scholarly journals Hemoglobin Levels and Postoperative Outcome in Pediatric Surgical Patients

2021 ◽  
Author(s):  
Claudine Kumba
Keyword(s):  
Postoperative Complications ◽  
Secondary Analysis ◽  
Length Of Hospital Stay ◽  
Postoperative Outcome ◽  
Surgical Patients ◽  
Preoperative Anemia ◽  
Preoperative Hemoglobin ◽  
Implementation Program ◽  
Number Of Patients ◽  
Pediatric Study

Abstract Background: Postoperative outcome in children is multifactorial. Among the reported predictors of postoperative outcome, preoperative anemia has been related to adverse outcome in children. A secondary analysis was undertaken to determine the correlation between hemoglobin levels and postoperative outcome in children included in a cohort of an observational pediatric study published previously since this analysis has not been done.Objective: To determine the correlation between preoperative, intra-operative, postoperative hemoglobin levels and postoperative outcome in children in neurosurgery, abdominal and orthopedic surgery.Methods: Secondary analysis of a sub-cohort of 252 pediatric surgical patients with a median age of 62 months [12.50-144.00].Results: Preoperative hemoglobin levels were negatively correlated to length of stay in the intensive care unit (LOSICU) (p=0.002), to length of hospital stay (LOS) (p<0.0001), to the number of patients with intra-operative and/or postoperative complications (p<0.0001) and to re-surgery (p<0001). Low preoperative hemoglobin levels below 6 g/dL were correlated to higher postoperative LOSICU and LOS. Intra-operative hemoglobin levels were negatively correlated to LOS (p<0.0001) and to the number of patients with intra-operative and/or postoperative complications (p=0.004). Low intra-operative hemoglobin levels below 5 g/dL were correlated to higher LOS. Postoperative hemoglobin levels were positively correlated to LMV (p=0.002). Conclusion: Hemoglobin levels are among other multifactorial predictors of postoperative outcome in pediatric surgical patients emphasizing the importance of a global patient blood management implementation program to improve outcome in surgical children.

scholarly journals Hemoglobin Levels and Postoperative Outcome in Pediatric Surgical Patients

2021 ◽  
Vol 1 (3) ◽  
Author(s):  
Claudine Kumba
Keyword(s):  
Postoperative Complications ◽  
Secondary Analysis ◽  
Length Of Hospital Stay ◽  
Postoperative Outcome ◽  
Surgical Patients ◽  
Preoperative Anemia ◽  
Preoperative Hemoglobin ◽  
Implementation Program ◽  
Number Of Patients ◽  
Pediatric Study

Background: Postoperative outcome in children is multifactorial. Among the reported predictors of postoperative outcome, preoperative anemia has been related to adverse outcome in children. A secondary analysis was undertaken to determine the correlation between hemoglobin levels and postoperative outcome in children included in a cohort of an observational pediatric study published previously since this analysis has not been done. Objective: To determine the correlation between preoperative, intra-operative, postoperative hemoglobin levels and postoperative outcome in children in neurosurgery, abdominal and orthopedic surgery. Methods: Secondary analysis of a sub-cohort of 252 pediatric surgical patients with a median age of 62 months [12.50-144.00]. Results: Preoperative hemoglobin levels were negatively correlated to length of stay in the intensive care unit (LOSICU) (p=0.002), to length of hospital stay (LOS) (p<0.0001), to the number of patients with intra-operative and/or postoperative complications (p<0.0001) and to re-surgery (p<0001). Low preoperative hemoglobin levels below 6g/dL were correlated to higher postoperative LOSICU and LOS. Intra-operative hemoglobin levels were negatively correlated to LOS (p<0.0001) and to the number of patients with intra-operative and/or postoperative complications (p=0.004). Low intra-operative hemoglobin levels below 5g/dL were correlated to higher LOS. Postoperative hemoglobin levels were positively correlated to LMV (p=0.002). Conclusion: Hemoglobin levels are among other multifactorial predictors of postoperative outcome in pediatric surgical patients emphasizing the importance of a global patient blood management implementation program to improve outcome in surgical children.

scholarly journals Hemoglobin Levels and Postoperative Outcome in Pediatric Surgical Patients

2021 ◽  
Author(s):  
Claudine Kumba
Keyword(s):  
Postoperative Complications ◽  
Secondary Analysis ◽  
Length Of Hospital Stay ◽  
Postoperative Outcome ◽  
Surgical Patients ◽  
Preoperative Anemia ◽  
Preoperative Hemoglobin ◽  
Implementation Program ◽  
Number Of Patients ◽  
Pediatric Study

Abstract Background: Postoperative outcome in children is multifactorial. Among the reported predictors of postoperative outcome, preoperative anemia has been related to adverse outcome in children. A secondary analysis was undertaken to determine the correlation between hemoglobin levels and postoperative outcome in children included in a cohort of an observational pediatric study published previously since this analysis has not been done.Objective: To determine the correlation between preoperative, intra-operative, postoperative hemoglobin levels and postoperative outcome in children in neurosurgery, abdominal and orthopedic surgery.Methods: Secondary analysis of a sub-cohort of 252 pediatric surgical patients with a median age of 62 months [12.50-144.00].Results: Preoperative hemoglobin levels were negatively correlated to length of stay in the intensive care unit (LOSICU) (p=0.002), to length of hospital stay (LOS) (p<0.0001), to the number of patients with intra-operative and/or postoperative complications (p<0.0001) and to re-surgery (p<0001). Low preoperative hemoglobin levels below 6 g/dL were correlated to higher postoperative LOSICU and LOS.Intra-operative hemoglobin levels were negatively correlated to LOS (p<0.0001) and to the number of patients with intra-operative and/or postoperative complications (p=0.004). Low intra-operative hemoglobin levels below 5 g/dL were correlated to higher LOS. Postoperative hemoglobin levels were positively correlated to LMV (p=0.002).Conclusion: Hemoglobin levels are among other multifactorial predictors of postoperative outcome in pediatric surgical patients emphasizing the importance of a global patient blood management implementation program to improve outcome in surgical children.

scholarly journals Is Obesity a Risk Factor for Spinal Surgeries? A Retrospective Study in a Specialized Orthopedic Spine Center

2021 ◽  
Vol 8 (1) ◽  
pp. 37-42
Author(s):  
Hasan Ghandhari ◽  
◽  
Ebrahim Ameri ◽  
Mohsen Motalebi ◽  
Mohamad-Mahdi Azizi ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Obese Group ◽  
Obese Patients ◽  
Number Of Patients ◽  
Significant Difference ◽  
Duration Of Surgery

Background: Various studies have shown the effects of morbid obesity on the adverse consequences of various surgeries, especially postoperative infections. However, some studies have shown that the complications of spinal surgery in obese and non-obese patients are not significantly different. Objectives: This study investigated and compared the duration of surgery, length of hospital stay, and complications after common spinal surgeries by orthopedic spine fellowship in obese and non-obese patients in a specialized spine center in Iran. Methods: All patients who underwent decompression with or without lumbar fusion were included in this retrospective study. These patients were classified into two groups: non-obese (BMI <30 kg/m2) and obese (BMI ≥30 kg/m2). The data related to type and levels of surgery, 30-day hospital complications, length of hospital stay, rate of postoperative wound infection, blood loss, and need for transfusion were all extracted and compared between the two groups. Results: A total of 148 patients (74%) were in the non-obese group and 52 patients (26%) in the obese group. The number of patients that need packed cells was significantly higher in the obese group (51.8% vs 32.6%) (P=0.01). Otherwise, there were not a significant difference between type of treatment (fusion or only decompression) (P=0.78), interbody fusion (P=0.26), osteotomy (P=0.56), duration of surgery (P=0.25), length of hospital stay (P=0.72), mean amount of blood loss (P=0.09), and postoperative complications (P=0.68) between the two groups. Conclusion: Our results suggest that duration of surgery, length of hospital stay, and postoperative complications are not associated with the BMI of the patients.

scholarly journals Two-port versus three-port video-assisted thoracoscopic surgery for primary spontaneous pneumothorax: feasibility, postoperative outcome and long-term recurrence rates

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Stephen Fung ◽  
Hany Ashmawy ◽  
Sami Safi ◽  
Anja Schauer ◽  
Alexander Rehders ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Hospital Stay ◽  
Chest Tube ◽  
Spontaneous Pneumothorax ◽  
Thoracoscopic Surgery ◽  
Length Of Hospital Stay ◽  
Operation Time ◽  
Postoperative Outcome ◽  
Primary Spontaneous Pneumothorax ◽  
Recurrence Rates

Abstract Background Two-port VATS (2-P-VATS) and three-port VATS (3-P-VATS) are well-established techniques for surgical therapy of primary spontaneous pneumothorax (PSP). However, comparisons of both techniques in terms of postoperative outcome and recurrence are limited. Methods From January 2010 to March 2020, we retrospectively reviewed data of 58 PSP patients who underwent VATS in our institution. For statistical analysis, categorical and continuous variables were compared by chi-square test or Fisher’s exact test and the Student´s t-test, respectively. Twenty-eight patients underwent 2-P-VATS and 30 were treated with 3-P-VATS. Operation time, length of hospital stay (LOS), total dose of analgesics per stay (opioids and non-opioids), duration of chest tube drainage, pleurectomy volume (PV), postoperative complications and recurrence rates were compared between both groups. Results Clinical and surgical characteristics including mean age, gender, Body-Mass-Index (BMI), pneumothorax size, smoking behaviour, history of contralateral pneumothorax, side of pneumothorax, pleurectomy volume and number of resected segments were similar in both groups. The mean operation time, LOS and total postoperative opioid and non-opioid dose was significantly higher in the 3-P-VATS group compared with the 2-P-VATS group. Despite not being statistically significant, duration of chest tube was longer in the 3-P-VATS group compared with the 2-P-VATS group. In terms of postoperative complications, the occurrence of hemothorax was significantly higher in the 3-P-VATS group (3-P-VATS vs. 2-P-VATS; p = 0.001). During a median follow-up period of 61.6 months, there was no significant statistical difference in recurrence rates in both groups (2/28 (16.7%) vs. 5/30 (7.1%); p = 0.274). Conclusion Our data demonstrate that 2-P-VATS is safer and effective. It is associated with reduced length of hospital stay and decreased postoperative pain resulting in less analgesic use.

scholarly journals Predictive Factors for Postoperative Outcome in Children with Jejunoileal Atresia

2019 ◽  
Vol 05 (04) ◽  
pp. e131-e136
Author(s):  
Charlotta Jarkman ◽  
Martin Salö
Keyword(s):  
Birth Weight ◽  
Postoperative Complications ◽  
Enteral Feeding ◽  
Univariate Analysis ◽  
Length Of Hospital Stay ◽  
Postoperative Outcome ◽  
Central Line ◽  
Jejunoileal Atresia ◽  
Tertiary Center ◽  
Full Enteral Feeding

Abstract Background Jejunoileal atresia is a relatively rare congenital gastrointestinal requiring surgery and long postoperative care. The postoperative outcome is affected by many factors and this study focuses on finding predictors for time to full enteral feeding, length of hospital stay (LOH), and postoperative complications. Methods This was a retrospective study of all children operated for isolated jejunoileal atresia between 2001 and 2017 at a tertiary center of pediatric surgery. Independent variables regarding demographical-, operative-, and postoperative data were abstracted. Primary outcome was time to full enteral feeding, LOH, and postoperative complications in terms of reoperation or central line complication. Any significant variables from the univariate analysis were further analyzed with logistic regression and presented as odds ratio with 95% confidence interval. Results After exclusion because of concomitant gastroschisis (n = 1), and death before discharge (n = 2), 47 patients were further analyzed (49% boys, 53% premature). No significant differences could be seen in the univariate analysis between children with short and long time (median > 17 days) to full enteral nutrition. Patients with longer LOH (median >32 days) had significantly lower birth weight compared with those with shorter LOH; median 2,550 g versus 2,980 g (p = 0.04). Patients with a central line complication had significantly longer median time to full enteral feeding (median 27 vs. 12 days, p = 0.03), and significantly longer median LOH (median 43 vs. 21 days, p = 0.03), but these parameters were not significant in a multivariate analysis. No significant results were found regarding reoperation. Conclusion Low birth weight seems associated with an increased LOH in children operated on for jejunoileal atresia, and central line complications seem related to the duration with central line in this group. The small cohort may constitute a power problem in this study and further research regarding the included variables may reveal more potential predictors for the postoperative outcome.

scholarly journals Pre-term Infants in Major Abdominal Surgery and Postoperative Outcome

2021 ◽  
Author(s):  
Claudine Kumba
Keyword(s):  
Respiratory Failure ◽  
Postoperative Complications ◽  
Observational Study ◽  
Abdominal Surgery ◽  
Secondary Analysis ◽  
Postoperative Outcome ◽  
Surgical Wound ◽  
Wound Sepsis ◽  
Term Infants ◽  
Initial Cohort

Abstract Background: A monocentric observational study was undertaken in pediatric surgical patients in neurosurgery, abdominal and orthopedic surgery to determine predictors of postoperative outcome. In this cohort of 594 patients with a mean age of 90.86±71.80 months there were 25 pre-terms aged less than 37 weeks. A description of postoperative outcome was undertaken in these pre-term infants. Objective: The objective of this study was to describe the characteristics in pre-term patients in this initial cohort. Methods: Secondary analysis of pre-term patients included in the initial retrospective observational study. The Ethics Committee approved the study. Results: 25 pre-terms aged <37 weeks were included with a mean weight of 2.43±0.75 kg in major neonatal abdominal surgery. 9 patient presented postoperative complications among which 1 had an intra-operative cardiac arrest, 4 had postoperative respiratory failure, 2 had pulmonary sepsis, 1 had surgical wound sepsis, 1 had septicemia and 1 had multi-organ sepsis. Conclusion: In this cohort of 25 critically ill pre-terms in major neonatal abdominal surgery, the most common postoperative complications concerned the respiratory system which included respiratory failure and pulmonary sepsis. There was no in-hospital mortality.

scholarly journals Neuroblastoma in Children: Intraoperative Goal Directed Therapy, Intraoperative And Postoperative Outcomes

2021 ◽  
Author(s):  
Claudine Kumba
Keyword(s):  
Postoperative Complications ◽  
Anesthetic Management ◽  
Secondary Analysis ◽  
Postoperative Outcome ◽  
Postoperative Outcomes ◽  
Transfusion Requirements ◽  
Intraoperative Management ◽  
Outcome Improvement ◽  
Challenging Situation ◽  
Surgical Setting

Abstract Background: Neuroblastoma is the most common tumor in children. Anesthetic management can be challenging due to the localization and catecholamine-secreting characteristics of the tumor. We undertook a secondary analysis in a previous study to describe patients who underwent neuroblastoma resection.Objective: To describe intraoperative and postoperative outcomes in patients who underwent neuroblastoma resection and to propose optimal intraoperative management for postoperative outcome improvement.Methods: This was a secondary analysis of children who underwent neuroblastoma resection in the initial retrospective study.Results: There were 16 patients with a mean age of 39.3±22.1 months. Seven (43.8%) patients presented with intraoperative or postoperative complications. One (6.3%) patient had intraoperative broncholaryngospasm and difficult intubation. Two (12.5%) patients had intraoperative hemorrhagic shock. One patient (6.3%) had postoperative renal failure. Two patients (12.5%) had postoperative respiratory failure, and 3 (18.8%) patients had postoperative cardiocirculatory failure. One (6.3%) had postoperative pulmonary sepsis and septicemia. Thirteen (81.3%) patients were intraoperatively transfused. There was no in-hospital mortality.Conclusion: In this cohort, 43.8% of the patients had intraoperative and/or postoperative complications in terms of organ dysfunction or sepsis. A total of 81.3% of the patients received intraoperative transfusion. Neuroblastoma surgery can be a challenging situation where cardiovascular instability, high blood loss and transfusion requirements can be encountered. Consequently, preoperative preparation and optimal intraoperative management with validated tools in children could be necessary for a better postoperative outcome in this surgical setting.

scholarly journals Postoperative Outcome in Non-Preterm Infants Under One Year Old in Non-Cardiac Surgery

2021 ◽  
Author(s):  
Claudine Kumba
Keyword(s):  
Postoperative Complications ◽  
Observational Study ◽  
Organ Failure ◽  
Preterm Infants ◽  
Secondary Analysis ◽  
Postoperative Outcome ◽  
Preterm Children ◽  
Surgery Patient ◽  
Neurosurgical Patients ◽  
One Year

Abstract Background and Objective : An observational study conducted earlier to determine predictors of postoperative outcome in non-cardiac surgical pediatric patients showed that factors which influenced postoperative evolution were multiple. These included American Society of Anesthesiologists (ASA) score, transfusion, age, emergency surgery, and surgery. The objective was to describe in details outcomes in non-preterm children under one year old included in the initial study. Methods : Secondary analysis of the initial retrospective observational study in 594 patients with a mean age of 90.86±71.80 months. The Ethics Committee approved the study under the registration number 2017-CK-5-R1. Results : There were 97 non-preterm children included with a mean age of 4.4±3.5 months. Mean weight was 5.1±2.7 kilograms. There were 48 abdominal surgical patients (49.5%), 48 neurosurgical patients (49.5%) and 1 orthopedic surgery patient (1%). 30 patients had intra-operative and or postoperative complications (organ failure or sepsis) (30.9%). The most common intra-operative complication was hemorrhagic shock (5.2%); the most affected system in the postoperative period was the respiratory system in terms of organ failure and pulmonary sepsis with an overall rate of 12.4%; the most common postoperative infection was septicemia (7.2%). The rate of postoperative renal failure was 1%. There were 5 in-hospital deaths (5.2%). Conclusion : In this cohort of 97 non-preterm infants under one year old, the rate of patients with intra-operative and or postoperative complications was 30.9%. It is time to reconsider integrating goal directed therapies in intra-operative patient management to improve postoperative outcome.

scholarly journals Evaluation of anemia as a postoperative risk factor in the evolution of patients with gastric resection for malignancies

2021 ◽  
Vol 6 (2) ◽  
pp. 136-140
Author(s):  
Bogdan Dumitriu ◽  
◽  
Sebastian Valcea ◽  
Gabriel Andrei ◽  
Mircea Beuran
Keyword(s):  
Gastric Cancer ◽  
Risk Factor ◽  
Postoperative Complications ◽  
Hospital Stay ◽  
Gastric Resection ◽  
Length Of Hospital Stay ◽  
Multivisceral Resection ◽  
Gastric Surgery ◽  
Infectious Complications ◽  
Preoperative Anemia

Introduction. Gastric cancer remains among the top three digestive diseases with the highest mortality rates in the world. Treatment of gastric cancer is multidisciplinary, gastric resection being essential for the best result. Anemia is one of the most common comorbidities present in patients diagnosed with gastric cancer. Materials and Methods. This is a retrospective analytical study over a period of 6 years (2014-2019). It is based on 114 consecutive gastric resections for cancer performed by a single team using exclusively resection and reconstruction stapling methods. The study aims to investigate a correlation between the presence of preoperative anemia and the incidence of postoperative morbidity and mortality. Results. Preoperative anemia was found in 70% of patients, with about half of these patients presenting with mild anemia. Most postoperative complications were grade I and II according to the Clavien Dindo scale. Anemia was correlated with an increase in infectious complications, anastomotic leaks and secondary peritoneal abscesses, pancreatic complications after multivisceral resection and length of hospital stay. Conclusions. Preoperative anemia is a risk factor that exposes the cancer patient to an increased incidence of life-threatening postoperative complications. In addition, it also extends the length of hospital stay and costs. Therefore, special attention should be paid to the identification and reduction of anemia before extensive gastric surgery in order to obtain the best possible therapeutic result.

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