scholarly journals Factors affecting postoperative survival of patients with insufficient union following osteoporotic vertebral fractures and impact of preoperative serum albumin on mortality

2020 ◽  
Author(s):  
Tetsuro Ohba ◽  
Hiroshi MD Yokomi ◽  
Kensuke MD Koy ◽  
Nobuki Tanaka ◽  
Kotaro Oda ◽  
...  
Keyword(s):  
Serum Albumin ◽  
Surgical Procedures ◽  
Vertebral Fractures ◽  
Spinal Surgery ◽  
Postoperative Mortality ◽  
Term Survival ◽  
Kaplan Meier ◽  
Osteoporotic Vertebral Fractures ◽  
Significant Difference

Abstract Background: Numerous comparative studies of surgical procedures have focused on clinical and radiographical outcomes, as well as the effect of bone fragility on the outcome of spinal surgery; however, insights concerning a long-term risk of mortality or morbidity have been limited. Additionally, the effect of surgical therapy on survival after vertebral compression fractures remains controversial. Our aim was to evaluate the preoperative factors that affected the long-term survival of patients who underwent spinal surgery for an insufficient union following osteoporotic vertebral fractures (OVF) and to determine long-term mortality.Methods: We retrospectively reviewed the cases of 105 consecutive patients who underwent spinal surgery for OVF. Mortality was estimated using the Kaplan-Meier method and a log-rank test. The preoperative backgrounds of patients were analyzed to determine which risk factors led to death among the OVF cases. Kaplan-Meier curves were used to estimate survival based on preoperative albumin levels of £ 3.5 g/dL (hypoalbuminemia) versus > 3.5 mg/dL.Results: The mean follow-up time for survival was 4.1 ±0.8 years. Two years after surgery, 15% of patients with OVF had died. The ratio of male-to-female was significantly higher for patients with OVF who died than for those who were still alive. No significant difference in mortality was observed among surgical procedures for OVF. Multivariate analysis revealed that only serum albumin £3.5 g/dL was a significant risk factor for long-term postoperative mortality of patients with OVF.Conclusions: Preoperative hypoalbuminemia was associated with long-term postoperative mortality following surgery for OVF.Level of Evidence: Level 3

scholarly journals Factors affecting postoperative survival of patients with insufficient union following osteoporotic vertebral fractures and impact of preoperative serum albumin on mortality

2020 ◽  
Author(s):  
Tetsuro Ohba ◽  
Hiroshi MD Yokomi ◽  
Kensuke MD Koy ◽  
Nobuki Tanaka ◽  
Kotaro Oda ◽  
...  
Keyword(s):  
Serum Albumin ◽  
Surgical Procedures ◽  
Vertebral Fractures ◽  
Spinal Surgery ◽  
Postoperative Mortality ◽  
Term Survival ◽  
Kaplan Meier ◽  
Osteoporotic Vertebral Fractures ◽  
Significant Difference

Abstract Background: Numerous comparative studies of surgical procedures have focused on clinical and radiographical outcomes, as well as the effect of bone fragility on the outcome of spinal surgery; however, insights concerning a long-term risk of mortality or morbidity have been limited. Additionally, the effect of surgical therapy on survival after vertebral compression fractures remains controversial. Our aim was to evaluate the preoperative factors that affected the long-term survival of patients who underwent spinal surgery for an insufficient union following osteoporotic vertebral fractures (OVF) and to determine long-term mortality. Methods: We retrospectively reviewed the cases of 105 consecutive patients who underwent spinal surgery for OVF. Mortality was estimated using the Kaplan-Meier method and a log-rank test. The preoperative backgrounds of patients were analyzed to determine which risk factors led to death among the OVF cases. Kaplan-Meier curves were used to estimate survival based on preoperative albumin levels of £ 3.5 g/dL (hypoalbuminemia) versus > 3.5 mg/dL. Results: The mean follow-up time for survival was 4.1 ±0.8 years. Two years after surgery, 15% of patients with OVF had died. The ratio of male-to-female was significantly higher for patients with OVF who died than for those who were still alive. No significant difference in mortality was observed among surgical procedures for OVF. Multivariate analysis revealed that only serum albumin £3.5 g/dL was a significant risk factor for long-term postoperative mortality of patients with OVF. Conclusions: Preoperative hypoalbuminemia was associated with long-term postoperative mortality following surgery for OVF.

scholarly journals Factors affecting postoperative survival of patients with insufficient union following osteoporotic vertebral fractures and impact of preoperative serum albumin on mortality

2019 ◽  
Author(s):  
Tetsuro Ohba ◽  
Hiroshi MD Yokomi ◽  
Kensuke MD Koy ◽  
Nobuki Tanaka ◽  
Kotaro Oda ◽  
...  
Keyword(s):  
Serum Albumin ◽  
Surgical Procedures ◽  
Vertebral Fractures ◽  
Spinal Surgery ◽  
Postoperative Mortality ◽  
Term Survival ◽  
Kaplan Meier ◽  
Osteoporotic Vertebral Fractures ◽  
Significant Difference

Abstract Background: Numerous comparative studies of surgical procedures have focused on clinical and radiographical outcomes, as well as the effect of bone fragility on the outcome of spinal surgery; however, insights concerning a long-term risk of mortality or morbidity have been limited. Additionally, the effect of surgical therapy on survival after vertebral compression fractures remains controversial. To evaluate the preoperative factors that affected the long-term survival of patients who underwent spinal surgery for an insufficient union following osteoporotic vertebral fractures (OVF) and to determine long-term mortality. Methods: We retrospectively reviewed the cases of 105 consecutive patients who underwent spinal surgery for OVF. Morbidity was estimated using the Kaplan-Meier method and a log-rank test. To determine which risk factors led to death among the OVF cases, the preoperative backgrounds of patients were analyzed. Kaplan-Meier curves were used to estimate survival based on the preoperative albumin levels of ≤3.5 g/dL (hypoalbuminemia) versus >3.5 mg/dL. Results: The mean follow-up for survival was 4.1 ±0.8 years. Two years after surgery, 15% of patients with OVF had died. The ratio of male-to-female was significantly higher for patients with OVF who died than for those who were still alive. No significant difference in mortality was observed among surgical procedures for OVF. Multivariate analysis revealed that only serum albumin ≤3.5 g/dL was a significant risk factor for long-term postoperative mortality of people with OVF. Conclusions: Preoperative hypoalbuminemia was associated with long-term postoperative mortality following surgery for OVF.

scholarly journals Factors affecting postoperative mortality of patients with insufficient union following osteoporotic vertebral fractures and impact of preoperative serum albumin on mortality

2020 ◽  
Author(s):  
Tetsuro Ohba ◽  
Hiroshi MD Yokomi ◽  
Kensuke MD Koy ◽  
Nobuki Tanaka ◽  
Kotaro Oda ◽  
...  
Keyword(s):  
Risk Factors ◽  
Serum Albumin ◽  
Surgical Procedures ◽  
Vertebral Fractures ◽  
Spinal Surgery ◽  
Significant Risk ◽  
Postoperative Mortality ◽  
Kaplan Meier ◽  
Osteoporotic Vertebral Fractures

Abstract Background: Numerous comparative studies of surgical procedures have focused on clinical and radiographical outcomes, as well as the effect of bone fragility on the outcome of spinal surgery; however, insights concerning a risk of mortality or morbidity have been limited. Additionally, the effect of surgical therapy on survival after vertebral compression fractures remains controversial. Our aim was to evaluate the preoperative factors that affected the long-term survival of patients who underwent spinal surgery for an insufficient union following osteoporotic vertebral fractures (OVF) and to determine postoperative mortality.Methods: We retrospectively reviewed the cases of 105 consecutive patients who underwent spinal surgery for OVF. Mortality was estimated using the Kaplan-Meier method and a log-rank test. The preoperative backgrounds of patients were analyzed to determine which risk factors led to death among the OVF cases. Kaplan-Meier curves were used to estimate survival based on preoperative albumin levels of £ 3.5 g/dL (hypoalbuminemia) versus > 3.5 mg/dL.Results: The mean follow-up time was 4.1 ±0.8 years. Two years after surgery, percentage of patients who had died was 15%. The VAS scores and modified Frankel classification were significantly improved one year after surgery. The ratio of male-to-female was significantly higher for patients with OVF who died than for those who were still alive. No significant difference in mortality was observed among surgical procedures for OVF. The univariate analysis showed that male gender, serum albumin <3.5g/dl, creatinine clearance<60mg/dl, and the American Society of Anesthesiologists classificat0ion ≥3 were significant risk factors for postoperative mortality. Multivariate analysis revealed that only serum albumin £3.5 g/dL was a significant risk factor for long-term postoperative mortality of patients with OVF.Conclusions: Preoperative hypoalbuminemia was associated with postoperative mortality following surgery for OVF.Level of Evidence: Level 3

scholarly journals Results of surgical treatment of carcinoma of papilla of Vater

Medicina ◽  
2006 ◽  
Vol 43 (6) ◽  
pp. 455 ◽  
Author(s):  
Giedrius Barauskas ◽  
Antanas Gulbinas ◽  
Juozas Pundzius
Keyword(s):  
Postoperative Morbidity ◽  
Postoperative Mortality ◽  
Long Term Results ◽  
Papilla Of Vater ◽  
Term Survival ◽  
Retrospective Design ◽  
Significant Difference ◽  
Survival Pattern ◽  
Better Than

Adenocarcinoma is the most common malignant tumor of the ampulla, but in general, it is still rare. Therefore, these tumors are difficult to study, and most reports are of retrospective design. To evaluate immediate postoperative and long-term results, we have collected data prospectively in a specially created database on 21 consecutive patients with adenocarcinoma of the papilla of Vater, operated on at the Department of Surgery, Kaunas University of Medicine Hospital. All patients have undergone classical or pylorus-preserving pancreatoduodenectomy. Postoperative mortality was 4.8% and overall morbidity – 28.6%. Pancreas-associated morbidity was 14.3% in the series. Actuarial 3-year survival among our patients was 89%. Stage I–II patients with T1–T2 and/or N negative tumors had significantly better 3-year survival when compared with stage III–IV patients, T3–T4 and/or N positive tumors. Patients with highly or moderately differentiated tumors (G1, G2) survived better than patients with poor cell differentiation (G3), though significant difference was not achieved. Results are satisfactory in terms of overall postoperative morbidity and mortality. Long-term survival pattern concerning T, N, and G status corresponds with other reports in literature, while the 3-year survival results are promising and speaks in favor of our surgical strategy.

Sleeve lobectomy an affidable lung sparing procedure

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 17159-17159
Author(s):  
G. Cavallesco ◽  
P. Maniscalco ◽  
F. Quarantotto ◽  
F. Acerbis ◽  
M. Santini ◽  
...  
Keyword(s):  
Main Bronchus ◽  
Rank Test ◽  
Sleeve Lobectomy ◽  
Term Survival ◽  
Average Hospital ◽  
Long Term Survival ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Similar Survival

17159 Background: Sleeve Lobectomy (Sl) is generally considered a surgical alternative of choice to Pneumonectomy (Pn) for the treatment of central NSCLC. The aim of this study is to value if the Sl could be really a Lung saving procedure that warrants right survivals, according to stage of disease, with acceptable perioperative risks. Methods: In 165 patients (67 Sl and 98 Pn) operated from 1995 to 2003 for NSCLC of main bronchus we have analyzed the hospital stay, morbidity and mortality within 30 days, long term survival. In 39 Sl and 46 Pn we compared spyrometric volume’s changes at a distance of 6–24 months from operation. Sl was performed where it was technically possible. Long term survivals had been separated and comparated according to pathologic stadium (TNM 1997) and lymphonodal involvement: all these data were estimated by Kaplan-Meier method and log rank test. All statistical data underwent SPSS elaboration and significant assumption for p < 0.05. Results: In our population of study we didn’t check any statistically significant’s differences comparing age, sex or preoperative Fev1. Complications occurred in 28% of cases where Sl was performed and in 36.7% after Pn with a mortality rate of 2.9% vs 5.1%. Average hospital staying was longer in patients underwent to Pneumonectomy. Long term survival (5 years) in Sl group is 36% and 24% in Pn group with a statistically significant difference P = 0.016, but this difference is not evident from the comparison between the two group’s survivals based on pathological stadium or lymphonodal involvement. Spyrometric values showed a global Fev1 reduction of 245 ml (−10%) after Sl procedure and 884ml (36.3%) after Pn with a significant difference of p = 0.0042. Conclusions: In this study Sl got similar survival results if not better, with those obtained after Pn. Moreover, Sl showed to be a lung sparing procedure with an acceptable operative risk. These data confirmed that SL is the gold standard surgical procedure in the treatment of central tumors where if technically possible. [Table: see text] No significant financial relationships to disclose.

Predictors of long-term survival with metastatic pancreatic cancer (mPC) in the gemcitabine era: The Fox Chase Cancer Center experience.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 253-253
Author(s):  
Namrata Vijayvergia ◽  
Efrat Dotan ◽  
Karthik Devarajan ◽  
Bianca Lewis ◽  
Steven J. Cohen
Keyword(s):  
Serum Albumin ◽  
Median Survival ◽  
Lung Metastases ◽  
Statistical Significance ◽  
Rank Test ◽  
Type I ◽  
Term Survival ◽  
Metastatic Setting ◽  
Significant Difference

253 Background: Although median survival (OS) for patients (pts) with mPC was ~6 months (m) in the gem era, a subset of pts lived significantly longer as long term survivors (LTS). We compared the patterns of care and outcomes of pts living < 12 m (Gp 1) and ≥ 12 m (Gp 2) to identify predictors for LTS. Methods: With IRB approval, we retrospectively analyzed medical charts of mPC pts treated at our center between 2000 and 2010. Gp 1 and Gp 2 were compared with respect to pt, tumor and treatment characteristics. Fisher’s exact and Mann-Whitney tests were used, respectively, to compare categorical and continuous variables, and the log-rank test to compare OS. All tests were two-sided and a Type I Error of 5% was used to determine statistical significance. Results: 579 mPC pts (median age 64 y, 56% males) were identified, 476 pts in Gp1 and 103 in Gp 2 (OS 4m vs 18 m, respectively). There was no significant difference in the age, site of pancreatic primary, comorbidities, tobacco use or stage at diagnosis between the two. 341 (72%) pts in Gp1 and 86 (83%) in Gp 2 had an initial PS <2 (p 0.06). Alcohol use was more prevalent in LTS [170 (36%) in Gp1 vs 50 (49%) in Gp2 (OR 1.8, p 0.008)]. 170 (36%) pts in Gp 1 and 55 (52%) in Gp 2 had serum albumin (alb) > 3.5 gm/dl (p< 0.001) and this predicted survival (OS 4m if Alb < 3.5 and 7m if Alb > 3.5, p <0.001). Use of chemotherapy in the metastatic setting (66% in Gp1 vs 93% in Gp 2) and number of agents used also predicted survival with 202 (42%) pts in Gp 1 and 79 (87%) in Gp 2 having received > one agent in the metastatic setting (p < 0.001). Liver metastases were more common as an initial site in Gp1 vs Gp2 [329 (70%) vs 48 (47%) respectively, p < 0.001]. In contrast, lung metastases were more common in Gp 2 [42 (9%) Gp 1 vs 20 (19%) in Gp 2, p< 0.001]. The median survival for pts with liver as initial metastatic site was worse than those with lung metastases (5m vs 7m, p < 0.001). Conclusions: Use of chemotherapy and increasing number of agents are associated with better survival in mPC, in line with the current practice of using combination chemotherapy. The site of initial metastasis and serum albumin also predict for survival. Clinical trial designs should consider the latter as stratification factors.

Transapical versus Conventional Aortic Valve Replacement�A Propensity-Matched Comparison

2012 ◽  
Vol 15 (1) ◽  
pp. 4 ◽  
Author(s):  
David M. Holzhey ◽  
William Shi ◽  
A. Rastan ◽  
Michael A. Borger ◽  
Martin H�nsig ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Survival Rates ◽  
Long Term Results ◽  
Term Survival ◽  
Kaplan Meier ◽  
Risk Patients ◽  
Short And Long Term ◽  
Good Treatment Option ◽  
Matched Comparison

<p><b>Introduction:</b> The goal of this study was to compare the short- and long-term outcomes after aortic valve (AV) surgery carried out via standard sternotomy/partial sternotomy versus transapical transcatheter AV implantation (taTAVI).</p><p><b>Patients and Methods:</b> All 336 patients who underwent taTAVI between 2006 and 2010 were compared with 4533 patients who underwent conventional AV replacement (AVR) operations between 2001 and 2010. Using propensity score matching, we identified and consecutively compared 2 very similar groups of 167 patients each. The focus was on periprocedural complications and long-term survival.</p><p><b>Results:</b> The 30-day mortality rate was 10.8% and 8.4% (<i>P</i> = .56) for the conventional AVR patients and the TAVI patients, respectively. The percentages of postoperative pacemaker implantations (15.0% versus 6.0%, <i>P</i> = .017) and cases of renal failure requiring dialysis (25.7% versus 12.6%, <i>P</i> = .004) were higher in the TAVI group. Kaplan-Meier curves diverged after half a year in favor of conventional surgery. The estimated 3-year survival rates were 53.5% � 5.7% (TAVI) and 66.7% � 0.2% (conventional AVR).</p><p><b>Conclusion:</b> Our study shows that even with all the latest successes in catheter-based AV implantation, the conventional surgical approach is still a very good treatment option with excellent long-term results, even for older, high-risk patients.</p>

scholarly journals Is It Definitely Clear That Long-Term Survival after Breast Cancer Surgery Is Not Affected by Anaesthetics?

Cancers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 3390
Author(s):  
Mats Enlund
Keyword(s):  
Breast Cancer ◽  
Survival Data ◽  
Retrospective Studies ◽  
Breast Cancer Surgery ◽  
Breast Cancer Patients ◽  
Term Survival ◽  
Long Term Survival ◽  
Significant Difference ◽  
One Year

Retrospective studies indicate that cancer survival may be affected by the anaesthetic technique. Propofol seems to be a better choice than volatile anaesthetics, such as sevoflurane. The first two retrospective studies suggested better long-term survival with propofol, but not for breast cancer. Subsequent retrospective studies from Asia indicated the same. When data from seven Swedish hospitals were analysed, including 6305 breast cancer patients, different analyses gave different results, from a non-significant difference in survival to a remarkably large difference in favour of propofol, an illustration of the innate weakness in the retrospective design. The largest randomised clinical trial, registered on clinicaltrial.gov, with survival as an outcome is the Cancer and Anesthesia study. Patients are here randomised to propofol or sevoflurane. The inclusion of patients with breast cancer was completed in autumn 2017. Delayed by the pandemic, one-year survival data for the cohort were presented in November 2020. Due to the extremely good short-term survival for breast cancer, one-year survival is of less interest for this disease. As the inclusions took almost five years, there was also a trend to observe. Unsurprisingly, no difference was found in one-year survival between the two groups, and the trend indicated no difference either.

scholarly journals Female Sex and Outcomes after Endovascular Aneurysm Repair for Abdominal Aortic Aneurysm: A Propensity Score Matched Cohort Analysis

2021 ◽  
Vol 10 (1) ◽  
pp. 162
Author(s):  
Christian-Alexander Behrendt ◽  
Thea Kreutzburg ◽  
Jenny Kuchenbecker ◽  
Giuseppe Panuccio ◽  
Mark Dankhoff ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Propensity Score ◽  
Acute Limb Ischemia ◽  
Insurance Claims ◽  
Long Term Outcomes ◽  
Term Survival ◽  
Abdominal Aortic ◽  
Significant Difference

Objective: Previous studies have showed a potential disadvantage of female patients who underwent abdominal aortic aneurysm (AAA) repair. The current study aims to determine sex-specific perioperative and long-term outcomes using propensity score matched unselected nationwide health insurance claims data. Methods: Insurance claims from a large German fund were used, covering around 8% of the insured German population. Patients who underwent endovascular aortic repair (EVAR) for intact AAA from 1 January 2011 to 30 April 2017 were included in the cohort. A 1:2 female to male propensity score matching was applied to adjust for confounding variables. Perioperative and long-term outcomes after 5 years were determined using matching and regression methods. Results: Among a total of 3736 patients (19.3% females, mean 75 years) undergoing EVAR for intact AAA, we identified 1863 matched patients. Before matching, females were more likely to be previously diagnosed with hypothyroidism, electrolyte disorders, rheumatoid disorders, and depression, while males were more often diabetics. In the matched sample, 23.4% of the females and 25.8% of the males died during a median follow-up of 776 and 792 days, respectively. Perioperatively, females were more likely to exhibit acute limb ischemia (5.3% vs. 3.2%, p = 0.031) and major bleeding (22.0% vs. 15.9%, p = 0.001) before they were discharged to rehabilitation (5.5% vs. 1.5%, p < 0.001) when compared to males. No statistically significant difference in perioperative (odds ratio 1.12, 95% CI 0.54–2.16) or long-term mortality (hazard ratio 0.91, 95% CI 0.76–1.08) was observed between sexes. This was also true regarding aortic reintervention rates after 1 year (2.0% vs. 2.9%) and 5 years (10.9% vs. 8.1%). Conclusion: The current retrospective matched analysis of insurance claims revealed high early access-related morbidity in females when compared to their male counterparts. Short-term or long-term survival and reintervention outcomes were similar between sexes.

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