Risk factors for perioperative complications in laparoscopic surgeries of retrorectal cystic lesions

Patients undergoing cardiac surgery are at elevated risk for perioperative complications; however, certain risk factors may be modifiable. Preoperative evaluation performed in advance of surgery provides an opportunity for the perioperative anesthesiologist to intervene to reduce risk. Performing a focused history and physical examination informs the selection of appropriate preoperative tests. Risk assessment via tools specific to cardiac surgery provide a detailed risk profile. Certain diseases common to cardiac surgical patients deserve particular focus during assessment. Poorly controlled diabetes mellitus and resultant hyperglycemia are modifiable risk factors. Undiagnosed obstructive sleep apnea is common and associated with postoperative complications. Concurrent carotid artery disease presents a management conundrum requiring multidisciplinary planning. Preoperative anemia is common; when due to iron deficiency, it is easily treated to improve outcomes. In addition to gathering information about the patient, the goal of preoperative evaluation is to identify ways to reduce risk and improve outcome from surgery in a resource-efficient manner.

Download Full-text

Perioperative Complications And Risk Factors In Degenerative Lumbar Scoliosis Surgery For Patients Older Than 70 Years Of Age

Clinical Interventions in Aging ◽

10.2147/cia.s218204 ◽

2019 ◽

Vol Volume 14 ◽

pp. 2195-2203

Author(s):

Jun-zhe Ding ◽

Chao Kong ◽

Xiang-yao Sun ◽

Shi-bao Lu

Keyword(s):

Risk Factors ◽

Perioperative Complications ◽

Degenerative Lumbar Scoliosis ◽

Scoliosis Surgery ◽

Lumbar Scoliosis

Download Full-text

Perioperative complications in a paediatric cardiac surgery program with limited systemic resources

Cardiology in the Young ◽

10.1017/s1047951120002486 ◽

2020 ◽

Vol 30 (11) ◽

pp. 1659-1665

Author(s):

Igor V. Polivenok ◽

William M. Novick ◽

Aleksander V. Pyetkov ◽

Marcelo Cardarelli

Keyword(s):

Risk Factors ◽

Cardiac Surgery ◽

Confidence Interval ◽

Odds Ratio ◽

Operative Mortality ◽

Perioperative Complications ◽

Failure To Rescue ◽

Middle Income ◽

Paediatric Cardiac Surgery ◽

Complications Rate

AbstractBackground:The perioperative complications rate in paediatric cardiac surgery, as well as the failure-to-rescue impact, is less known in low- and middle-income countries.Aim:To evaluate perioperative complications rate, mortality related to complications, different patients’ demographics, and procedural risk factors for perioperative complication and post-operative death.Methods:Risk factors for perioperative complications and operative mortality were assessed in a retrospective single-centre study which included 296 consecutive children undergoing cardiac surgery.Results:Overall mortality was 5.7%. Seventy-three patients (24.7%) developed 145 perioperative complications and had 17 operative mortalities (23.3%). There was a strong association between the number of perioperative complications and mortality – 8.1% among patients with only 1 perioperative complication, 35.3% – with 2 perioperative complications, and 42.1% – with 3 or more perioperative complications (p = 0.007). Risk factors of perioperative complications were younger age (odds ratio 0.76; (95% confidence interval 0.61, 0.93), previous cardiac surgery (odds ratio 3.5; confidence interval 1.33, 9.20), extracardiac structural anomalies (odds ratio 3.03; confidence interval 1.27, 7.26), concomitant diseases (odds ratio 3.23; confidence interval 1.34, 7.72), and cardiopulmonary bypass (odds ratio 6.33; confidence interval 2.45, 16.4), whereas the total number of perioperative complications per patient was the only predictor of operative death (odds ratio 1.89; confidence interval 1.06, 3.37).Conclusions:In a program with limited systemic resources, failure-to-rescue is a major contributor to operative mortality in paediatric cardiac surgery. Despite the comparable crude mortality, the operative mortality among patients with perioperative complications in our series was significantly higher than in the developed world. A number of initiatives are needed in order to improve failure-to-rescue rates in low- and middle-income countries.

Download Full-text