National Fontan Operation outcomes at or below 2-years-of-age compared to older than 2- years-of-age

Introduction: Opinion is divided about optimal early timing of the Fontan Operation (FO). While some studies have suggested 3 years-of-age, others have shown good outcomes below 2 years-of -age. We analyzed the impact of age ≤2-years as compared age >2-years on short-term outcome of the FO using a large national database. Methods: A retrospective analysis of the Kids Inpatient Database (2009-16) for the FO was done. The groups were divided into those who underwent FO at age ≤2-years (EF) as compared to age >2-years (LF). The data was abstracted for demographics, clinical characteristics, and operative outcomes. Standard statistical tests were used. Results: 3381 patients underwent FO during this period of which 1482 (44%) were EF. The mean ages of the EF and LF were 1.6 and 4.3, respectively (p< 0.001). LF were more likely to be non-White, female, and have Heterotaxy syndrome. HLHS was more common in EF. There was no difference in the discharge mortality, length of stay, disposition (majority went home), and mean total charges incurred. The overall discharge mortality was low at 0.7% (24/3381). In multivariate analysis: cardiac arrest, acute kidney injury, mechanical ventilation >96 hours, endocardial cushion defect and non-White ethnicity were predictors of a mortality and not age. Conclusion: Contemporary outcomes for FO are excellent with equivalent short-term outcomes in both the age groups. Occurrence of postoperative complications, non-white ethnicity and endocardial cushion defect diagnosis were predictive of a negative outcome.

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Traumatic Brain Injury: The Silent Epidemic

AACN Advanced Critical Care ◽

10.4037/15597768-1992-1002 ◽

1992 ◽

Vol 3 (1) ◽

pp. 9-18 ◽

Cited By ~ 7

Author(s):

Kathy Coburn

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

National Database ◽

Assessment Practices ◽

Term Outcome ◽

Long Term Outcome ◽

Acute Health Care ◽

Focal Injury ◽

The Impact ◽

The Brain

It is difficult to accurately determine the number of people affected annually by the devastating effects of traumatic brain injury. It is clear, however, that the impact of traumatic brain injury exceeds the financial cost of acute health care. The long-term outcome of patients with traumatic brain injury has been targeted specifically for improvement during this decade. The initial brain injury—known as the primary injury—may occur in one area of the brain (focal injury) or may affect the entire brain (diffuse injury). The outcome depends on many factors, including the severity of the brain injury and the effectiveness of the interventions received. Accurate assessment of the scope of the problem would be improved by the development of a national database and the standardization of assessment practices. Critical care nurses can contribute skill and knowledge in the care of patients with traumatic brain injury and in efforts to prevent the accidents and violence that cause traumatic brain injury

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The Impact of the Duration of Untreated Psychosis On the Short-term Outcome in Schizophrenia

European Psychiatry ◽

10.1016/s0924-9338(15)31326-2 ◽

2015 ◽

Vol 30 ◽

pp. 1726

Author(s):

H. Rebhi ◽

W. Cherif ◽

L. Chennoufi ◽

A. Belkhiria ◽

M. Cheour

Keyword(s):

Duration Of Untreated Psychosis ◽

Short Term ◽

Term Outcome ◽

Short Term Outcome ◽

The Impact

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Effect of Smoking on Short-term Postoperative Complications After Elective Upper Extremity Surgery

Hand ◽

10.1177/1558944720926638 ◽

2020 ◽

pp. 155894472092663

Author(s):

Michael A. Del Core ◽

Junho Ahn ◽

Ann S. Golden ◽

Robert L. Bass ◽

Douglas Sammer ◽

...

Keyword(s):

Regression Analysis ◽

Postoperative Complications ◽

Upper Extremity ◽

Surgical Site Infections ◽

National Database ◽

Short Term ◽

Improvement Program ◽

Current Smoking ◽

The Impact ◽

Surgical Site Complications

Background: There is a paucity of literature exploring the impact of smoking on short-term complications, readmissions, and reoperations after elective upper extremity surgery using a large multicenter national database. We hypothesized that smokers will have an increased rate of complications, readmissions, and reoperations compared with a cohort of nonsmokers undergoing elective upper extremity surgery. Methods: Patient data were collected from the American College of Surgeons National Surgical Quality Improvement Program database between the years 2012 and 2017. Patients were included if they underwent elective surgery of the upper extremity using 338 predetermined Current Procedural Terminology codes. The data collected were divided into patient demographics, comorbidities, perioperative variables, and 30-day complications. Current smoking status was defined as smoking within 1 year prior to surgery. The incidence of surgical complications, reoperations, and readmissions was compared between the 2 cohorts using multivariable regression analysis. Results: Of the 107 943 patients undergoing elective surgeries of the upper extremity, 73 806 met the inclusion criteria. Of these, 57 986 (78.6%) were nonsmokers in the year prior to surgery, and 15 820 (21.4%) were current smokers. Between these groups, current smokers were younger ( P < .001), more often men ( P < .001), had lower body mass index ( P < .001), and more often underwent procedures that involved bone manipulation ( P < .001). Multivariate regression analysis defined current smoking as significantly associated with overall surgical site complications, superficial surgical site infections, deep surgical site infections, reoperation, and readmission. Conclusion: Current smoking was significantly associated with an increase in all surgical site complications, readmissions, and reoperations after elective upper extremity surgery. Surgeons should consider smoking a modifiable risk factor for postoperative complications and appropriately counsel patients on outcomes and complications given the elective nature of upper extremity surgery.

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A study proposal on short term outcome and prognosis of primary and delayed fulguration in posterior urethral valve

International Surgery Journal ◽

10.18203/2349-2902.isj20203999 ◽

2020 ◽

Vol 7 (10) ◽

pp. 3389

Author(s):

Jeevarathi T. ◽

Gomathi Vadivelu

Keyword(s):

Urinary Tract ◽

Renal Insufficiency ◽

Urinary Tract Obstruction ◽

Posterior Urethral Valve ◽

Short Term ◽

Term Outcome ◽

Current Series ◽

Lower Urinary Tract Obstruction ◽

Urethral Valve ◽

The Impact

Background: Posterior urethral valve (PUV) is the most common cause of lower urinary tract obstruction in male neonates. The incidence is 1 in 4000, 1 in 7500 births PUV occur exclusively in males. This disease has a broad spectrum of presentations. They may present at any age during childhood and may vary from ascites in the neonate to renal failure in infants and only minor voiding dysfunction in an older child. Urinary tract infection is common at all ages. The objectives of the study were to assess the impact of primary impaction on short term outcomes and to assess the outcome of diversion and delayed fulguration.Methods: This retrospective study was conducted at the Pediatric Urology outpatient department (OPD) at the Institute of Child Health and Hospital for Children, Madras Medical College, Chennai including the patients who attended the pediatric surgery from August 2008 to December 2011.Results: In the current series, the incidence of renal insufficiency in patients with urosepsis was 45%. Recurrent urosepsis >3 episodes in a year (fever with urine culture showing infection) primarily due to poor patient compliance lead to progressing pyelonephritis and nephron damage and plays an important role in the outcome of these children.Conclusions: The incidence of renal insufficiency in children with posterior urethral valves in this series was 38% (30-45%) with an average follow up 3 years. Several factors were important in prognosticating the progression towards renal insufficiency and bladder dysfunction. Urodynamics is of immense help in cases having symptoms despite good stream. The use of anticholinergic for abnormal urodynamics gives encouraging results.

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The impact of being newly diagnosed with a bipolar disorder and the short-term outcome of disorder-specific management

Bipolar Disorders ◽

10.1111/bdi.12146 ◽

2013 ◽

Vol 16 (2) ◽

pp. 172-179 ◽

Cited By ~ 4

Author(s):

Gordon B Parker ◽

Rebecca K Graham ◽

Kathryn Fletcher ◽

Shulamit M Futeran ◽

Paul Friend

Keyword(s):

Bipolar Disorder ◽

Newly Diagnosed ◽

Short Term ◽

Term Outcome ◽

Short Term Outcome ◽

The Impact ◽

Specific Management

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The Short-Term Outcome of Neurotic Disorders in the Community: The Relation of Remission to Clinical Factors and to ‘Neutralizing’ Life Events

The British Journal of Psychiatry ◽

10.1192/bjp.139.3.213 ◽

1981 ◽

Vol 139 (3) ◽

pp. 213-220 ◽

Cited By ~ 73

Author(s):

Christopher Tennant ◽

Paul Bebbington ◽

Jane Hurry

Keyword(s):

Life Events ◽

Drug Prescription ◽

A Priori ◽

Demographic Variables ◽

Favourable Outcome ◽

Short Term ◽

Neurotic Disorder ◽

Term Outcome ◽

The Impact ◽

First Interview

SummaryA longitudinal study of neurotic disorder in the community showed that half the cases identified at first interview had remitted one month later. Remission was significantly related to four variables: recency of onset and of peak of the disorder, the occurrence of recent threatening life events and the occurrence of subsequent ‘neutralizing’ life events. A neutralizing event was defined a priori as one which neutralized the impact of an earlier threatening life event or difficulty. One third of all remissions were caused by such an event. Remission of disorder was not significantly related to demographic variables, symptom severity, syndrome type, medical consultation or psychotropic drug prescription. The implications for neurotic disorder in the community are discussed, in particular its relation to life events and the favourable outcome in the absence of treatment.

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The Impact of Divestment Announcements on the Share Price of Fossil Fuel Stocks

Sustainability ◽

10.3390/su11113122 ◽

2019 ◽

Vol 11 (11) ◽

pp. 3122 ◽

Cited By ~ 5

Author(s):

Truzaar Dordi ◽

Olaf Weber

Keyword(s):

Stock Prices ◽

Fossil Fuel ◽

Statistical Tests ◽

Price Change ◽

Abnormal Returns ◽

Efficient Market Hypothesis ◽

Share Price ◽

Short Term ◽

Share Prices ◽

The Impact

Several prominent institutional investors concerned about climate change have announced their intention or have divested from fossil fuel shares, to limit their exposure to the industry. The act of fossil fuel divestment may directly depress share prices or stigmatize the industry’s reputation, resulting in lower share value. While there has been considerable research conducted on the performance of the fossil fuel industry, there is not yet any empirical evidence that divestment announcements influence share prices. Adopting an event study methodology, this study measures abnormal deviations in stock prices of the top 200 global oil, gas, and coal companies by proven reserves, on days of prominent divestment announcements. Events are analyzed independently and in aggregate. The results make several notable contributions. While many events experienced short-term negative abnormal returns around the event day, the effects of events were more pronounced over longer event windows following the New York Climate March, suggesting a shift in investor perception. The results also find that divestment announcements related to campaigns, pledges, and endorsements all have a significant effect over the short-term event window. Finally, the results control for the general underperformance of the industry over the estimation window, attesting that the price change is caused by divestment announcements. Several robustness tests using alternate expected returns models and statistical tests were conducted to ensure the accuracy of the result. Overall, this study finds that divestment announcements decrease the share price of the fossil fuel companies, and thus, we conclude that ‘divestors’ can influence the share price of their target companies. Theoretically, the result adds new knowledge regarding the efficacy of the efficient market hypothesis in relation to divestment.

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