scholarly journals Total hip arthroplasty and chronic obstructive pulmonary disease in a high dependency unit

2017 ◽  
Vol 3 (3b) ◽  
pp. 101-103
Author(s):  
Leonidas Grigorakos ◽  
Katerina Sakagianni ◽  
Mariza Gioka ◽  
Victoria Charizopoulou ◽  
Dimitra Markopoulou ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Total Hip Arthroplasty ◽  
Pulmonary Disease ◽  
Hip Arthroplasty ◽  
Chronic Obstructive ◽  
High Dependency Unit ◽  
Obstructive Pulmonary Disease ◽  
Total Hip ◽  
High Dependency

Chronic Obstructive Pulmonary Disease Is Associated With Short-Term Complications Following Total Hip Arthroplasty

2018 ◽  
Vol 33 (6) ◽  
pp. 1926-1929 ◽  
Author(s):  
George A. Yakubek ◽  
Gannon L. Curtis ◽  
Nipun Sodhi ◽  
Mhamad Faour ◽  
Alison K. Klika ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Total Hip Arthroplasty ◽  
Pulmonary Disease ◽  
Hip Arthroplasty ◽  
Chronic Obstructive ◽  
Short Term ◽  
Obstructive Pulmonary Disease ◽  
Total Hip

scholarly journals Influenza in Malaysian adult patients hospitalized with community-acquired pneumonia, acute exacerbation of chronic obstructive pulmonary disease or asthma: a multicenter, active surveillance study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yong Kek Pang ◽  
Ahmad Izuanuddin Ismail ◽  
Yoke Fun Chan ◽  
Adelina Cheong ◽  
Yoong Min Chong ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Active Surveillance ◽  
Community Acquired Pneumonia ◽  
Surveillance Study ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
High Dependency ◽  
Increased Risk

Abstract Background Available data on influenza burden across Southeast Asia are largely limited to pediatric populations, with inconsistent findings. Methods We conducted a multicenter, hospital-based active surveillance study of adults in Malaysia with community-acquired pneumonia (CAP), acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and acute exacerbation of asthma (AEBA), who had influenza-like illness ≤10 days before hospitalization. We estimated the rate of laboratory-confirmed influenza and associated complications over 13 months (July 2018–August 2019) and described the distribution of causative influenza strains. We evaluated predictors of laboratory-confirmed influenza and severe clinical outcomes using multivariate analysis. Results Of 1106 included patients, 114 (10.3%) were influenza-positive; most were influenza A (85.1%), with A/H1N1pdm09 being the predominant circulating strain during the study following a shift from A/H3N2 from January–February 2019 onwards. In multivariate analyses, an absence of comorbidities (none versus any comorbidity [OR (95%CI), 0.565 (0.329–0.970)], p = 0.038) and of dyspnea (0.544 (0.341–0.868)], p = 0.011) were associated with increased risk of influenza positivity. Overall, 184/1106 (16.6%) patients were admitted to intensive care or high-dependency units (ICU/HDU) (13.2% were influenza positive) and 26/1106 (2.4%) died (2.6% were influenza positive). Males were more likely to have a severe outcome (ICU/HDU admission or death). Conclusions Influenza was a significant contributor to hospitalizations associated with CAP, AECOPD and AEBA. However, it was not associated with ICU/HDU admission in this population. Study registration, NMRR ID: NMRR-17-889-35,174.

Readmission for Early Prosthetic Dislocation after Primary Total Hip Arthroplasty

2020 ◽  
Vol 04 (01) ◽  
pp. 023-032
Author(s):  
Wesley M. Durand ◽  
William J. Long ◽  
Ran Schwarzkopf
Keyword(s):  
Risk Factors ◽  
Total Hip Arthroplasty ◽  
Operating Room ◽  
Hip Arthroplasty ◽  
Postoperative Management ◽  
Chronic Obstructive ◽  
Improvement Program ◽  
Obstructive Pulmonary Disease ◽  
Total Hip ◽  
Early Reoperation

AbstractProsthetic dislocation in total hip arthroplasty (THA) is the most common cause for readmission in the 90 days following surgery. This investigation sought to quantify risk factors for readmission for early prosthetic dislocation within 30 days after primary THA. This study used the National Surgical Quality Improvement Program (NSQIP) database for the years 2012 to 2017. The primary outcome was reoperation or readmission for prosthetic dislocation within 30 days after primary total hip replacement. Secondary outcomes included native NSQIP medical complications. A total of 159,234 patients were included. Of these, 0.25% (n = 399) experienced reoperation or readmission for prosthetic dislocation within 30 days postoperatively. A total of 217 dislocated hips (54.4%) returned to the operating room only once, and 27 hips (6.8%) returned to the operating room twice. The mean day of first reoperation/readmission for dislocation was 13.5 (standard deviation [SD]: 9.0). In multivariable logistic regression, the following factors were significantly associated with early reoperation/readmission for prosthetic dislocation: patient age 80+ years (odds ratio [OR]: 1.51 vs. 50–59), high creatinine (OR: 1.75 vs. normal range), smoking (OR: 1.53), history of severe chronic obstructive pulmonary disease (COPD) (OR: 1.73), general anesthesia (OR: 1.41 vs. spinal), American Society of Anesthesiologists (ASA) class 3–5 (OR: 1.66 vs. 1 or 2), fracture (OR: 2.17), chronic steroid use (OR: 1.54), and operative duration ≥ 2 hours (all p < 0.05). Early prosthetic dislocation was significantly associated with the further development of surgical site infection (OR: 2.25) (both p < 0.05). This study identified risk factors for early reoperation/readmission for prosthetic dislocation after THA. These findings have implications for preoperative planning, postoperative management, and dislocation precautions.

scholarly journals Effect of time and day of admission on hospital care quality for patients with chronic obstructive pulmonary disease exacerbation in England and Wales: single cohort study

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e015532 ◽  
Author(s):  
Christopher Michael Roberts ◽  
Derek Lowe ◽  
Emma Skipper ◽  
Michael C Steiner ◽  
Rupert Jones ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Cohort Study ◽  
Pulmonary Disease ◽  
Care Quality ◽  
Chronic Obstructive ◽  
Process Of Care ◽  
Obstructive Pulmonary Disease ◽  
England And Wales ◽  
High Dependency ◽  
Day Of The Week

ObjectiveTo evaluate if observed increased weekend mortality was associated with poorer quality of care for patients admitted to hospital with chronic obstructive pulmonary disease (COPD) exacerbation.DesignProspective case ascertainment cohort study.Setting199 acute hospitals in England and Wales, UK.ParticipantsConsecutive COPD admissions, excluding subsequent readmissions, from 1 February to 30 April 2014 of whom 13 414 cases were entered into the study.Main outcomesProcess of care mapped to the National Institute for Health and Care Excellence clinical quality standards, access to specialist respiratory teams and facilities, mortality and length of stay, related to time and day of the week of admission.ResultsMortality was higher for weekend admissions (unadjusted OR 1.20, 95% CI 1.00 to 1.43), and for case-mix adjusted weekend mortality when calculated for admissions Friday morning through to Monday night (adjusted OR 1.19, 95% CI 1.00 to 1.43). Median time to death was 6 days. Some clinical processes were poorer on Mondays and during normal working hours but not weekends or out of hours. Specialist respiratory care was less available and less prompt for Friday and Saturday admissions. Admission to a specialist ward or high dependency unit was less likely on a Saturday or Sunday.ConclusionsIncreased mortality observed in weekend admissions is not easily explained by deficiencies in early clinical guideline care. Further study of out-of-hospital factors, specialty care and deaths later in the admission are required if effective interventions are to be made to reduce variation by day of the week of admission.

Oral and Oropharyngeal Sensory Function in Adults With Chronic Obstructive Pulmonary Disease

2020 ◽  
Vol 29 (2) ◽  
pp. 864-872
Author(s):  
Fernanda Borowsky da Rosa ◽  
Adriane Schmidt Pasqualoto ◽  
Catriona M. Steele ◽  
Renata Mancopes
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Oral Cavity ◽  
Pulmonary Disease ◽  
Thermal Sensation ◽  
Sensory Function ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Age Related ◽  
Copd Patients

Introduction The oral cavity and pharynx have a rich sensory system composed of specialized receptors. The integrity of oropharyngeal sensation is thought to be fundamental for safe and efficient swallowing. Chronic obstructive pulmonary disease (COPD) patients are at risk for oropharyngeal sensory impairment due to frequent use of inhaled medications and comorbidities including gastroesophageal reflux disease. Objective This study aimed to describe and compare oral and oropharyngeal sensory function measured using noninstrumental clinical methods in adults with COPD and healthy controls. Method Participants included 27 adults (18 men, nine women) with a diagnosis of COPD and a mean age of 66.56 years ( SD = 8.68). The control group comprised 11 healthy adults (five men, six women) with a mean age of 60.09 years ( SD = 11.57). Spirometry measures confirmed reduced functional expiratory volumes (% predicted) in the COPD patients compared to the control participants. All participants completed a case history interview and underwent clinical evaluation of oral and oropharyngeal sensation by a speech-language pathologist. The sensory evaluation explored the detection of tactile and temperature stimuli delivered by cotton swab to six locations in the oral cavity and two in the oropharynx as well as identification of the taste of stimuli administered in 5-ml boluses to the mouth. Analyses explored the frequencies of accurate responses regarding stimulus location, temperature and taste between groups, and between age groups (“≤ 65 years” and “> 65 years”) within the COPD cohort. Results We found significantly higher frequencies of reported use of inhaled medications ( p < .001) and xerostomia ( p = .003) in the COPD cohort. Oral cavity thermal sensation ( p = .009) was reduced in the COPD participants, and a significant age-related decline in gustatory sensation was found in the COPD group ( p = .018). Conclusion This study found that most of the measures of oral and oropharyngeal sensation remained intact in the COPD group. Oral thermal sensation was impaired in individuals with COPD, and reduced gustatory sensation was observed in the older COPD participants. Possible links between these results and the use of inhaled medication by individuals with COPD are discussed.

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