scholarly journals Postoperative respiratory depression after hysterectomy

2020 ◽  
Author(s):  
Mariana L. Laporta ◽  
Michelle O. Kinney ◽  
Darrell R. Schroeder ◽  
Juraj Sprung ◽  
Toby N. Weingarten
Keyword(s):  
Risk Factors ◽  
Confidence Interval ◽  
Respiratory Depression ◽  
Oral Morphine ◽  
Pulmonary Complications ◽  
Postoperative Pulmonary Complications ◽  
Opioid Dose ◽  
Factors Associated ◽  
Depression Risk ◽  
Lower Body Weight

To investigate if sex-specific physiologic characteristics could impact postoperative respiratory depression risks in women, we studied incidence and risk factors associated with postoperative respiratory depression in a gynecologic surgical cohort. Only hysterectomies performed under general anesthesia from 2012 to 2017 were included to minimize interprocedural variability. Respiratory depression was defined as episodes of apnea, hypopnea, hypoxemia, pain-sedation mismatch, unplanned positive airway pressure device application, or naloxone administration in the post-anesthesia care unit. Multivariable logistic regression was used to explore the association with clinical characteristics. From 1,974 hysterectomies, 253 had postoperative respiratory depression, yielding an incidence of 128 (95% confidence interval, 114–144) per 1,000 surgeries. Risk factors associated with respiratory depression were older age (odds ratio 1.22 [95% confidence interval 1.02–1.46] per decade increase, p = 0.03), lower body weight (0.77 [0.62–0.94] per 10 kg/m2, p = 0.01), and higher intraoperative opioid dose (1.05 [1.01–1.09] per 10 mg oral morphine equivalents, p = 0.01); while sugammadex use was associated with a reduced risk (0.48 [0.30–0.75], p = 0.002). Respiratory depression was not associated with increased hospital stay, postoperative complications, or mortality. Postoperative respiratory depression risk in women increased with age, lower weight, and higher intraoperative opioids and decreased with sugammadex use; however, it was not associated with postoperative pulmonary complications.

Influence of Concomitant Polypharmacy on Docetaxel-induced Febrile Neutropenia

2021 ◽  
Vol 1 (3) ◽  
pp. 135-141
Author(s):  
KATSUYA MAKIHARA ◽  
YUKA SHIMEDA ◽  
TOMOKAZU MATSUMURA
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Febrile Neutropenia ◽  
Confidence Interval ◽  
Cytochromes P450 ◽  
Cyp3a4 Activity ◽  
Factors Associated ◽  
Cyp3a4 Inhibitors ◽  
Concomitant Medications ◽  
Main Factor

Background/Aim: Docetaxel (DTX) is metabolized by liver cytochromes P450 (CYP) 3A4 (CYP3A4) and 3A5 (CYP3A5) CYP3A4 activity is considered the main factor affecting the effectiveness in DTX clearance. We, therefore, explored the association between DTX-induced febrile neutropenia (FN) and concomitant polypharmacy involving CYP3A4 inhibitors in cancer patients. Patients and Methods: Among patients who received docetaxel, we compared the number of concomitant medications between patients with and without FN, and risk factors associated with FN were identified. Results: The total number of concomitant CYP3A4 inhibitors and substrates used was significantly higher in patients with FN [mean: 2.1 (95% confidence interval (CI)=1.5-2.9)] than in those without FN [mean: 1.4 (95% CI=1.0-1.8)] (p=0.01). The only risk factor for FN was the use of ≥2 concomitant CYP3A4 inhibitors and substrates in total (OR=4.82, 95% CI=1.77-14.1; p=0.002). Conclusion: Polypharmacy involving CYP3A4 inhibitors and substrates increases the risk of DTX-induced FN.

Pulmonary Diseases: Preoperative Assessment

2018 ◽  
Author(s):  
Suzanne Bennett ◽  
Quinn M Nguyen
Keyword(s):  
Risk Factors ◽  
Pulmonary Disease ◽  
Pulmonary Function Tests ◽  
Preoperative Evaluation ◽  
Pulmonary Complications ◽  
Perioperative Outcomes ◽  
Surgical Patient ◽  
Postoperative Pulmonary Complications ◽  
Related Risk ◽  
Obstructive Sleep

Postoperative pulmonary complications contribute to significant morbidity, mortality, and healthcare costs. The surgical patient with underlying pulmonary disease experiences a higher risk for postoperative pulmonary complications. Evaluation of the patient with pulmonary disease prior to surgery allows for the early identification of risk factors and opportunity for optimization resulting in improved perioperative outcomes for all surgical procedures. Complete understanding of the anesthetic options and their effect on pulmonary physiology and postoperative pulmonary complications assists in the evaluation and management of the patient with pulmonary disease. The patient-related risk factors, procedure-related risk factors, and risk factor stratification must be evaluated and performed while taking into consideration the risk and type of surgery. A thorough preoperative evaluation of the patient with pulmonary disease allows for the rational development of a multidisciplinary perioperative plan with the goal of reducing postoperative pulmonary complications. This review contains 5 figures, 7 tables, and 48 references. Keywords: assessment of perioperative risk, asthma, bronchitis, cessation of smoking, COPD, emphysema, obstructive sleep apnea, perioperative smoking, Pulmonary Function Tests (PFTs), nitrogen washout

scholarly journals Frequency and Determinant Factors for Calcification in Neurocysticercosis

2020 ◽  
Author(s):  
Javier A Bustos ◽  
Gianfranco Arroyo ◽  
Robert H Gilman ◽  
Percy Soto-Becerra ◽  
Isidro Gonzales ◽  
...  
Keyword(s):  
Risk Factors ◽  
Confidence Interval ◽  
Antibody Response ◽  
Human Brain ◽  
Risk Ratio ◽  
Factors Associated ◽  
Patient Level ◽  
Increased Risk ◽  
Acquired Epilepsy ◽  
Antiparasitic Treatment

Abstract Background Neurocysticercosis is a major cause of acquired epilepsy. Larval cysts in the human brain eventually resolve and either disappear or leave a calcification that is associated with seizures. In this study, we assessed the proportion of calcification in parenchymal neurocysticercosis and risk factors associated with calcification. Methods Data for 220 patients with parenchymal NCC from 3 trials of antiparasitic treatment were assessed to determine what proportion of the cysts that resolved 6 months after treatment ended up in a residual calcification at 1 year. Also, we evaluated the risk factors associated with calcification. Results The overall proportion of calcification was 38% (188/497 cysts, from 147 patients). Predictors for calcification at the cyst level were cysts larger than 14 mm (risk ratio [RR], 1.34; 95% confidence interval [CI], 1.02–1.75) and cysts with edema at baseline (RR, 1.39; 95% CI, 1.05–1.85). At the patient level, having had more than 24 months with seizures (RR, 1.25; 95% CI, 1.08–1.46), mild antibody response (RR, 1.14; 95% CI, 1.002–1.27), increased dose albendazole regime (RR, 1.26; 95% CI, 1.14–1.39), lower doses of dexamethasone (RR, 1.36; 95% CI, 1.02–1.81), not receiving early antiparasitic retreatment (RR, 1.45; 95% CI, 1.08–1.93), or complete cure (RR, 1.48; 95% CI, 1.29–1.71) were associated with a increased risk of calcification. Conclusions Approximately 38% of parenchymal cysts calcify after antiparasitic treatment. Some factors associated with calcification are modifiable and may be considered to decrease or avoid calcification, potentially decreasing the risk for seizure relapses.

Risk Factors for Postoperative Pulmonary Complications After Noncardiothoracic Surgery in Adult Asthma Patients

CHEST Journal ◽  
2015 ◽  
Vol 148 (4) ◽  
pp. 12A
Author(s):  
Seung Eun Lee ◽  
Woo Hyun Cho ◽  
Seung Hyun Lee ◽  
Yun Seong Kim ◽  
Hye Ju Yeo
Keyword(s):  
Risk Factors ◽  
Pulmonary Complications ◽  
Postoperative Pulmonary Complications ◽  
Adult Asthma ◽  
Asthma Patients

scholarly journals Postoperative pulmonary complications following thoracic surgery: are there any modifiable risk factors?

Thorax ◽  
2010 ◽  
Vol 65 (9) ◽  
pp. 815-818 ◽  
Author(s):  
P. Agostini ◽  
H. Cieslik ◽  
S. Rathinam ◽  
E. Bishay ◽  
M. S. Kalkat ◽  
...  
Keyword(s):  
Risk Factors ◽  
Thoracic Surgery ◽  
Pulmonary Complications ◽  
Modifiable Risk Factors ◽  
Postoperative Pulmonary Complications
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