scholarly journals Older fusion-surgery age in congenital scoliosis patients is a risk factor for extended length of stay, more estimated blood loss, longer fused segments and higher medical costs: a retrospective study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Xiran Chai ◽  
Guanfeng Lin ◽  
Shengru Wang ◽  
Yang Yang ◽  
Zhe Su ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Length Of Stay ◽  
Blood Loss ◽  
Congenital Scoliosis ◽  
Medical Costs ◽  
Fusion Surgery ◽  
Thoracic Deformity ◽  
Estimated Blood Loss ◽  
Extended Length

Abstract Background Contradictory opinions about whether early correction and fusion surgeries should be performed for congenital scoliosis (CS) patients at a young age exist. The objectives of this study were to analyze the association between patient characteristics and fusion-surgery outcomes in CS patients treated with spinal correction and fusion surgeries and to report risk factors for extended length of stay (LOS), more estimated blood loss (EBL), longer fused segments and higher medical costs. Methods We analyzed data of 1,207 CS inpatients treated with fusion surgeries in our institute from January 2010 - December 2019. All patients underwent spinal X-ray, CT, MRI, echocardiogram and urogenital ultrasound. We analyzed demographic and clinical information and outcome measures, including LOS, EBL, fused segments and medical costs. Results Age at fusion (OR = 1.053; p < 0.001), musculoskeletal defects (OR = 1.670; p = 0.004) and thoracic deformity (OR = 1.519; p = 0.03) were risk factors for extended LOS. Age at fusion (OR = 1.117; p < 0.001), male sex (OR = 1.813; p < 0.001), mixed defects (OR = 1.662; p = 0.027) and failure of formation (OR = 1.718; p = 0.021) were risk factors for more EBL. Age at fusion (OR = 1.213; p < 0.001) was a risk factor for longer fused segments. Age at fusion (OR = 1.091; p < 0.001) and thoracic deformity (OR = 1.853; p = 0.004) were risk factors for higher medical costs. Conclusions We found that older age at fusion in CS patients is a risk factor for extended LOS, more EBL, longer fused segments and higher medical costs with the risk increasing by 5–21 % for each year of age. Other identified risk factors include thoracic deformity for extended LOS; longer fused segments, higher medical costs, and musculoskeletal defects for extended LOS; and CS type (FF and MD) and sex (male) for more EBL.

scholarly journals Retrospective comparison of three minimally invasive approaches for adrenal tumors: perioperative outcomes of transperitoneal laparoscopic, retroperitoneal laparoscopic and robot-assisted laparoscopic adrenalectomy

BMC Urology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Changwei Ji ◽  
Qun Lu ◽  
Wei Chen ◽  
Feifei Zhang ◽  
Hao Ji ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Blood Loss ◽  
Minimally Invasive ◽  
Laparoscopic Adrenalectomy ◽  
Perioperative Outcomes ◽  
Adrenal Tumors ◽  
Transfusion Rate ◽  
Robot Assisted ◽  
Estimated Blood Loss ◽  
Minimally Invasive Adrenalectomy

Abstract Background To compare the perioperative outcomes of transperitoneal laparoscopic (TLA), retroperitoneal laparoscopic (RLA), and robot-assisted transperitoneal laparoscopic (RATLA) adrenalectomy for adrenal tumors in our center. Methods Between April 2012 and February 2018, 241 minimally invasive adrenalectomies were performed. Cases were categorized based on the minimally invasive adrenalectomy technique. Demographic characteristics, perioperative information and pathological data were retrospectively collected and analyzed. Results This study included 37 TLA, 117 RLA, and 87 RATLA procedures. Any two groups had comparable age, ASA score, Charlson Comorbidity Index, and preoperative hemoglobin. The tumor size for RLA patients was 2.7 ± 1.1 cm, which was significantly smaller compared to patients who underwent TLA/RATLA (p = 0.000/0.000). Operative time was similar in any two groups, while estimated blood loss was lower for RATLA group (75.6 ± 95.6 ml) compared with the TLA group (131.1 ± 204.5 ml) (p = 0.041). Conversion to an open procedure occurred in only one (2.7%) patient in the TLA group for significant adhesion and hemorrhage. There were no significant differences between groups in terms of transfusion rate and complication rate. Length of stay was shorter for the RATLA group versus the TLA/RLA group (p = 0.000/0.029). In all groups, adrenocortical adenoma and pheochromocytoma were the most frequent histotypes. Conclusions Minimally invasive adrenalectomy is associated with expected excellent outcomes. In our study, the RATLA approach appears to provide the benefits of decreased estimated blood loss and length of stay. Robotic adrenalectomy appears to be a safe and effective alternative to conventional laparoscopic adrenalectomy.

Does MIS Surgery Allow for Shorter Constructs in the Surgical Treatment of Adult Spinal Deformity?

Neurosurgery ◽  
2017 ◽  
Vol 80 (3) ◽  
pp. 489-497 ◽  
Author(s):  
Juan S. Uribe ◽  
Joshua Beckman ◽  
Praveen V. Mummaneni ◽  
David Okonkwo ◽  
Pierce Nunley ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Blood Loss ◽  
Clinical Outcomes ◽  
Spinal Deformity ◽  
Lumbar Lordosis ◽  
Adult Spinal Deformity ◽  
Radiographic Parameters ◽  
Estimated Blood Loss ◽  
Significant Difference ◽  
The Impact

Abstract BACKGROUND: The length of construct can potentially influence perioperative risks in adult spinal deformity (ASD) surgery. A head-to-head comparison between open and minimally invasive surgery (MIS) techniques for treatment of ASD has yet to be performed. OBJECTIVE: To examine the impact of MIS approaches on construct length and clinical outcomes in comparison to traditional open approaches when treating similar ASD profiles. METHODS: Two multicenter databases for ASD, 1 involving MIS procedures and the other open procedures, were propensity matched for clinical and radiographic parameters in this observational study. Inclusion criteria were ASD and minimum 2-year follow-up. Independent t-test and chi-square test were used to evaluate and compare outcomes. RESULTS: A total of 1215 patients were identified, with 84 patients matched in each group. Statistical significance was found for mean levels fused (4.8 for circumferential MIS [cMIS] and 10.1 for open), mean interbody fusion levels (3.6 cMIS and 2.4 open), blood loss (estimated blood loss 488 mL cMIS and 1762 mL open), and hospital length of stay (6.7 days cMIS and 9.7 days open). There was no significant difference in preoperative radiographic parameters or postoperative clinical outcomes (Owestry Disability Index and visual analog scale) between groups. There was a significant difference in postoperative lumbar lordosis (43.3° cMIS and 49.8° open) and pelvic incidence-lumbar lordosis correction (10.6° cMIS and 5.2° open) in the open group. There was no significant difference in reoperation rate between the 2 groups. CONCLUSION: MIS techniques for ASD may reduce construct length, reoperation rates, blood loss, and length of stay without affecting clinical and radiographic outcomes when compared to a similar group of patients treated with open techniques.

Extended Length of Stay After Robotic-Assisted Hysterectomy: Association with Uterine Weight and Other Risk Factors

2016 ◽  
Vol 32 (1) ◽  
pp. 19-23
Author(s):  
Tarek Toubia ◽  
Lauren Schiff ◽  
Ganesa Wegienka ◽  
Roopina Sangha
Keyword(s):  
Risk Factors ◽  
Length Of Stay ◽  
Uterine Weight ◽  
Robotic Assisted ◽  
Extended Length

scholarly journals Hidden blood loss and the risk factors after posterior lumbar fusion surgery

Medicine ◽  
2020 ◽  
Vol 99 (19) ◽  
pp. e20103
Author(s):  
Fei Lei ◽  
Zhongyang Li ◽  
Wen He ◽  
Xinggui Tian ◽  
Lipeng Zheng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Loss ◽  
Lumbar Fusion ◽  
Fusion Surgery ◽  
Posterior Lumbar Fusion ◽  
Lumbar Fusion Surgery ◽  
Hidden Blood Loss

Effect of an additional neurosurgical resident on procedure length, operating room time, estimated blood loss, and post-operative length-of-stay

2019 ◽  
Vol 34 (6) ◽  
pp. 611-615
Author(s):  
Anthony V. Nguyen ◽  
William S. Coggins ◽  
Rishabh R. Jain ◽  
Daniel W. Branch ◽  
Randall Z. Allison ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Blood Loss ◽  
Operating Room ◽  
Estimated Blood Loss ◽  
Room Time ◽  
Operating Room Time

Genitofemoral Nerve Protection During the Lateral Retroperitoneal Transpsoas Approach

2013 ◽  
Vol 73 (2) ◽  
pp. ons192-ons197 ◽  
Author(s):  
Gabriel C. Tender ◽  
Daniel Serban
Keyword(s):  
Length Of Stay ◽  
Blood Loss ◽  
Minimally Invasive ◽  
Operative Time ◽  
Femoral Nerve ◽  
Psoas Muscle ◽  
Lateral Approach ◽  
Direct Visualization ◽  
Genitofemoral Nerve ◽  
Estimated Blood Loss

Abstract BACKGROUND: The minimally invasive lateral retroperitoneal approach for lumbar fusions is a novel technique with good results, but also with significant sensory and motor complications. OBJECTIVE: To present the early results of a modified surgical technique, in which the psoas muscle is dissected under direct visualization. METHODS: Thirteen consecutive patients with L4-5 or L3-4 pathology were prospectively followed after being treated using a minimally invasive lateral approach with direct exposure of the psoas muscle before dissection. There were 7 woman and 6 men with a mean age of 52.3 years. Perioperative parameters like operative time, estimated blood loss, and length of stay, were noted. Pain, paresthesia, and motor weakness, as well as any other complications, were evaluated at 2 weeks and 3 months postoperatively. RESULTS: The mean operative time, estimated blood loss, and length of stay were 163 minutes, 126 mL, and 3 days, respectively. One patient exhibited anterior thigh pain and paresthesia at 2 weeks, both of which resolved by 3 months. Two patients experienced superficial wound infections that healed with antibiotics. The genitofemoral nerve was identified and protected in 7 patients; in 4 patients, it had a more posterior anatomic location than expected. The femoral nerve was not exposed or detected in the operative field by neuromonitoring, nor were there any symptoms related to a femoral nerve injury in any patient. CONCLUSION: Dissection of the psoas muscle under direct visualization during the minimally invasive lateral approach may provide increased safety to the genitofemoral and femoral nerves.

scholarly journals Risk Factor for Mortality in COVID-19 Patients in Mohammad Hoesin Hospital, Palembang, Indonesia

2021 ◽  
Vol 12 (1) ◽  
pp. 69-76
Author(s):  
Rico Januar Sitorus ◽  
Nyoman Yudi Antara ◽  
Rosyada Elviani ◽  
Zen Ahmad ◽  
Harun Hudari ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Length Of Stay ◽  
World Health ◽  
Dominant Factor ◽  
The Novel ◽  
Cross Sectional ◽  
Rapid Spread ◽  
The Mean ◽  
Health Organization

World Health Organization (WHO) has declared the novel corona virus (COVID-19) as a pandemic due to its high transmission and the rapid spread of the COVID-19. Along these lines, there is a need for more research about risk factors that can affect the spread of COVID-19 and its fatality. Therefore, this study aims to analyze risk factors in patients who died from COVID-19 at the Mohammad Hoesin Hospital in Palembang, South Sumatra, Indonesia. This study used a cross-sectional approach. The data were collected from all patients who died with suspected, probable, and confirmed status until September 2020  Data on death due to COVID-19 were collected with suspect, probable, and confirmed status. The results showed that comorbidity became the most dominant factor (62.1%) with (OR Adj) 3.780 (1.000 – 3.168) after controlling for contact history with confirmed cases and sex. There were differences in the mean age and length of stay in patients with confirmed COVID-19 and not. Prevention of death in COVID-19 patients can be done by controlling comorbidities and contact history with positive cases of COVID-19.

Feasibility of Correction With Instrumentation Only in Congenital Scoliosis

Neurosurgery ◽  
2013 ◽  
Vol 74 (1) ◽  
pp. 35-41 ◽  
Author(s):  
Choon Sung Lee ◽  
Chang Ju Hwang ◽  
Dong-Joon Kim ◽  
Joon Kwon ◽  
Yung-Tae Kim ◽  
...  
Keyword(s):  
Blood Loss ◽  
Deformity Correction ◽  
Operation Time ◽  
Congenital Scoliosis ◽  
Estimated Blood Loss ◽  
Curve Magnitude ◽  
Average Patient ◽  
Patient Groups ◽  
Invasive Techniques ◽  
Main Curve

Abstract BACKGROUND: Although effective correction of deformity in congenital scoliosis can often be achieved with instrumentation only and without more invasive techniques such as hemivertebrectomy (HV), reports of the feasibility of correction with instrumentation only (IO) are lacking. OBJECTIVE: To compare the results of deformity correction using IO vs HV and to examine the feasibility of and indications for correction with IO in patients with congenital scoliosis. METHODS: Twenty-five patients underwent correction with either IO (n = 14) or HV (n = 11). The 2 patient groups were compared in terms of age at the time of surgery, preoperative magnitude and flexibility of the main curve, correction rates after surgery and at the final follow-up, surgery time, estimated blood loss, and complications. RESULTS: The 2 groups did not differ significantly in terms of average patient age or curve magnitude, but the correction with the IO group had greater preoperative curve flexibility (37.1%) than the HV group (21.0%). The correction rates immediately after surgery were high in both groups. The correction with IO group had a shorter mean operation time (308 minutes vs 366 minutes) and less blood loss (540 mL vs 1547 mL) than the HV group. CONCLUSION: Satisfactory correction of congenital scoliosis can be obtained with IO if there is adequate flexibility in the main curve, thus avoiding the need for more invasive procedures such as HV.

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