scholarly journals Evaluation of postoperative complications associated  with tobacco use in thoracic surgery patients                   

2021 ◽  
Author(s):  
Mehmet Degirmenci ◽  
CELAL KUŞ
Keyword(s):  
Postoperative Complications ◽  
Thoracic Surgery ◽  
Tobacco Use ◽  
Intensive Therapy ◽  
Length Of Hospital Stay ◽  
Patient Characteristics ◽  
Tobacco Products ◽  
Mortality And Morbidity ◽  
Thoracic Diseases ◽  
Poor Outcomes

Introduction: Tobacco products can make thoracic diseases more complicated by affecting their respiratory functions in a short or long time and can increase mortality and morbidity related to these diseases. While smoking causes many diseases that require surgical treatment, especially thoracic surgery, on the other hand, it affects surgical results. This study aims to determine the relationship between tobacco use and postoperative complications in thoracic surgery patients and contribute to public health by supporting tobacco cessation programs. Method: Patient characteristics and tobacco use habits of the patients, and the types of tobacco they used were determined. Postoperative complications, admission to the intensive therapy unit, reintubation, death, and length of stay in hospital were defined as surgical outcomes. These results were compared and analyzed with tobacco use. Results: Retrospectively, 754 patients consisting of 536 (71.1%) males and 218 (28.9%) females were evaluated.  Tobacco use was more common in men (X2=223.216, p<0.001) and younger ages (X2=45.342, p<0.001). Complications occurred in 96 patients, 76 (79.2%) of whom used tobacco. Tobacco use (p<0.001, OR=3.547), ASA score (p=0.029, OR=2.004), major surgeries (p<0.001, OR=4.458), and minimally invasive surgeries (p=0.027, OR=2.323) are associated with complications. Length of hospital stay is related to the amount of tobacco (p <0.001, OR = 3.706), size of surgery (p <0.001, OR = 14.797), over 65 years (p <0.001, OR = 2.635), and infectious diseases (p = 0.039, OR: 1.939) Conclusion: Tobacco use is related to poor outcomes in thoracic surgery patients, and it is a severe health problem, especially at young ages. Tobacco control programs should be supported to prevent the effects of tobacco use on thoracic diseases and postoperative complications. Keywords: tobacco use, postoperative complications, thoracic surgery, tobacco products, pulmonary diseases, smoking.

scholarly journals Evaluation of post-operative complications associated with tobacco use in thoracic surgery patients

2021 ◽  
Vol 8 (8) ◽  
pp. 2272
Author(s):  
Mehmet Degirmenci ◽  
Celal Kus
Keyword(s):  
Postoperative Complications ◽  
Thoracic Surgery ◽  
Tobacco Use ◽  
Intensive Therapy ◽  
Length Of Hospital Stay ◽  
Patient Characteristics ◽  
Thoracic Diseases ◽  
Operative Complications ◽  
Poor Outcomes ◽  
Post Operative Complications

Background: Tobacco can make thoracic diseases more complicated by affecting their respiratory functions. Smoking causes many diseases that require surgical treatment and affects surgical results. The aim of the study was to determine the relationship between tobacco use and post-operative complications in thoracic surgery patients and contribute to public health.Methods: In this study, 754 patients were evaluated retrospectively. Patient characteristics and tobacco use habits of the patients were determined. Postoperative complications, admission to the intensive therapy unit, intubation, death, and length of stay in hospital were defined as surgical outcomes. These results were compared and analyzed with tobacco use.Results: The patients consisted of 536 (71.1%) men and 218 (28.9%) women. Tobacco use was more common in men (X2=223.216, p<0.001) and younger ages (X2=45.342, p<0.001). Complications occurred in 96 patients, 76 (79.2%) of whom used tobacco. Tobacco use (p<0.001, OR=3.547), ASA score (p=0.029, OR=2.004), major surgeries (p<0.001, OR=4.458), and minimally invasive surgeries (p=0.027, OR=2.323) are associated with complications. Length of hospital stay is related to the amount of tobacco (p<0.001, OR=3.706), size of surgery (p<0.001, OR=14.797), over 65 years (p<0.001, OR=2.635), and infectious diseases (p=0.039, OR=1.939).Conclusions: Tobacco use is related to poor outcomes in thoracic surgery patients, and it is a severe health problem, especially at young ages. Tobacco control programs should be supported to prevent the effects of tobacco use on thoracic diseases and postoperative complications.

scholarly journals Laparoscopic Primary Colorrhaphy for Acute Iatrogenic Perforations during Colonoscopy

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Eric M. Haas ◽  
Rodrigo Pedraza ◽  
Madhu Ragupathi ◽  
Ali Mahmood ◽  
T. Bartley Pickron
Keyword(s):  
Postoperative Complications ◽  
Thermal Injury ◽  
Early Recognition ◽  
Primary Repair ◽  
Length Of Hospital Stay ◽  
Patient Characteristics ◽  
Open Procedure ◽  
Direct Trauma ◽  
The Mean ◽  
Surgical Modality

Purpose. We present our experience with laparoscopic colorrhaphy as definitive surgical modality for the management of colonoscopic perforations.Methods. Over a 17-month period, we assessed the outcomes of consecutive patients presenting with acute colonoscopic perforations. Patient characteristics and perioperative parameters were tabulated. Postoperative outcomes were evaluated within 30 days following discharge.Results. Five female patients with a mean age of 71.4 ± 9.7 years (range: 58–83), mean BMI of 26.4 ± 3.4 kg/m2(range: 21.3–30.9), and median ASA score of 2 (range: 2-3) presented with acute colonoscopic perforations. All perforations were successfully managed through laparoscopic colorrhaphy within 24 hours of development. The perforations were secondary to direct trauma(n=3)or thermal injury(n=2)and were localized to the sigmoid(n=4)or cecum(n=1). None of the patients required surgical resection, diversion, or conversion to an open procedure. No intra- or postoperative complications were encountered. The mean length of hospital stay was 3.8 ± 0.8 days (range: 3–5). There were no readmissions or reoperations.Conclusion. Acute colonoscopic perforations can be safely managed via laparoscopic primary repair without requiring resection or diversion. Early recognition and intervention are essential for successful outcomes.

scholarly journals Prevalence of Tobacco Use and Its Associated Factors among School Going Adolescents in Birgunj Sub-Metropolitan, Nepal

2019 ◽  
Vol 5 (1) ◽  
pp. 72-76
Author(s):  
Arbind Kumar Chaudhary ◽  
Tulsi Ram Bhandari
Keyword(s):  
Influencing Factors ◽  
Tobacco Use ◽  
Associated Factors ◽  
Peer Pressure ◽  
Tobacco Product ◽  
Easy Access ◽  
Global Youth Tobacco Survey ◽  
Cross Sectional ◽  
Tobacco Products ◽  
Mortality And Morbidity

Tobacco use means consumption of any form of tobacco products either smoked or smokeless. Common used tobacco products are cigarette, cigars, pipe tobacco and favored Sisha tobacco, Surti/khaini, Panmasala, and Gutkha. It is one of the major causes of preventable mortality and morbidity worldwide. Objective of the study was to assess the prevalence of tobacco use and its associated factors among higher secondary school going adolescents of Birgunj Sub-metropolitan, Nepal. A schools based cross-sectional descriptive study was carried out using self-administrative questionnaire and it was prepared based on Global Youth Tobacco Survey. It was developed and validated for assessing the tobacco use among adolescents. Amongst 16 higher secondary schools, three public and three private schools were selected randomly. Similarly required sample (307) were recruited as proportionately from each school considering number of students studying in each selected school from August to December 2016. Prevalence of ever use of tobacco was 15.6 %. Cigarette was the most (70.8%) commonly used as tobacco product. The average age of initiation of tobacco use was 13.96++2.62 year. More than half (52.1%) of the tobacco users purchased tobacco from shops. Peer pressure (45.8%) was one of the major influencing factors of ever use of tobacco. Age, gender, friends pressure and parent's education were found significantly associated with ever use of tobacco among students. Nearly one-fifth adolescents used some type of tobacco products in last six month. Tobacco used by parents, peers and others family members at home and public places, and easy access of tobacco products were the major influencing factors of tobacco use among students. School and community based awareness programs and tobacco control legislations should be implemented consistently to control and discourage the consumption of tobacco products. Keywords: Adolescents, students, associated factors, tobacco use

scholarly journals Outcomes of hospitalizations with atrial fibrillation-flutter on a weekday versus weekend: an analysis from a 2014 nationwide inpatient sample

PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e6211 ◽  
Author(s):  
Dinesh C. Voruganti ◽  
Ghanshyam Palamaner Subash Shantha ◽  
Abhishek Deshmukh ◽  
Michael C. Giudici
Keyword(s):  
Atrial Fibrillation ◽  
Hospital Mortality ◽  
Nationwide Inpatient Sample ◽  
Length Of Hospital Stay ◽  
Patient Characteristics ◽  
International Classification Of Diseases ◽  
Primary Diagnosis ◽  
Significant Difference ◽  
Poor Outcomes ◽  
Atrial Fibrillation And Flutter

Background Patients with atrial fibrillation-flutter (AF) admitted on the weekends were initially reported to have poor outcomes. The primary purpose of this study is to re-evaluate the outcomes for weekend versus weekday AF hospitalization using the 2014 Nationwide Inpatient Sample (NIS). Methods Included hospitalizations were aged above 18 years. The hospitalizations with AF were identified using the international classification of diseases 9 (ICD-9) codes (427.31, 427.32). In-hospital mortality, length of stay (LOS), other co-morbidities, cardioversion procedures, and time to cardioversion were recorded. All analysis was performed using SAS 9.4 statistical software (Cary, North Carolina). Results A total of 453,505 hospitalizations with atrial fibrillation and flutter as primary discharge diagnosis were identified. Among the total hospitalizations with a primary diagnosis of AF, 20.3% were admitted on the weekend. Among the weekend hospitalizations, 0.19% died in hospital compared to 0.74% among those admitted during the week. After adjusting for patient characteristics, hospital characteristics and disease severity, the adjusted odds for in-hospital mortality were not significantly different for weekend vs. weekday hospitalizations (OR = 0.91, 95% CI [0.77–1.11]; p = 0.33). The weekend admissions were associated with significantly lower odds of cardioversion procedures (OR = 0.72, 95% CI [0.69–0.76], P < 0.0001), lower cost of hospitalization (USD 8265.8 on weekends vs. USD 8966.5 on the weekdays, P < 0.001), slightly lower rate of anticoagulation (17.09% on the weekends vs. 18.73% on the weekdays. P < 0.0001), and slightly increased time to cardioversion (1.94 days on the weekend vs. 1.73 days on weekdays, P < 0.0005). The mean length of hospital stay (LOS) was statistically not different in both groups: (3.49 days ± 3.70 (SD) in the weekend group vs. 3.47 days ± 3.50 (SD) in the weekday group, P = 0.42) Discussion The weekend AF hospitalizations did not have a clinically significant difference in mortality and LOS compared to those admitted on a weekday. However, the use of cardioversion procedures and cost of hospitalization was significantly lower on the weekends.

scholarly journals Robotic thoracic surgery for inflammatory and infectious lung disease: initial experience in Brazil

2021 ◽  
Vol 48 ◽  
Author(s):  
PEDRO HENRIQUE CUNHA LEITE ◽  
ALESSANDRO WASUM MARIANI ◽  
PEDRO HENRIQUE XAVIER NABUCO DE ARAUJO ◽  
CARLOS EDUARDO TEIXEIRA LIMA ◽  
FELIPE BRAGA ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Thoracic Surgery ◽  
Hospital Stay ◽  
Operative Time ◽  
Length Of Hospital Stay ◽  
Extent Of Resection ◽  
Lung Abscess ◽  
Safe Procedure ◽  
Open Thoracotomy ◽  
The Mean

ABSTRACT Objective: in Latin America, especially Brazil, the use of a robotic platform for thoracic surgery is gradually increasing in recent years. However, despite tuberculosis and inflammatory pulmonary diseases are endemic in our country, there is a lack of studies describing the results of robotic surgical treatment of bronchiectasis. This study aims to evaluate the surgical outcomes of robotic surgery for inflammatory and infective diseases by determining the extent of resection, postoperative complications, operative time, and length of hospital stay. Methods: retrospective study from a database involving patients diagnosed with bronchiectasis and undergoing robotic thoracic surgery at three hospitals in Brazil between January of 2017 and January of 2020. Results: a total of 7 patients were included. The mean age was 47 + 18.3 years (range, 18-70 years). Most patients had non-cystic fibrosis bronchiectasis (n=5), followed by tuberculosis bronchiectasis (n=1) and lung abscess (n=1). The performed surgeries were lobectomy (n=3), anatomic segmentectomy (n=3), and bilobectomy (n=1). The median console time was 147 minutes (range 61-288 min.) and there was no need for conversion to open thoracotomy. There were no major complications. Postoperative complications occurred in one patient and it was a case of constipation with the need for an intestinal lavage. The median for chest tube time and hospital stay, in days, was 1 (range, 1-6 days) and 5 (range, 2-14 days) respectively. Conclusions: robotic thoracic surgery for inflammatory and infective diseases is a feasible and safe procedure, with a low risk of complications and morbidity.

Activity Tracking After Surgery: Does It Correlate With Postoperative Complications?

2021 ◽  
pp. 000313482098881
Author(s):  
Yehonatan Nevo ◽  
Tali Shaltiel ◽  
Naama Constantini ◽  
Danny Rosin ◽  
Mordechai Gutman ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Enhanced Recovery ◽  
Length Of Hospital Stay ◽  
Inverse Correlation ◽  
Complication Rates ◽  
Activity Tracking ◽  
Primary Endpoints ◽  
Specific Complication ◽  
Secondary Endpoints ◽  
Enhanced Recovery Programs

Background Postoperative ambulation is an important tenet in enhanced recovery programs. We quantitatively assessed the correlation of decreased postoperative ambulation with postoperative complications and delays in gastrointestinal function. Methods Patients undergoing major abdominal surgery were fitted with digital ankle pedometers yielding continuous measurements of their ambulation. Primary endpoints were the overall and system-specific complication rates, with secondary endpoints being the time to first passage of flatus and stool, the length of hospital stay, and the rate of readmission. Results 100 patients were enrolled. We found a significant, independent inverse correlation between the number of steps on the first and second postoperative days (POD1/2) and the incidence of complications as well as the recovery of GI function and the likelihood of readmission ( P < .05). POD2 step count was an independent risk factor for severe complications ( P = .026). Discussion Digitally quantified ambulation data may be a prognostic biomarker for the likelihood of severe postoperative complications.

565 POST-OPERATIVE WEIGHT LOSS AND OUTCOMES FOLLOWING ESOPHAGECTOMY

2020 ◽  
Vol 33 (Supplement_1) ◽  
Author(s):  
R Khaw ◽  
S Munro ◽  
J Sturrock ◽  
H Jaretzke ◽  
S Kamarajah ◽  
...  
Keyword(s):  
Weight Loss ◽  
Length Of Stay ◽  
Hospital Stay ◽  
Enhanced Recovery ◽  
Length Of Hospital Stay ◽  
Failure To Thrive ◽  
Post Discharge ◽  
Postoperative Weight Loss ◽  
Poor Outcomes ◽  
The Impact

Abstract   Oesophageal cancer is the 11th most common cancer worldwide, with oesophagectomy remaining the mainstay curative treatment, despite significant associated morbidity and mortality. Postoperative weight loss remains a significant problem and is directly correlated to poor prognosis. Measures such as the Enhanced Recovery After Surgery (ERAS) programme and intraoperative jejunostomy feed have looked to tackle this. This study investigates the impact of these on mortality, length of hospital stay and postoperative weight loss. Methods Patients undergoing oesophagectomy between January 1st 2012—December 2014 and 28th October 2015–December 31st 2019 in a national tertiary oesophagogastric unit were included retrospectively. Variables measured included comorbidities, operation, histopathology, weights (pre- and post-operatively), length of hospital stay, postoperative complications and mortality. Pre-operative body weight was measured at elective admission, and further weights were identified from a prospectively maintained database, during further clinic appointments. Other data was collected through patient notes. Results 594 patients were included. Mean age at diagnosis was 65.9 years (13–65). Majority of cases were adenocarcinoma (63.3%), with varying stages of disease (TX-4, NX-3). Benign pathology accounted for 8.75% of cases. Mean weight loss post-oesophagectomy exceeded 10% at 6 months (SD 14.49). Majority (60.1%) of patients were discharged with feeding jejunostomy, and 5.22% of these required this feed to be restarted post-discharge. Length of stay was mean 16.5 days (SD 22.3). Complications occurred in 68.9% of patients, of which 13.8% were infection driven. Mortality occurred in 26.6% of patients, with 1.83% during hospital admission. 30-day mortality rate was 1.39%. Conclusion Failure to thrive and prolonged weight-loss following oesophagectomy can contribute to poor recovery, with associated complications and poor outcomes, including increased length of stay and mortality. Further analysis of data to investigate association between weight loss and poor outcomes for oesophagectomy patients will allow for personalised treatment of high-risk patients, in conjunction with members of the multidisciplinary team, including dieticians.

Higher-Than-Expected Rates of Distal Radioulnar Joint Fixation in Radial Shaft Fractures: Location of Fracture Matters

Hand ◽  
2021 ◽  
pp. 155894472110068
Author(s):  
Joanne Y. Zhang ◽  
Aneesh V. Samineni ◽  
David C. Sing ◽  
Alyssa Rothman ◽  
Andrew B. Stein
Keyword(s):  
Risk Factors ◽  
Postoperative Complications ◽  
Patient Characteristics ◽  
Distal Radioulnar Joint ◽  
Older Age ◽  
Radioulnar Joint ◽  
Factors Associated ◽  
Shaft Fractures ◽  
Male Sex ◽  
Preoperative Patient

Background: The purpose of this study was to evaluate rates of distal radioulnar joint (DRUJ) fixation based on location of the radial shaft fracture and risk factors associated with postoperative complications following radial shaft open reduction internal fixation (ORIF). Methods: Adult patients who underwent isolated radial shaft ORIF from 2014 to 2018 were identified from American College of Surgeons National Surgical Quality Improvement Program database and stratified by fracture location and by the presence or absence of DRUJ fixation. Preoperative patient characteristics and postoperative complications were compared to determine risk factors associated with DRUJ fixation. Results: We identified 1517 patients who underwent isolated radial shaft ORIF, of which 396 (26.1%) underwent DRUJ fixation. Preoperative patient characteristics and postoperative complications were similar between cohorts. Distal radioulnar joint fixation was performed in 50 (30.7%) of 163 distal radial shaft fractures, 191 (21.8%) of 875 midshaft fractures, and 3 (13.0%) of 23 proximal shaft fractures ( P = .025). Risk factors for patients readmitted include male sex (odds ratio [OR] = 12.76, P = .009) and older age (OR = 4.99, P = .035). Risk factors for patients with any postoperative complication include dependent functional status (OR = 6.78, P = .02), older age (50-69 vs <50) (OR = 2.73, P = .05), and American Society of Anesthesiologists (ASA) ≥3 (OR = 2.45, P = .047). Conclusions: The rate of DRUJ fixation in radial shaft ORIF exceeded previously reported rates of concomitant DRUJ injury, especially among distal radial shaft fractures. More distally located radial shaft fractures are significantly associated with higher rates of DRUJ fixation. Male sex is a risk factor for readmission, whereas dependent functional status, older age, and ASA ≥3 are risk factors for postoperative complications.

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