The Extended Postoperative Care-Score (EXPO-Score)—An Objective Tool for Early Identification of Indication for Extended Postoperative Care

Extended postoperative care and intensive care unit capacity is limited and efficient patient allocation is mandatory. This study aims to develop an effective yet simple score to predict indication for extended postoperative care, as there is a lack of objective criteria for early prediction of admission to extended care in surgical patients. This prospective observational study was divided into two periods (Period 1: Extended Postoperative Care-Score (EXPO)-Score generation; Period 2: EXPO-Score validation) and it was performed at a tertiary university center in Germany. A total of 4042 (Period 1) and 2198 (Period 2) adult patients ≥ 18 years old receiving elective or emergency surgery were included in this study. After identifying patient- and surgery-related risk factors by an expert panel, the EXPO-Score was developed through logistic regression from data of Period 1 and validated in Period 2. Three risk factors are sufficient for generating a reliable predictive EXPO-Score: (1) the American Society of Anesthesiologists’ (ASA) physical status, (2) cardiopulmonary physical exercise status expressed in metabolic equivalents (MET), and (3) the type of surgery. The score threshold (0.23) has a sensitivity of 0.87, a specificity of 0.91, and an accuracy of 0.90 for predicting indication for extended postoperative care. The EXPO-Score provides a validated, early collectable, and easy-to-use tool for predicting indication of extended postoperative care in adult surgical patients.

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Role of pulse oximetric monitoring during gastrointestinal endoscopy. Prospective multicenter study of the Gastroenterological Working Group of the Veszprém Regional Committee of the Hungarian Academy of Sciences (VEAB)

Orvosi Hetilap ◽

10.1556/oh.2013.29613 ◽

2013 ◽

Vol 154 (21) ◽

pp. 825-833

Author(s):

Zoltán Döbrönte ◽

Mária Szenes ◽

Beáta Gasztonyi ◽

Lajos Csermely ◽

Márta Kovács ◽

...

Keyword(s):

Risk Factors ◽

Multicenter Study ◽

Hungarian Academy ◽

Prospective Multicenter Study ◽

Standard Requirement ◽

Long Duration ◽

Related Risk ◽

American Society ◽

Academy Of Sciences ◽

Endoscopic Investigation

Introduction: Recent guidelines recommend routine pulse oximetric monitoring during endoscopy, however, this has not been the common practice yet in the majority of the local endoscopic units. Aims: To draw attention to the importance of the routine use of pulse oximetric recording during endoscopy. Method: A prospective multicenter study was performed with the participation of 11 gastrointestinal endoscopic units. Data of pulse oximetric monitoring of 1249 endoscopic investigations were evaluated, of which 1183 were carried out with and 66 without sedation. Results: Oxygen saturation less than 90% was observed in 239 cases corresponding to 19.1% of all cases. It occurred most often during endoscopic retrograde cholangiopancreatography (31.2%) and proximal enteroscopy (20%). Procedure-related risk factors proved to be the long duration of the investigation, premedication with pethidine (31.3%), and combined sedoanalgesia with pethidine and midazolam (34.38%). The age over 60 years, obesity, consumption of hypnotics or sedatives, severe cardiopulmonary state, and risk factor scores III and IV of the American Society of Anestwere found as patient-related risk factors. Conclusion: To increase the safety of patients undergoing endoscopic investigation, pulse oximeter and oxygen supplementation should be the standard requirement in all of the endoscopic investigation rooms. Pulse oximetric monitoring is advised routinely during endoscopy with special regard to the risk factors of hypoxemia. Orv. Hetil., 2013, 154, 825–833.

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VTE primary prevention, including hospitalised medical and orthopaedic surgical patients

Thrombosis and Haemostasis ◽

10.1160/th14-10-0823 ◽

2015 ◽

Vol 113 (06) ◽

pp. 1216-1223 ◽

Cited By ~ 7

Author(s):

Serena Granziera ◽

Alexander T. Cohen

Keyword(s):

Risk Factors ◽

Primary Prevention ◽

Significant Proportion ◽

Primary Prophylaxis ◽

Surgical Patients ◽

Medical Patients ◽

Related Risk ◽

Different Populations ◽

One Year ◽

Significant Disease

summaryPrimary prevention is the key to managing a significant proportion of the burden of venous thromboembolism (VTE), defined as deep venous thrombosis (DVT) or pulmonary embolism (PE). This is because VTE may lead to sudden death or are often misdiagnosed and therefore treatment is not feasible. Primary prevention usually commences in hospital as VTE following hospitalisation adds to the significant disease burden worldwide. Numerous medical, surgical and other risk factors have been recognised and studied as indications for prophylaxis. The risk of VTE continues following admission to hospital with a medical or surgical condition, usually long after discharge and therefore prolonged primary prophylaxis is often recommended. Clinical and observational studies in surgical patients show this risk extends for months and perhaps more than one year, for medical patients the risk extends for at least several weeks. For the specific groups of patients at higher risk of developing VTE primary prevention, either pharmaceutical or mechanical, is recommended. The aim of this review is to describe the population at risk, the main related risk factors and the approach to thromboprophylaxis in different populations.

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Emergency surgery and American Society of Anesthesiologists physical status score are the most influential risk factors of death in nonagenarian surgical patients

Geriatrics and Gerontology International ◽

10.1111/ggi.13624 ◽

2019 ◽

Vol 19 (4) ◽

pp. 293-298 ◽

Cited By ~ 4

Author(s):

Roberto Fariña‐Castro ◽

Cristina Roque‐Castellano ◽

Manuel Artiles‐Armas ◽

Joaquín Marchena‐Gómez

Keyword(s):

Risk Factors ◽

Emergency Surgery ◽

Surgical Patients ◽

Physical Status ◽

Status Score ◽

American Society ◽

American Society Of Anesthesiologists

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500-P: Renal Function Decline and the Related Risk Factors in a Cohort of Beijing Community Diabetes Study

Diabetes ◽

10.2337/db20-500-p ◽

2020 ◽

Vol 69 (Supplement 1) ◽

pp. 500-P

Author(s):

MINGXIA YUAN ◽

SHENYUAN YUAN ◽

Keyword(s):

Risk Factors ◽

Renal Function ◽

Renal Function Decline ◽

Related Risk

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Risk factors related to surgical site infections among surgical patients in developing world: a systematic review

International Journal of Medicine in Developing Countries ◽

10.24911/ijmdc.51-1598614458 ◽

2020 ◽

pp. 1984-1992

Author(s):

Faihan Alotaibi ◽

Faisal Alnemari ◽

Alwaleed Alsufyani ◽

Aisha Al-sanea ◽

Abeer Al-Nashri ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Developing World ◽

Surgical Site Infections ◽

Surgical Patients

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Non-operative Risk Factors and the Implications of Sandostatin for Postoperative Pancreatic Fistula in Malignant Pancreatic Surgery

Revista de Chimie ◽

10.37358/rc.17.12.5997 ◽

2018 ◽

Vol 68 (12) ◽

pp. 2875-2878

Author(s):

Delia Rusu Andriesi ◽

Ana Maria Trofin ◽

Irene Alexandra Cianga Spiridon ◽

Corina Lupascu Ursulescu ◽

Cristian Lupascu

Keyword(s):

Risk Factors ◽

Pancreatic Fistula ◽

Pancreatic Surgery ◽

Postoperative Pancreatic Fistula ◽

University Center ◽

Preoperative Hemoglobin ◽

Term Administration ◽

Postoperative Administration

Pancreatic fistula is the most frecquent and severe postoperative complication after pancreatic surgery, with impressive implications for the quality of life and vital prognosis of the patient and for these reasons it is essential to identify risk factors. In the current study, who included 109 patient admitted to a single university center and who underwent pancreatic resection for malignant pathology, we assessed the following factors as risk factors: age, sex, preoperative hemoglobin value, preoperative total protein value, obesity and postoperative administration of sandostatin. Of the analyzed factors, it appears that only obesity and long-term administration of sandostatin influences the occurrence of pancreatic fistula.

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