scholarly journals Intraoperative Hypotension and Related Risk Factors for Postoperative Mortality After Noncardiac Surgery in Elderly Patients: A Retrospective Analysis Report

2021 ◽  
Vol Volume 16 ◽  
pp. 1757-1767
Author(s):  
Benhui Zhao ◽  
Xingtong Chen ◽  
Qian Chen ◽  
Gaoming Li ◽  
Zhe Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Elderly Patients ◽  
Retrospective Analysis ◽  
Postoperative Mortality ◽  
Noncardiac Surgery ◽  
Intraoperative Hypotension ◽  
Related Risk ◽  
Surgery In Elderly

scholarly journals Risk factors associated with outcomes of hip fracture surgery in elderly patients

2015 ◽  
Vol 68 (6) ◽  
pp. 561 ◽  
Author(s):  
Byung Hoon Kim ◽  
Sangseok Lee ◽  
Byunghoon Yoo ◽  
Woo Yong Lee ◽  
Yunhee Lim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hip Fracture ◽  
Elderly Patients ◽  
Factors Associated ◽  
Hip Fracture Surgery ◽  
Fracture Surgery ◽  
Surgery In Elderly

scholarly journals The cumulative duration of bispectral index less than 40 concurrent with hypotension is associated with 90-day postoperative mortality: a retrospective study

2020 ◽  
Author(s):  
Soohyuk Yoon ◽  
Seokha Yoo ◽  
Min Hur ◽  
Sun-Kyung Park ◽  
Hyung-Chul Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Bispectral Index ◽  
Odds Ratio ◽  
Postoperative Mortality ◽  
Anesthetic Depth ◽  
Intraoperative Hypotension ◽  
Cumulative Duration ◽  
The Relationship ◽  
Cumulative Time

Abstract Background The relationship between intraoperative low bispectral index (BIS) values and poor clinical outcomes has been controversial. Intraoperative hypotension is associated with postoperative complication. The purpose of this study was to investigate the influence of intraoperative low BIS values and hypotension on postoperative mortality in patients undergoing major abdominal surgery. Methods This retrospective study analyzed 1,862 cases of general anesthesia. We collected the cumulative time of BIS values below 20 and 40 as well as electroencephalographic suppression and documented the incidences in which these states were maintained for at least 5 minutes. Durations of intraoperative mean arterial pressures (MAP) less than 50 mmHg were also recorded. Multivariable logistic regression was used to evaluate the association between suspected risk factors and postoperative mortality. Results Ninety-day mortality and 180-day mortality were 1.5% and 3.2% respectively. The cumulative time in minutes for BIS values falling below 40 coupled with MAP falling below 50 mmHg was associated with 90-day mortality (odds ratio, 1.26; 95% confidence interval, 1.04-1.53; P = .019). We found no association between BIS related values and 180-day mortality. Conclusions Delicate adjustment of anesthetic depth is important to avoid excessive brain suppression and hypotension, which could be associated with postoperative mortality.

Retrospective Study of Cerebral Vasospasm-related Risk Factors in Elderly Patients With Subarachnoid Hemorrhage

2010 ◽  
Vol 20 (4) ◽  
pp. 258-262
Author(s):  
Guang Jian Liu ◽  
Yun Fu Wang ◽  
Yong Liu ◽  
Guo Hou He ◽  
Jun Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Subarachnoid Hemorrhage ◽  
Elderly Patients ◽  
Cerebral Vasospasm ◽  
Related Risk

scholarly journals The related risk factors of diabetic retinopathy in elderly patients with Type 2 diabetes mellitus: A cohort study

2020 ◽  
Author(s):  
Ying-Chu Chiu ◽  
Tien-Lung Tsai ◽  
Meiyin Su ◽  
Tsan Yang ◽  
Peng-Lin Tseng ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Family History ◽  
Elderly Patients ◽  
Betel Nut ◽  
Family History Of Diabetes ◽  
Related Risk ◽  
History Of

Abstract Background: Diabetic retinopathy (DR) caused by small vessel disease was the main cause of blindness in person with diabetes, and it mainly occurred in patients with Type 2 diabetes mellitus (T2DM). Taiwan was one of the Asian countries with the highest prevalence rate of DR, there were only few studies for the risk of DR in patients with T2DM in Taiwan. According to some studies have shown DR was a major cause of blindness on elderly both in developed and other developing countries. The purpose was to investigate the related risk factors of DR in elderly patients with T2DM. Methods: During July 2010 to December 2017, 4010 T2DM patients without DR were preselected for this study, but 792 patients completed the continuously follow-up evaluation. Patients were invited to have an outpatient visit at least every three months, and they were asked to fill out a brief questionnaire and collect their blood samples. Additionally, statistical methods used independent sample T-test, Chi-square tests and logistic regression in univariate analysis to analyze the relationships between onset DR and each related factor; and finally the optimal multivariate logistic regression model would be determined by stepwise model selection. Results: Of the 792 effective samples, 611 patients (77.1%) progressed to DR and 181 patients (22.9%) did not get DR during the follow-up period. According to the results, the significant factors were women (OR, 2.20; 95%CI, 1.52-3.17), longer diabetic duration (OR, 1.05; 95% CI, 1.03-1.08), family history of diabetes (OR, 1.55; 95% CI: 1.09-2.21), higher concentration glycated hemoglobin (HbA1c) (OR, 1.27; 95% CI: 1.12-1.44), higher mean low density lipoprotein cholesterol (LDL-c) (OR, 1.01; 95% CI: 1.00-1.01), and chewing betel nut (OR, 2.85; 95% CI: 1.41-5.77). Conclusions: This prospective cohort study showed that gender, behavior of chewing betel nut, diabetic duration, family history of diabetes, HbA1c, and LDL-c, were important factors for the development of DR in elderly patients with T2DM. It suggested that those patients should well control their HbA1c and LDL-c and quit chewing betel nut to prevent from DR, especially for female patients with family history of diabetes and longer duration of diabetes.

scholarly journals Incidence and risk factors of acute kidney injury after femoral neck fracture in elderly patients: a retrospective case-control study

2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Sizheng Zhan ◽  
Wenyong Xie ◽  
Ming Yang ◽  
Dianying Zhang ◽  
Baoguo Jiang
Keyword(s):  
Risk Factors ◽  
Femoral Neck ◽  
Elderly Patients ◽  
Femoral Neck Fracture ◽  
Kidney Injury ◽  
Intraoperative Hypotension ◽  
Neck Fracture ◽  
Potential Risk Factors ◽  
Independent Risk Factors ◽  
Postoperative Aki

Abstract Background Hip fracture is highly associated with disability and consequently, mortality in the elderly population. Postoperative acute kidney injury (AKI) is not unusual and is associated with considerable morbidity and mortality. We aimed to determine the incidences and potential risk factors for postoperative AKI in elderly patients with femoral neck fracture. Methods We retrospectively evaluated patients over 65 years of age who had been subjected to surgery for femoral neck fracture at Peking University People's Hospital from January 2015 to December 2019. Demographic characteristics and potential risk factors were collected. AKI was defined according to the Kidney Disease Improving Global Outcomes Guidelines (KDIGO). Results A total of 308 elderly patients with femoral neck fracture were included in the study. The overall incidence of postoperative AKI was 12% (37 cases). Through binary logistic regression analysis, adjusted for age, intraoperative blood loss and BMI, we identified that early postoperative albumin levels, hemoglobin changes and intraoperative hypotension are independent risk factors for postoperative AKI. The model considering the three factors can improve accuracy of predicting the possibility of developing AKI. The patients with AKI had a significantly higher mortality of 40.5% than those without AKI (24.0%, p < 0.001) Conclusion The incidence of postoperative AKI in elderly patients with femoral neck fracture was 12%. Independent risk factors for postoperative AKI included hemoglobin changes, early postoperative hypoalbuminemia and intraoperative hypotension. At the same time, postoperative AKI significantly increased mortality in elderly patients with femoral neck fracture. Taking multiple possible factors into consideration can better predict the possibility of elderly patients developing AKI after surgery.

Medical Evaluation of the Surgical Patient (SAGHE)

2014 ◽  
Author(s):  
Marie Gerhard-Herman ◽  
Jonathan Gates
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Stress Test ◽  
Risk Index ◽  
Fluid Management ◽  
Postoperative Mortality ◽  
Noncardiac Surgery ◽  
Surgical Patient ◽  
Improvement Program ◽  
Medical Evaluation

Medical evaluation prior to surgery includes risk assessment and the institution of therapies to decrease perioperative morbidity and mortality to improve patient outcomes. The most effective medical consultation for surgical patients begins with an assessment of the individual patient and knowledge of the planned surgery and anesthesia followed by clear communication of a concise and specific recommended plan of perioperative care to the surgical team. This chapter describes anesthetic, cardiac, pulmonary, hepatic, nutritional, and endocrine risk assessment. Perioperative thrombotic management and postoperative care and complications, including fluid management; pulmonary, cardiac, renal complications; and delirium are discussed. Tables outline the American Society of Anesthesiologists class and perioperative mortality risk, a comparison of the Revised Cardiac Risk Index and National Surgery Quality Improvement Program, Duke Activity Status Index, high-risk stress test findings, markers for increased perioperative risk in pulmonary hypertension, aortic stenosis and nonemergent noncardiac surgery, risk factors for pulmonary complications in noncardiac surgery, the Model for End-Stage Liver Disease score to predict postoperative mortality, venous thromboembolism risk factors and options for pharmacologic prophylactic regimens, perioperative management of warfarin, and Brigham and Women’s Hospital guidelines for postoperative blood product replacement. Figures include a care algorithm for noncardiac surgery, an illustration of types of myocardial infarction, and an algorithm for the treatment of postoperative delirium. This review contains 3 highly rendered figures, 12 tables, and 68 references.

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