scholarly journals Serum pre-albumin, a novel indicator of risk of anastomotic leak in bowel anastomosis

2018 ◽  
Vol 5 (5) ◽  
pp. 1724
Author(s):  
Sameer M. D. ◽  
Suchita Chase ◽  
Beulah Roopavathana S. ◽  
Abinaya R. Nadarajan ◽  
Sukria Nayak
Keyword(s):  
Risk Factors ◽  
Anastomotic Leak ◽  
Large Bowel ◽  
Univariate Analysis ◽  
Preoperative Risk ◽  
Asa Score ◽  
Medical College ◽  
Preoperative Risk Factors ◽  
Independent Risk Factors ◽  
Large Bowel Resection

Background: Various preoperative and intraoperative risk factors associated with anastomotic leak have been extensively analyzed. Albumin is considered as the gold standard preoperative marker of nutrition, but recently pre-albumin is found to be a better indicator of nutrition. The main aim of this study was to analyze the preoperative risk factors including pre-albumin to predict anastomotic leak following small and large bowel anastomsois.Methods: This was a prospective observational, quality improvement study in a cohort of 100 patients undergoing small and large bowel resection in the Division of Surgery at Christian Medical College, Vellore. Univariate and multivariate analysis was done to show the significant variables associated with anastomotic leak.Results: In present study, leak rate was 21% (21/100). In univariate analysis, 6 factors had significant association with anastomotic leak, age >45 years, ASA score of II, hemoglobin ≤9.0 gm/dl, serum albumin ≤3.0 gm/dl, serum pre-albumin ≤20 mg/dl and preoperative diagnosis of malignancy. Age >45 years, ASA score of II, serum pre-albumin ≤20 mg/dl and malignancy were found to be independent risk factors of anastomotic leak. In present study prelbumin, was found to be a better indicator of anastomotic leak when compared to albumin and it was statistically significant (p=0.002).Conclusions: Serum pre-albumin is superior to albumin as an acute marker of malnutrition and help us to identify those at risk of anastomotic leak and adequately build nutrition preoperatively and decrease the morbidity.

scholarly journals Preoperative risk factors for postoperative blood transfusion after hip fracture surgery: establishment of a nomogram

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Fu Cheng Bian ◽  
Xiao Kang Cheng ◽  
Yong Sheng An
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Hip Fracture ◽  
Blood Transfusion ◽  
Multivariate Logistic Regression ◽  
Preoperative Risk ◽  
Hip Fracture Surgery ◽  
Preoperative Risk Factors ◽  
Independent Risk Factors ◽  
Fracture Surgery

Abstract Background This study aimed to explore the preoperative risk factors related to blood transfusion after hip fracture operations and to establish a nomogram prediction model. The application of this model will likely reduce unnecessary transfusions and avoid wasting blood products. Methods This was a retrospective analysis of all patients undergoing hip fracture surgery from January 2013 to January 2020. Univariate and multivariate logistic regression analyses were used to evaluate the association between preoperative risk factors and blood transfusion after hip fracture operations. Finally, the risk factors obtained from the multivariate regression analysis were used to establish the nomogram model. The validation of the nomogram was assessed by the concordance index (C-index), the receiver operating characteristic (ROC) curve, decision curve analysis (DCA), and calibration curves. Results A total of 820 patients were included in the present study for evaluation. Multivariate logistic regression analysis demonstrated that low preoperative hemoglobin (Hb), general anesthesia (GA), non-use of tranexamic acid (TXA), and older age were independent risk factors for blood transfusion after hip fracture operation. The C-index of this model was 0.86 (95% CI, 0.83–0.89). Internal validation proved the nomogram model’s adequacy and accuracy, and the results showed that the predicted value agreed well with the actual values. Conclusions A nomogram model was developed based on independent risk factors for blood transfusion after hip fracture surgery. Preoperative intervention can effectively reduce the incidence of blood transfusion after hip fracture operations.

Is it possible to predict outcome in cardiac ECMO? Analysis of preoperative risk factors

Perfusion ◽  
2007 ◽  
Vol 22 (4) ◽  
pp. 225-229 ◽  
Author(s):  
Kari Wagner ◽  
Ivar Risnes ◽  
Michael Abdelnoor ◽  
Harald M. Karlsen ◽  
Jan Ludvig Svennevig
Keyword(s):  
Risk Factors ◽  
Cardiac Failure ◽  
Multiple Logistic Regression Analysis ◽  
Univariate Analysis ◽  
Early Mortality ◽  
Cardiac Insufficiency ◽  
Preoperative Risk ◽  
Preoperative Risk Factors ◽  
Va Ecmo ◽  
Ecmo Treatment

Background. Serious heart failure may be treated with extracorporeal membrane oxygenation (ECMO) when other treatment fails. The aim of the present study was to analyse preoperative risk factors of early mortality in patients treated with veno-arterial (VA)-ECMO. Methods. We studied a total of 18 possible risk factors in 80 patients with severe cardiac insufficiency treated with VA-ECMO. All consecutive cases treated at our institution between Sept.1990 and May 2006 were included. Univariate analysis and multiple logistic regression analysis were performed on 16 risk factors. The endpoint was early mortality (any death within 30 days of ECMO treatment). Results. Thirty patients (37.5%) died within 30 days. Age, gender, cause of cardiac failure, pre-ECMO treatment (ventilator, NO, IABP) did not significantly influence early mortality. A higher SvO2 was associated with survival and remained significant in the multivariate analysis. Conclusion. Treatment with VA-ECMO in patients with severe cardiac failure may save lives. It is, however, difficult to predict outcome. In this study, only SvO2 values prior to ECMO were positively associated with survival. Perfusion (2007) 22, 225—229.

Meniscal Deficiency Period and High Body Mass Index Are Preoperative Risk Factors for Joint Space Narrowing After Meniscal Allograft Transplantation

2021 ◽  
Vol 49 (3) ◽  
pp. 693-699
Author(s):  
Sang-Min Lee ◽  
Seong-Il Bin ◽  
Jong-Min Kim ◽  
Bum-Sik Lee ◽  
Kuen Tak Suh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Femoral Condyle ◽  
Joint Space ◽  
Preoperative Risk ◽  
Meniscal Allograft Transplantation ◽  
Time Points ◽  
Allograft Transplantation ◽  
Preoperative Risk Factors ◽  
Meniscal Allograft ◽  
The Difference

Background: Several studies have reported further reduction in joint space width (JSW) after meniscal allograft transplantation; some contributing postoperative factors are known, although preoperative factors remain unclear. This study is the first to analyze the preoperative risk factors for reduced JSW in patients after lateral meniscal allograft transplantation (LMAT). Hypothesis: Poor cartilage status and high preoperative body mass index (BMI) influence the postoperative progression of joint space narrowing. Study Design: Case-control study; Level of evidence, 3. Methods: We retrospectively studied 79 patients after LMAT who were observed for at least 5 years. JSWs on weightbearing flexion posteroanterior radiographs were measured preoperatively and at the 5-year mark. Differences in JSW were divided into more progression and less progression groups. The modified Outerbridge cartilage grades based on magnetic resonance imaging assessments were compared at subtotal/total meniscectomy and at LMAT to determine the difference between time points. Preoperative between-group differences in sex, age, surgical side, follow-up period, weight, height, BMI, and meniscal deficiency period were analyzed. Clinical outcomes were evaluated using the Lysholm score. Data were examined using univariate and multivariate logistic regressions. Results: Radiographically, the overall change in JSW from preoperative to follow-up was 0.58 mm (range, –0.23 to 1.83 mm). Reductions in JSW in the more progression and less progression groups were 0.94 ± 0.32 and 0.22 ± 0.21 mm (mean ± SD), respectively. There was no difference in cartilage status between the groups at meniscectomy or LMAT; however, changes between time points were significant on the lateral femoral condyle and lateral tibial plateau. Clinically, there were significant differences in weight, BMI, and meniscal deficiency period between the 2 groups. Postoperative Lysholm scores increased as compared with the preoperative scores, but there was no difference among the postoperative time points. In the univariate logistic regression risk analysis, weight, BMI, meniscal deficiency period, and the difference in cartilage status between time points for the lateral femoral condyle and lateral tibial plateau were identified as significant. In the subsequent multivariate logistic regression, BMI (odds ratio, 1.45; P = .016) and meniscal deficiency period (odds ratio, 1.21; P = .037) were the statistically significant factors. Conclusion: BMI and meniscal deficiency period were preoperative risk factors for JSW narrowing after LMAT. This suggests that the meniscal deficiency period from meniscectomy to LMAT may be shortened and that proper weight management can lead to successful LMAT.

scholarly journals A New Preoperative Risk Score for Predicting Postoperative Complications in Elderly Patients Undergoing Hepatectomy

2021 ◽  
Author(s):  
Koichi Tomita ◽  
Itsuki Koganezawa ◽  
Masashi Nakagawa ◽  
Shigeto Ochiai ◽  
Takahiro Gunji ◽  
...  
Keyword(s):  
Risk Factors ◽  
Skeletal Muscle ◽  
Postoperative Complications ◽  
Elderly Patients ◽  
Risk Score ◽  
Surgical Procedure ◽  
Evaluation Method ◽  
Preoperative Risk ◽  
Preoperative Serum ◽  
Independent Risk Factors

Abstract Background Postoperative complications are not rare in the elderly population after hepatectomy. However, predicting postoperative risk in elderly patients undergoing hepatectomy is not easy. We aimed to develop a new preoperative evaluation method to predict postoperative complications in patients above 65 years of age using biological impedance analysis (BIA). Methods Clinical data of 59 consecutive patients (aged 65 years or older) who underwent hepatectomy at our institution between 2017 and 2020 were retrospectively analyzed. Risk factors for postoperative complications (Clavien-Dindo ≥ III) were evaluated using multivariate regression analysis. Additionally, a new preoperative risk score was developed for predicting postoperative complications. Results Fifteen patients (25.4%) had postoperative complications, with biliary fistula being the most common complication. Abnormal skeletal muscle mass index from BIA and type of surgical procedure were found to be independent risk factors in the multivariate analysis. These two variables and preoperative serum albumin levels were used for developing the risk score. The postoperative complication rate was 0.0% with a risk score of ≤ 1 and 57.1% with a risk score of ≥ 4. The area under the receiver operating characteristic curve of the risk score was 0.810 (p = 0.001), which was better than that of other known surgical risk indexes. Conclusion Decreased skeletal muscle and the type of surgical procedure for hepatectomy were independent risk factors for postoperative complications after elective hepatectomy in elderly patients. The new preoperative risk score is simple, easy to perform, and will help in the detection of high-risk elderly patients undergoing elective hepatectomy.

scholarly journals Risk factors for cholesterol polyp formation in the gallbladder are closely related to lipid metabolism

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Zhihao Yu ◽  
Changlin Yang ◽  
Xuesong Bai ◽  
Guibin Yao ◽  
Xia Qian ◽  
...  
Keyword(s):  
Risk Factors ◽  
Low Density Lipoprotein ◽  
Univariate Analysis ◽  
Density Lipoprotein ◽  
High Volume ◽  
Population Characteristics ◽  
Polyp Formation ◽  
Logistic Analysis ◽  
Cholesterol Polyp ◽  
Independent Risk Factors

Abstract Background The purpose of this study was to assess the risk factors for cholesterol polyp formation in the gallbladder. Methods This was a multicenter retrospective study based on pathology. From January 2016 to December 2019, patients who underwent cholecystectomy and non-polyp participants confirmed by continuous ultrasound follow-ups were reviewed. Patients in the cholesterol polyp group were recruited from three high-volume centers with a diagnosis of pathologically confirmed cholesterol polyps larger than 10 mm. Population characteristics and medical data were collected within 24 h of admission before surgery. The non-polyp group included participants from the hospital physical examination center database. They had at least two ultrasound examinations with an interval longer than 180 days. Data from the final follow-up of the non-polyp group were analyzed. The risk factors for cholesterol polyp formation were analyzed by comparing the two groups. Results A total of 4714 participants were recruited, including 376 cholesterol polyp patients and 4338 non-polyp participants. In univariate analysis, clinical risk factors for cholesterol polyps were age, male sex, higher body mass index (BMI), higher low-density lipoprotein (LDL), lower high-density lipoprotein (HDL), and higher aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels. In multivariate logistic analysis, independent risk factors were age > 50 years (odds ratio [OR] = 3.02, 95% confidence interval [CI] 2.33–3.91, P < 0.001], LDL > 2.89 mmol/L (OR = 1.38, 95% CI 1.08–1.78, P = 0.011), lower HDL (OR = 1.78 95% CI 1.32–2.44, P < 0.001), AST > 40 IU/L (OR = 3.55, 95% CI 2.07–6.07, P < 0.001), and BMI > 25 kg/m 2 (OR = 1.32, 95% CI 1.01–1.72, P = 0.037). Conclusions Age, LDL, HDL, AST, and BMI are strong risk factors for cholesterol polyp formation. Older overweight patients with polyps, accompanied by abnormal lipid levels, are at high risk for cholesterol polyps.

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