late Outcome, Mortality and Major Morbidity After Lung Cancer Surgery for Primary Carcinoma

2018 ◽  
Vol 2 (2) ◽  
Author(s):  
Fadil Gradica ◽  
L. Lisha ◽  
Dh. Argjiri ◽  
A. Cani ◽  
F. Kokici ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lung Cancer Surgery ◽  
Cardiovascular Complications ◽  
Cancer Surgery ◽  
University Hospital ◽  
Mortality And Morbidity ◽  
Preoperative Ct ◽  
Laboratory Examinations ◽  
Surgical Modality ◽  
Upper Abdomen

Background: Radical surgical resection of lung cancer with or without adjuvant treatment is still a prerequisitefor cure. Advances in operative and postoperative care led to a decline in complications and mortality rates during the last decades. In spite of different additional modes of treatment, survival is still poor.The aim of study: To examine the operative mortality and morbidity after lung cancer surgery and to identify factors associated with an adverse outcome.Material and methods: The study comprised 968 consecutive patients referred to University Hospital of Lung Disease, “Shefqet Ndroqi” Tirana, Albania, for lung carcinoma, during a 13-years period (January 2004-December 2017). All patients underwent routine laboratory examinations spirometry and preoperative CT- scan of the thorax and upper abdomen. PET-CT, EBUS–EUS, Mediastinotomy or Mediastinoscopy wasn’t performed as routine.Results: Of 968 patients, 690 (70.5%) were male and 278 (28.7%) female. Mean age 65.5±9.4 years (range 15 - 87 years). Lobectomy was the most used surgical modality in 566 (58.5%) patients, meanwhile pneumonectomy was performed in 112 (11.6%) of patients. Minor complications during surgery occurred in 45 (11.7%) ofpatients. Continuous air leakage was the most complication after surgery in 25.3%, followed by lung atelectasis in 21.3% and cardiovascular complications in 17%.Conclusion: our results show low mortality and morbidity after lung cancer surgery. However, patients with reduced lung capacity, older age and those undergoing pneumonectomy should be treated with great care.

345 Analysis of 3298 Consecutive Neurosurgical Cases Demonstrates that Overlapping Surgery has no Adverse Effect on Patient Outcome

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 278-278
Author(s):  
Brian M Howard ◽  
Christopher Michael Holland ◽  
David Painton Bray ◽  
Jason J Lamanna ◽  
James G Malcolm ◽  
...  
Keyword(s):  
Postoperative Mortality ◽  
Severity Of Illness ◽  
Study Groups ◽  
University Hospital ◽  
Unplanned Readmission ◽  
Neurosurgical Procedures ◽  
Mortality And Morbidity ◽  
Severe Morbidity ◽  
Logistic Regression Models ◽  
Discharge Location

Abstract INTRODUCTION Overlapping surgery is commonly practiced. However, a dearth of evidence exists to support or refute the safety of overlapping surgery. We endeavored to determine whether overlapping surgery is associated worsened morbidity and mortality in a large series of complex, neurosurgical cases. METHODS A retrospective cohort study was completed for all patients who underwent neurosurgical procedures at Emory University Hospital between January 1, 2014 and December 31, 2015. Logistic regression models were executed to compare outcomes for overlapping and nonoverlapping surgery. Investigators were blinded to study cohorts during data collection and analysis. Patients were operated on for pathologies across the spectrum of neurosurgical disorders in 3298 included cases. The primary outcome measures were 90-day postoperative mortality and morbidity. RESULTS >Of 3298 operations, 1518 (46%) were nonoverlapping while 1780 (54%) were overlapping. The mean age was similar across study groups. The majority of the cohort was female (54% vs. 46%). Patients who underwent overlapping surgery were more likely to be female (56% vs 44%, P = 0.002). The distribution of American Association of Anesthesiologists Score was similar between overlapping and nonoverlapping surgery cohorts. Median (IQR) surgical times, in-room and skin-to-skin, were significantly longer for overlapping surgery (203[153.8] vs 173[148.3]; P < 0.001 and 125[130] vs 98[120]; P = 0.002) than nonoverlapping surgery. Overlapping surgery was more frequently elective (91.3% vs 84.3%; P < 0.001). Regression analysis failed to demonstrate a correlation between overlapping surgery and complications such as mortality, any or severe morbidity or unplanned readmission. Measures of baseline severity of illness, such as ASA>3 and emergent surgery, or complexity of surgery, such as the presence of a co-surgeon associated with mortality, overall and severe morbidity, unfavorable discharge location and functional status, both at discharge and follow-up (OdR>1, CI>1 for all). CONCLUSION These data indicated that overlapping surgery can be safely performed if appropriate safety precautions and patient selection are followed.

scholarly journals Clinical features and outcomes of thoracic surgery patients during the COVID-19 pandemic

2020 ◽  
Vol 58 (4) ◽  
pp. 738-744
Author(s):  
María Salmerón Jiménez ◽  
Fátima Hermoso Alarza ◽  
Ivan Martínez Serna ◽  
Carmen Marrón Fernández ◽  
José Carlos Meneses Pardo ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Thoracic Surgery ◽  
Clinical Features ◽  
Surgical Procedures ◽  
Initial Period ◽  
Recovery Period ◽  
University Hospital ◽  
Polymerase Chain Reaction Test ◽  
Symptom Screening ◽  
Surgery Patient

Abstract OBJECTIVES The goal of this study was to describe the clinical features and outcomes of thoracic surgery patients during the coronavirus disease 2019 (COVID-19) pandemic. METHODS Thirty-five patients were treated at the 12 de Octubre University Hospital in Madrid between 1 March 2020 and 24 April 2020 during the COVID-19 pandemic. Patient demographics, surgical procedures, complications, COVID-19 symptoms and outcomes were recorded. A protocol was introduced to reduce the risk of operating on patients with COVID-19, including symptom screening, a polymerase chain reaction test for severe acute respiratory syndrome coronavirus 2 and computed tomography scans of the chest. Surgical activity changed significantly during this time, from an initial period of near-normal activity, through an emergency-only period and finally a recovery period when some oncological surgical cases were restarted. Selection criteria for surgical patients are also described. RESULTS A total of 34 patients underwent surgery during the pandemic period. We performed 22 lung resections (11 lobectomies and 11 sublobar resections). No hospital deaths were recorded. An elective surgery patient and an emergency surgery patient were diagnosed with COVID-19 (5.88%). The former died within 30 days after surgery. CONCLUSIONS Severe acute respiratory syndrome coronavirus 2 represents a tremendous limitation for thoracic surgical practice. Preoperative practices to exclude asymptomatic cases infected with the virus allowed us to perform thoracic surgical procedures.

Recovery Pattern in Different Surgical Approaches on Thoracic Enhanced Recovery based Fourteen-Step Protocol in Patients Undergoing Cardio-thoracic Surgery at University Hospital of Nepal

2020 ◽  
Vol 18 (2) ◽  
pp. 78-82
Author(s):  
R.M. Karmacharya ◽  
R. Shakya ◽  
A.K. Singh ◽  
S. Baidya ◽  
S. Dahal ◽  
...  
Keyword(s):  
Thoracic Surgery ◽  
Hospital Stay ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
University Hospital ◽  
Early Recovery ◽  
Video Assisted Thoracic Surgery ◽  
Icu Stay ◽  
Video Assisted ◽  
Surgery Group

Background Cardio-thoracic surgery involves open and minimally invasive techniques. Enhanced recovery after surgery is used for early recovery from surgery. Enhanced recovery after surgery decreases hospital stay duration. Patients undergoing Enhanced recovery after surgery after video assisted thoracic surgery use less pain killers and have less hospital cost. There has not been any study on outcomes on patient who follow physiotherapy protocol designed in our setting. Objective To find the physiotherapy outcomes in patients undergoing thoracic enhanced recovery after surgery (T-ERAS) based 14 step protocol locally designed at Dhulikhel Hospital, Kathmandu University Hospital (DH, KUH). Method This is a retrospective cross sectional observational study. All the cases who underwent cardiothoracic surgery were classified based on the approach of chest surgery performed into groups Sternotomy, Thoracotomy and Video Assisted Thoracic Surgery (VATS) groups. Patients were advised for Thoracic Enhanced recovery after surgery based on the protocol that has been devised at Dhulikhel Hospital. The recovery of patients based on activities they could perform was noted and analyzed. Result Both ICU stay and hospital stay in number of days were highest in thoracotomy (6.04 days) group while that was lowest in video assisted thoracic surgery group (1.67 days). There is a similar recovery until step 5, i.e. 2 days and rapid progression in further steps in video assisted thoracic surgery group while it is much slower in both sternotomy and thoracotomy groups. Conclusion Postoperative mobilization and physiotherapy enhance early healing and decrease hospital stay. Mean hospital stay and ICU stay were shorter for video assisted thoracic surgery cases compared to Thoracotomy and Sternotomy groups and the mean days to achieve different steps varied within the protocol between groups compared.

Sign in / Sign up

Export Citation Format

Share Document