scholarly journals Usefulness of the modified hemophagocytic syndrome diagnostic score as a prognostic factor in lung transplantation patients

2021 ◽  
Author(s):  
Ji Yeon Choi ◽  
Song Yee Kim ◽  
Sang Hoon Lee ◽  
A La Woo ◽  
Seung Hyun Young ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Lung Transplantation ◽  
Hemophagocytic Syndrome ◽  
Postoperative Mortality ◽  
Multivariate Regression Analysis ◽  
Serum Glutamic Oxaloacetic Transaminase ◽  
Diagnostic Score ◽  
Protein Levels ◽  
Reactive Hemophagocytic Syndrome ◽  
Severance Hospital

Abstract Background: Lung transplantation (LTX) is an established treatment for end-stage lung disease; however, the post-LTX mortality rate remains high. This study aimed to evaluate the prognostic value of the modified reactive hemophagocytic syndrome diagnostic score (mHScore) and its individual components on mortality after LTX.Methods: We retrospectively analyzed 294 patients who underwent LTX at Severance Hospital, Yonsei University, Korea, from January 2012 and December 2020, and classified them into high (n=114, mHScore > 104.0) and low mHScore (n=180, mHScore ≤ 104.0) groups. Triglyceride, ferritin, serum glutamic oxaloacetic transaminase, fibrinogen, and cytopenia were used to calculate the mHScore. We compared baseline characteristics and mortality rates as LTX prognostic factors.Results: The high mHScore group had significantly more cytopenia and higher ferritin, triglyceride, lactate dehydrogenase, and C-reactive protein levels than the low mHScore group. The mortality rate was significantly higher in the high than in the low mHScore group (hazard ratio, 4.429, p < 0.001). Multivariate regression analysis revealed that a high mHScore was significantly associated with postoperative mortality, even after adjusting for other confounding factors. A high mHScore was also associated with postoperative complications.Conclusions: The mHScore can be used to estimate post-LTX prognosis and predict postoperative mortality.

Pylorus-Preserving Pancreaticoduodenectomy: Evaluation of 50 Cases

2017 ◽  
Vol 13 (1) ◽  
pp. 42-45
Author(s):  
SM Shakhwat Hossain ◽  
Ferdous Rahman
Keyword(s):  
Gastric Emptying ◽  
Mortality Rate ◽  
Wound Infection ◽  
Postoperative Mortality ◽  
Operation Time ◽  
Armed Forces ◽  
Military Hospital ◽  
Morbidity Rate ◽  
Proper Patient Selection ◽  
Periampullary Neoplasms

Introduction: Pancreaticoduodenectomy is the procedure of choice for periampullary neoplasms. It is considered as a major surgical procedure. It is associated with relatively higher postoperative mortality and morbidity rate, however, with development of technology, proper patient selection, meticulous operative technique, appropriate postoperative care, morbidity and mortality rate has decreased subsequently. Up to the 1970s, the operative mortality rate after pancreaticoduodenectomy approached 20% but it has been reduced to less than 5% in recent reports. This study is designed to evaluate the postoperative outcomes of pylorus-preserving pancreaticoduodenectomy procedure in our set up. Objective: To evaluate the outcome of the pylorus-preserving pancreaticoduodenectomy procedure with the intention to measure operation time and per-operative bleeding, observing postoperative anastomotic leakage and gastric emptying time. To find out postoperative wound infection and complications to detect the dumping syndrome. Materials and Methods: A prospective observational study was carried out in the Department of Hepatobiliary Surgery, Combined Military Hospital, Dhaka from July 2013 to January 2017. Fifty patients who underwent pylorus-preserving pancreaticodudenectomy procedure were included in this study. Results: Out of 50 postoperative patients, 12(24%) patients developed complications. Of these patients, 3(6%) developed wound infection, 2(4%) developed bile leakage and 2(4%) developed postoperative haemorrhage. Pancreatic fistula, vomiting, delayed gastric emptying and abdominal collection all were 1(2%) each. Postoperative mortality was 3(6%). Conclusion: The present study demonstrated the development of postoperative complications after pylorus-preserving pancreaticoduodenectomy is as similar as published in different studies. Better outcome can be achieved with meticulous pre-operative evaluation of risk factors and per-operative skill maneuvering. Journal of Armed Forces Medical College Bangladesh Vol.13(1) 2017: 42-45

Reactive Hemophagocytic Syndrome Caused by Rickettsial Infection: Report of a Case

2012 ◽  
Vol 18 (2) ◽  
pp. 14-16 ◽  
Author(s):  
S. Anoun ◽  
Y. Traoue ◽  
A. Ouled Lahcen ◽  
K. Gamraoui ◽  
S. Faez ◽  
...  
Keyword(s):  
Hemophagocytic Syndrome ◽  
Rickettsial Infection ◽  
Reactive Hemophagocytic Syndrome

scholarly journals NCOG-65. MR-GUIDED LASER INTERSTITIAL THERMAL THERAPY FOR BRAIN TUMORS IN GERIATRIC PATIENTS

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii144-ii144
Author(s):  
Elizabeth Ginalis ◽  
Shabbar Danish
Keyword(s):  
Mortality Rate ◽  
Neurological Symptom ◽  
Geriatric Patients ◽  
Age Groups ◽  
Postoperative Mortality ◽  
Thermal Therapy ◽  
Partial Recovery ◽  
Intracranial Tumors ◽  
Laser Interstitial Thermal Therapy ◽  
Significant Difference

Abstract INTRODUCTION There is a paucity of studies assessing the use of magnetic resonance-guided laser interstitial thermal therapy (LITT) in the elderly population. METHODS Geriatric patients (≥65 years) treated with LITT for intracranial tumors at a single institution from January 2011 to November 2019 were retrospectively identified. We grouped patients into two cohorts: 65-74 years (group 1) and 75 years or older (group 2). Baseline characteristics, operative parameters, postoperative course, and morbidity were recorded. RESULTS There were 55 patients who underwent 64 distinct LITT procedures. The majority of tumors (62.5%) treated were recurrent brain metastasis/radiation necrosis. The median hospital length of stay was 1 day, with no significant difference between age groups. Hospital stay was significantly longer in patients who presented with a neurological symptom and in those who experienced a postoperative complication. The majority of patients (68.3%) were discharged to their preoperative accommodation. Rate of discharge to home was not significantly different between age groups. Those discharged to rehabilitation facilities were more likely to have presented with a neurological symptom. Nine patients (14.1%) were found to have acute neurological complications, with nearly all patients showing complete or partial recovery at follow-up. The 30-day postoperative mortality rate was 1.6% (n = 1). The complication and 30-day postoperative mortality rate were not significantly different between age groups. CONCLUSIONS LITT can be considered as a minimally invasive and safe neurosurgical procedure for treatment of intracranial tumors in geriatric patients. Careful preoperative preparation and postoperative care is essential as LITT is not without risk. Appropriate patient selection for cranial surgery is essential as neurosurgeons treat an increasing number of elderly patients, but advanced age alone should not exclude patients from LITT.

scholarly journals Mortality in Patients with Brainstem Cavernous Malformations

2021 ◽  
pp. 1-7
Author(s):  
Julia Velz ◽  
Marian Christoph Neidert ◽  
Yang Yang ◽  
Kevin Akeret ◽  
Peter Nakaji ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Postoperative Mortality ◽  
Mortality Rates ◽  
Cavernous Malformations ◽  
Patient Cohort ◽  
Actual Risk ◽  
Single Center Study

<b><i>Objective:</i></b> Brainstem cavernous malformations (BSCM)-associated mortality has been reported up to 20% in patients managed conservatively, whereas postoperative mortality rates range from 0 to 1.9%. Our aim was to analyze the actual risk and causes of BSCM-associated mortality in patients managed conservatively and surgically based on our own patient cohort and a systematic literature review. <b><i>Methods:</i></b> Observational, retrospective single-center study encompassing all patients with BSCM that presented to our institution between 2006 and 2018. In addition, a systematic review was performed on all studies encompassing patients with BSCM managed conservatively and surgically. <b><i>Results:</i></b> Of 118 patients, 54 were treated conservatively (961.0 person years follow-up in total). No BSCM-associated mortality was observed in our conservatively as well as surgically managed patient cohort. Our systematic literature review and analysis revealed an overall BSCM-associated mortality rate of 2.3% (95% CI: 1.6–3.3) in 22 studies comprising 1,251 patients managed conservatively and of 1.3% (95% CI: 0.9–1.7) in 99 studies comprising 3,275 patients with BSCM treated surgically. <b><i>Conclusion:</i></b> The BSCM-associated mortality rate in patients managed conservatively is almost as low as in patients treated surgically and much lower than in frequently cited reports, most probably due to the good selection nowadays in regard to surgery.

Development and Validation of the HScore, a Score for the Diagnosis of Reactive Hemophagocytic Syndrome

2014 ◽  
Vol 66 (9) ◽  
pp. 2613-2620 ◽  
Author(s):  
Laurence Fardet ◽  
Lionel Galicier ◽  
Olivier Lambotte ◽  
Christophe Marzac ◽  
Cedric Aumont ◽  
...  
Keyword(s):  
Hemophagocytic Syndrome ◽  
Reactive Hemophagocytic Syndrome ◽  
Development And Validation

scholarly journals A simple risk stratification model that predicts 1‐year postoperative mortality rate in patients with solid‐organ cancer

2015 ◽  
Vol 4 (11) ◽  
pp. 1687-1696 ◽  
Author(s):  
Wen‐Chi Chou ◽  
Frank Wang ◽  
Yu‐Fan Cheng ◽  
Miao‐Fen Chen ◽  
Chang‐Hsien Lu ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Risk Stratification ◽  
Postoperative Mortality ◽  
Solid Organ ◽  
Risk Stratification Model

scholarly journals Pancreatic trauma: proposal for management algorithm

2020 ◽  
Author(s):  
Daisuke Hashimoto ◽  
Tomohisa Yamamoto ◽  
So Yamaki ◽  
Kazuhito Sakuramoto ◽  
Rintaro Yui ◽  
...  
Keyword(s):  
Interventional Radiology ◽  
Mortality Rate ◽  
Pancreatic Duct ◽  
Conservative Management ◽  
Main Pancreatic Duct ◽  
Surgical Techniques ◽  
Postoperative Mortality ◽  
Pancreatic Trauma ◽  
Endoscopic Nasopancreatic Drainage ◽  
Nasopancreatic Drainage

IntroductionPancreatic trauma is potentially lethal despite recent improvements in surgical techniques and conservative management. However, no guidelines for the management of pancreatic trauma have been established. In this report, we propose an algorithm for the management of pancreatic trauma based on our experience of nine cases and a literature review.Case presentationThis study included nine patients with pancreatic trauma (five men and four women). The patients’ median age was 40 years (range, 17–75 years). The overall mortality rate was 22.2%, and the postoperative mortality rate was 16.7%. Superficial trauma was present in two patients. Deep trauma without injury to the main pancreatic duct was present in one patient, and this patient was treated successfully with endoscopic nasopancreatic drainage. Active bleeding was present in two patients and controlled by interventional radiology. Deep trauma with injury to the main pancreatic duct was present in six patients. Among them, one patient died after conservative treatment with endoscopic nasopancreatic drainage. The other five patients underwent surgery (pancreatic resection in four and necrosectomy in one).ConclusionThe herein-described algorithm recommends interventional radiology for active arterial bleeding, conservative management for trauma without ductal injury, and surgery for trauma with ductal injury. This algorithm may provide a basis for future establishment of guidelines.

scholarly journals Perioperative complications of esophagectomy - prevention, diagnosis and management

2017 ◽  
Vol 64 (1) ◽  
pp. 27-38
Author(s):  
Dejan Stojakov ◽  
Predrag Sabljak ◽  
Bratislav Spica ◽  
Dejan Velickovic ◽  
Vladimir Sljukic ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Perioperative Complications ◽  
Rapid Development ◽  
Postoperative Mortality ◽  
High Volume ◽  
Esophageal Resection ◽  
Vocal Cord Palsy ◽  
Pulmonary Complications ◽  
High Rate ◽  
Septic Complications

Esophageal resection with reconstruction is complex surgical procedure with high rate of postoperative morbidity, with decreasing mortality rate during last decades, particularly in high-volume hospitals. Numerous preoperative, intraoperative and postoperative factors have contribute to incidence and type of complications. Intraoperative haemorrhage and tracheobronchial lesions could be avoid by good surgical judgement and operative technique. Pulmonary complications are often, with multifactorial etiology, and they are the main cause of postoperative mortality after esophagectomy. Dehiscence of esophageal anastomosis could be fatal, and only high index of suspicion and early diagnosis lead to successful treatment. In majority of such cases conservative measures are successful, however, conduit necrosis is indication for surgical reoperation. Vocal cord palsy due to intraoperative injury of recurrent laryngeal nerves is not rare and increases pulmonary complications rate. New onset of arrhythmia could be associate with other surgical complications. Postesophagectomy chylothorax is life-threatening complication due to rapid development of immunosuppression and septic complications, and early ligation of thoracic duct is often mandatory. Intrathoracic herniation of intrabdominal viscera is rare, and ischemic spinal cord lesions are very rare after esophagectomy. Majority of perioperative complications could be prevented or solved, decreasing mortality rate of esophagectomy.

Benefit of Endoscopic Surgery in the Management of Acute Invasive Skull Base Fungal Rhinosinusitis

2020 ◽  
Vol 82 (S 03) ◽  
pp. e330-e334
Author(s):  
Megan R. D'Andrea ◽  
Corey M. Gill ◽  
Melissa Umphlett ◽  
Satish Govindaraj ◽  
Anthony Del Signore ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Mortality Rate ◽  
Skull Base ◽  
Fungal Infections ◽  
Hematologic Malignancy ◽  
Nasal Congestion ◽  
Postoperative Mortality ◽  
Surgical Interventions ◽  
Presenting Symptoms ◽  
Fungal Rhinosinusitis

Abstract Objective This article aims to characterize 14 patients who underwent purely endoscopic surgical debridement of acute invasive skull base fungal rhinosinusitis, and to evaluate postoperative outcomes and risk for recurrence. Design Retrospective cohort study. Setting Tertiary single-institution neurosurgery department. Participants We performed a retrospective analysis of all patients with skull base fungal infections treated with a purely endoscopic surgical approach at Mount Sinai Hospital from 1998 to 2018. Main Outcome Measures Clinical presentation, number of recurrences, and mortality rate. Results The most common underlying medical comorbidities were hematologic malignancy in 8 (57.1%) patients and poorly controlled diabetes mellitus in 7 (50%) patients. Presenting symptoms included headache (50%), eye pain (35.7%), facial pain (28.6%), visual changes (21.4%), and nasal congestion (14.3%). The fungal organisms identified on culture were Aspergillus (42.9%), Mucorales (28.6%), Fusarium (14.3%), Penicillium (7.1%), and unspecified (7.1%). Eight (57.1%) patients developed recurrence and required multiple surgical debridements. Patients who had only a hematologic malignancy were more likely to require multiple surgical debridements compared with those who did not have a hematologic malignancy or those who had both hematologic malignancy and underlying diabetes mellitus (p = 0.03). The mortality rate from surgery was 42.9%. Conclusion Surgical endoscopic intervention is an option for definitive management of acute invasive skull base fungal rhinosinusitis; however, postoperative mortality and risk of recurrence requiring additional surgical interventions remains high. Patients with hematologic malignancy may be more susceptible to recurrent infection requiring multiple surgical debridements. We recommend early aggressive multimodal treatment. Multiple debridements may be warranted in most cases; close clinical surveillance is needed during neurosurgical intervention.

Colectomy for Fulminant Clostridium difficile Colitis: Predictors of Mortality

2010 ◽  
Vol 76 (4) ◽  
pp. 418-421 ◽  
Author(s):  
Anton Dias Perera ◽  
Robert P. Akbari ◽  
Michael S. Cowher ◽  
Thomas E. Read ◽  
James T. Mccormick ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Clostridium Difficile ◽  
Serum Albumin ◽  
Organ Failure ◽  
Univariate Analysis ◽  
Postoperative Mortality ◽  
Clinical Variable ◽  
Symptom Duration ◽  
Multisystem Organ Failure ◽  
Clostridium Difficile Colitis

The purpose of this study was to define clinical and radiographic variables associated with postoperative mortality after urgent colectomy for fulminant Clostridium difficile colitis. Data were obtained regarding patients undergoing colectomy for fulminant C. difficile colitis at two institutions (1997-2005). Univariate analysis of factors predicting 30-day mortality was performed using χ2 and Student's t tests. Multivariable logistic regression was done to include all variables whose P value was < 0.20. Clinical variables analyzed included: age, gender, recent operation, comorbidities, preoperative multisystem organ failure, vasopressors, symptom duration, time to surgery, serum albumin, change in serum albumin, serum creatinine, white blood cell count, and extent of colectomy. Computed tomography variables included: ascites, megacolon, and extent of colitis. Thirty-five patients (mean age 70 years, 46% male) underwent urgent colectomy for C. difficile colitis. The 30-day mortality rate was 45.7 per cent (16/35). The only clinical variable associated with mortality was preoperative multisystem organ failure (non-survivors 9/16 vs survivors: 4/19; P = 0.037). None of the three patients undergoing partial colectomy survived, although the difference in survival versus those undergoing subtotal colectomy was not significant. Patients with fulminant C. difficile colitis undergoing colectomy have a high mortality rate. Preoperative presence of multisystem organ failure was independently predictive of mortality.

Sign in / Sign up

Export Citation Format

Share Document