scholarly journals Critical Incidents during Anesthesia and Early Post-Anesthetic Period: A Descriptive Cross-sectional Study

2020 ◽  
Vol 58 (224) ◽  
Author(s):  
Binod Gautam ◽  
Babu Raja Shrestha
Keyword(s):  
Human Error ◽  
Critical Incidents ◽  
Elective Surgery ◽  
Maintenance Phase ◽  
Patient Characteristics ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Risk Patients ◽  
Obstetric Surgery

Introduction: Critical incidents related to peri-operative anesthesia carry a risk of unwanted patientoutcomes. Studying those helps detect problems, which is crucial in minimizing their recurrence. Weaimed to identify the frequency of peri-anesthetic critical incidents. Methods: This is a hospital-based descriptive cross-sectional study of voluntarily reported incidents,which occurred during anesthesia or following 24 hours among patients subjected to non-cardiacsurgery within the calendar year 2019. Patient characteristics, anesthesia, and surgery types, category,context, and outcome of incidents were recorded in an indigenously designed form. Incidents wereassigned to attributable (patient, anesthesia or surgery) factor, and were analyzed for the system,equipment or human error contribution. Results: Altogether 464 reports were studied, which consisted of 524 incidents. Cardiovascularcategory comprised of 345 (65.8%) incidents. Incidents occurred in 433 (93%) otherwise healthypatients and during 258 (55.6%) spinal anesthetics. Obstetric surgery was involved in 179 (38.6%)incidents. Elective surgery and anesthesia maintenance phase included the context in 293 (63%)and 378 (72%) incidents respectively. Majority incidents 364 (69.5%) were anesthesia-attributable,with system and human error contribution in 196 (53.8%) and 152 (41.7%) cases respectively. Allrecovered fully except for 25 cases of mortality, which were mostly associated with patient factors,surgical urgency, and general anesthesia. Conclusions: Critical incidents occur even in low-risk patients during anesthesia delivery. Patientfactors and emergency surgery contribute to the most serious incidents.

scholarly journals Sensitivity and Specificity Comparison Between APFEL, KOIVURANTA, and SINCLAIR Score As PONV Predictor In Post General Anesthesia Patient

2020 ◽  
Vol 4 (1) ◽  
pp. 69
Author(s):  
M Yusuf Gunawan ◽  
Arie Utariani ◽  
Maulydia Maulydia ◽  
Anna Surgean Veterini
Keyword(s):  
High Risk ◽  
General Anesthesia ◽  
Elective Surgery ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Prophylactic Administration ◽  
Risk Patients ◽  
Auc Value ◽  
Post Operative Nausea

ABSTRACTBackground: Post Operative Nausea Vomiting (PONV) are the two most common and unpleasant side effects after anesthesia and surgery. Without proper prophylactic administration, the PONV incidence is currently around 20% -30% in normal patients and 70% in high-risk patients (Butterworth et al., 2013). Recently, many PONV predictor scores have been used to determine the PONV severity and prophylactic administration. Objective: To compare the scores of Apfel, Koivuranta, and Sinclair as predictors of PONV in adult patients after general anesthesia at RSUD Dr. Soetomo. Methods: A cross-sectional study design conducted in 100 patients who underwent elective surgery under general anesthesia at RSUD Dr. Soetomo Surabaya. Patients who meet the criteria will be recorded in the clinical research form and being followed to evaluate the assessment using Apfel, Koivuranta, and Sinclair scores when the patient is in the recovery room and the ward. A diagnostic test is performed to assess the accuracy between these scores. Results: In this study, the prevalence of PONV after general anesthesia in elective surgery at GBPT RSUD Dr Soetomo Surabaya is 26%. The Apfel score obtained has a sensitivity value of 79.5%, a specificity of 45.9% with an AUC value of 0.701. The Koivuranta score has a sensitivity value of 96.2%, a specificity of 27% with an AUC value of 0.628. The Sinclair score has a sensitivity value of 73.1%, a specificity of 48.6% with an AUC value of 0.619. Conclusion: Apfel's score is more accurate PONV prediction score and has a simpler score determination variable. Keywords                   : PONV, predictor score, apfel score, koivuranta score, sinclair score, general anesthesia. 

scholarly journals The effect of stone and patient characteristics in predicting extra-corporal shock wave lithotripsy success rate: A cross sectional study

2021 ◽  
Vol 70 ◽  
pp. 102829
Author(s):  
Mohammad Al- zubi ◽  
Ammar Al Sleibi ◽  
Basel Mazen Elayan ◽  
Subhi Zahi Al-issawi ◽  
Morad Bani-hani ◽  
...  
Keyword(s):  
Shock Wave ◽  
Success Rate ◽  
Shock Wave Lithotripsy ◽  
Patient Characteristics ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Use of complementary and alternative therapies by patients with eye diseases: a hospital-based cross-sectional study from Palestine

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dania Jaber ◽  
Rafat Abu Ghannam ◽  
Waleed Rashed ◽  
Mohammad Shehadeh ◽  
Sa’ed H. Zyoud
Keyword(s):  
Patient Characteristics ◽  
Developed Countries ◽  
Cross Sectional Study ◽  
Alternative Therapies ◽  
University Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Complementary And Alternative Therapies ◽  
Source Of Information ◽  
Complementary And Alternative

Abstract Background Generally, complementary and alternative therapies (CAT) are accepted methods of treatment by patients with various types of conditions. Their use is becoming especially prevalent among patients with eye problems even in developed countries. Thus, we aimed to determine the pattern of use of CAT in this patient population, to identify the patient characteristics associated with the use of CAT, and to assess the types of CAT used. Methods A descriptive, cross-sectional study was conducted in Palestine at An-Najah National University Hospital between the time periods of October 2019 to May 2020, using questionnaire-based face to face interviews. Data were collected through convenience sampling. Patients responded to the questionnaire, which was focused on information adapted from previous research in this area, covering socio-demographic and clinical characteristics, types of CAT, source of information, and side effects on CAT use. Results A total of 86 patients were interviewed for our study. Over two thirds, 67% reported using CAT for the specific purpose of improving their eye condition, and about one third (29.1%) received more than one therapy. The most common therapies reported were duea’ (i.e. supplication) (47.1%) and herbal therapies (24.1%). It was shown that patients with bilateral involvement of their eyes were almost twice more likely to describe using CAT than patients with unilateral eye pathology (p = 0.006). Also, patients who underwent surgery as their route of treatment were significantly less likely to use CAT (p = 0.043). Most of our study participants mentioned a non-physician source as their source of information regarding CAT with family members being the most frequently mentioned (30.2%) followed by the internet (25.6%) and friends (19.8%). Conclusions The prevalence of CAT use among patients with eye disease is somewhat high in our study population. Because CAT may trigger adverse reactions, influence the progression of the disease, and interfere with conventional treatment, the ophthalmologist should frequently be asked patients with such diagnostics regarding the use of these therapies. Further work is required to analyze the mechanisms of action and to establish realistic guidelines for the use of these modalities.

scholarly journals Outcomes of out-of-hospital cardiac arrest in Beijing: a 5-year cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e041917
Author(s):  
Fei Shao ◽  
Haibin Li ◽  
Shengkui Ma ◽  
Dou Li ◽  
Chunsheng Li
Keyword(s):  
Cardiac Arrest ◽  
Urban Areas ◽  
Patient Characteristics ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Term Survival ◽  
Shockable Rhythm ◽  
Bystander Cpr ◽  
Hospital Cardiac Arrest

ObjectiveThe purpose of this study was to assess the trends in outcomes of out-of-hospital cardiac arrest (OHCA) in Beijing over 5 years.DesignCross-sectional study.MethodsAdult patients with OHCA of all aetiologies who were treated by the Beijing emergency medical service (EMS) between January 2013 and December 2017 were analysed. Data were collected using the Utstein Style. Cases were followed up for 1 year. Descriptive statistics were used to characterise the sample and logistic regression was performed.ResultsOverall, 5016 patients with OHCA underwent attempted resuscitation by the EMS in urban areas of Beijing during the study period. Survival to hospital discharge was 1.2% in 2013 and 1.6% in 2017 (adjusted rate ratio=1.0, p for trend=0.60). Survival to admission and neurological outcome at discharge did not significantly improve from 2013 to 2017. Patient characteristics and the aetiology and location of cardiac arrest were consistent, but there was a decrease in the initial shockable rhythm (from 6.5% to 5.6%) over the 5 years. The rate of bystander cardiopulmonary resuscitation (CPR) increased steadily over the years (from 10.4% to 19.4%).ConclusionSurvival after OHCA in urban areas of Beijing did not improve significantly over 5 years, with long-term survival being unchanged, although the rate of bystander CPR increased steadily, which enhanced the outcomes of patients who underwent bystander CPR.

scholarly journals Comparison of Novel, Bach Mai Boston Tool (BBT) and the Patient-Generated Subjective Global Assessment (PG-SGA) for Oncology Inpatients

2019 ◽  
Vol 26 (1) ◽  
pp. 107327481986376 ◽  
Author(s):  
Binh Pham Van ◽  
Linh Nguyen Thuy ◽  
Hoa Nguyen Thi Thanh ◽  
Anh Nguyen Le Tuan ◽  
Phuong Duong Thi ◽  
...  
Keyword(s):  
Global Assessment ◽  
Cross Sectional Study ◽  
Subjective Global Assessment ◽  
Sectional Study ◽  
Cross Sectional ◽  
Nutrition Screening ◽  
Kappa Value ◽  
Risk Patients ◽  
The Mean ◽  
Sensitivity Specificity

Oncology inpatients are at high risk of malnutrition. Identification of at risk patients by nutrition screening requires a practical and easy to use tool. The aim of this study was to determine the validity of the Bach Mai Boston Tool (BBT) compared to a ‘gold standard’ full nutrition assessment using the Patient-Generated Subjective Global Assessment (PG-SGA). A cross-sectional study was conducted on 270 oncology inpatients from January to December 2016. Cohen’s Kappa, sensitivity, specificity and ROC analyses were performed. 270 inpatients were included in this study with a mean age of 56.3 ± 12.1 years old. Of these patients, 51.8% were male, and 74.1% had gastrointestinal cancer. The mean body mass index of patients was 20.6 ± 3.0 kg/m2. The PG-SGA tool identified 146 (54.1%) malnourished patients, while the BBT identified 105 (39.9%) malnourished patients. The BBT had a medium consistency, with a Kappa value of 0.6. Using a cut-off point of ≥ 4, the BBT had a sensitivity of 87.7% and a specificity of 72.6%. On the other hand, a BBT with a cut-off point ≥ 5 resulted in a sensitivity of 67.1%, a specificity of 94.4%, and an AUC of 0.81. The BBT is a practical, informative and valid tool for detecting malnutrition in hospitalized oncology patients. We recommend using a cut-off point of 4 for screening the risk of malnutrition for oncology inpatients.

scholarly journals Testing the assumptions of an indicator of unmet need for obstetric surgery in Ghana: A cross‐sectional study of linked hospital and population‐based delivery data

Birth ◽  
2019 ◽  
Vol 46 (4) ◽  
pp. 638-647
Author(s):  
Francesca L. Cavallaro ◽  
Lisa S. Hurt ◽  
Jenny A. Cresswell ◽  
Karen Edmond ◽  
Seeba Amenga‐Etego ◽  
...  
Keyword(s):  
Unmet Need ◽  
Population Based ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Obstetric Surgery

scholarly journals Chest discomfort at night and risk of acute coronary syndrome: cross-sectional study of telephone conversations

2020 ◽  
Vol 37 (4) ◽  
pp. 473-478 ◽  
Author(s):  
Loes T Wouters ◽  
Dorien L Zwart ◽  
Daphne C Erkelens ◽  
Noël S Cheung ◽  
Esther de Groot ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Risk Ratio ◽  
Patient Characteristics ◽  
Final Diagnosis ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Chest Discomfort ◽  
Cross Sectional ◽  
Adjusted Risk ◽  
Coronary Syndrome

Abstract Background During telephone triage, it is difficult to assign adequate urgency to patients with chest discomfort. Considering the time of calling could be helpful. Objective To assess the risk of acute coronary syndrome (ACS) in certain time periods and whether sex influences this risk. Methods Cross-sectional study of 1655 recordings of telephone conversations of patients who called the out-of-hours services primary care (OHS-PC) for chest discomfort. Call time, patient characteristics, symptoms, medical history and urgency allocation of the triage conversations were collected. The final diagnosis of each call was retrieved at the patient’s general practice. Absolute numbers of patients with and without ACS were plotted and risks per hour were calculated. The risk ratio of ACS at night (0 to 9 am) was calculated by comparing to the risk at other hours and was adjusted for gender and age. Results The mean age of callers was 58.9 (standard deviation ±19.5) years, 55.5% were women and, in total, 199 (12.0%) had an ACS. The crude risk ratio for an ACS at night was 1.80 (confidence interval 1.39–2.34, P < 0.001): 2.33 (1.68–3.22, P < 0.001) for men and 1.29 (0.83–1.99, P = 0.256) for women. The adjusted risk ratio for ACS of all people at night was 1.82 (1.07–3.10, P = 0.039). Conclusions Patients calling the OHS-PC for chest discomfort between 0 and 9 am have almost twice a higher risk of ACS than those calling other hours, a phenomenon more evident in men than in women. At night, dispatching ambulances more ‘straightaway’ could be considered for these patients with chest discomfort. Trial number NTR7331.

scholarly journals Prevalence and Predictors of Cancellation of Elective Surgical Procedures at a Tertiary Hospital in Uganda: A Cross-Sectional Study

2020 ◽  
Vol 2020 ◽  
pp. 1-7 ◽  
Author(s):  
Alfred Ogwal ◽  
Felix Oyania ◽  
Emmanuel Nkonge ◽  
Timothy Makumbi ◽  
Moses Galukande
Keyword(s):  
Surgical Procedures ◽  
Orthopedic Surgery ◽  
Elective Surgery ◽  
Cross Sectional Study ◽  
Mulago Hospital ◽  
Sectional Study ◽  
Related Factors ◽  
Cross Sectional ◽  
Elective Surgical Procedures ◽  
Cancellation Rate

Introduction. The cancellation of elective procedures has been shown to waste resources and to have the potential to increase morbidity and mortality among patients. This study aimed to determine the prevalence of the cancellation of elective surgical procedures and to identify the factors associated with these cancellations at Mulago Hospital, a large public hospital in Kampala, Uganda. Methods. A cross-sectional study was conducted from January 10, 2018, to February 20, 2018. We recruited patients of all ages who were admitted to surgical wards and scheduled for elective surgery. Data on patients’ demographic characteristics and diagnosis, as well as the specialty of the surgery, the planned procedure, the specific operating theatre, cancellation, and the reasons for cancellation were extracted and analyzed using logistic regression. Results. Of a total of 400 cases, 115 procedures were canceled—a cancellation prevalence of 28.8%. Orthopedic surgery had the highest cancellation rate, at 40.9% (n = 47). Facility-related factors were responsible for 67.8% of all cancellations. The most common reason for cancellation was insufficient time in the theatre to complete the procedure on the scheduled day. No procedures were canceled because of a lack of intensive care unit beds. There was a significant association between surgical specialty and cancellation (P<0.05) at multivariate analysis. Conclusion. The prevalence of cancellation of elective surgical procedures at Mulago Hospital was 28.8%, with orthopedic surgery having the highest cancellation rate. Two-thirds of the factors causing cancellations were facility-related, and more than 50% of all cancellations were potentially preventable. Quality-improvement strategies are necessary in the specialties that are susceptible to procedure cancellation because of facility factors.

Sign in / Sign up

Export Citation Format

Share Document