scholarly journals Assessment of complication rates based on time of feeding initiation in radiologically guided gastrostomy tubes: a retrospective study

Author(s):  
Ryan Judd ◽  
◽  
Wesley Klejch ◽  
Alexander Lionberg ◽  
Mikin V. Patel ◽  
...  
2021 ◽  
pp. 014556132110257
Author(s):  
Dongho Shin ◽  
Andrew Ma ◽  
Yvonne Chan

Objective: The primary objective of this study was to review the complication rate of percutaneous tracheostomies performed by a single surgeon in a community teaching hospital. Methods: This retrospective study reviewed the patients who underwent percutaneous tracheostomy with bronchoscopic guidance in a community hospital setting between 2009 and 2017. Patients older than the age of 18 requiring percutaneous tracheostomy were chosen for this retrospective study. Patients who were medically unstable, had no palpable neck landmarks, and inadequate neck extension were excluded. Indications for percutaneous tracheostomy included patients who had failed to wean from mechanical ventilation, required pulmonary toileting, or in whom airway protection was required. Results: Of the 600 patients who received percutaneous tracheostomy, 589 patients were included in the study. Intraoperative complication (2.6%) and postoperative complication rates (11.4%) compared similarly to literature reported rates. The most common intraoperative complications were bleeding, technical difficulties, and accidental extubation. Bleeding, tube obstruction, and infection were the most common postoperative complications. Overall burden of comorbidity, defined by Charlson Comorbidity Index, and coagulopathy were also found to be associated with higher complication rates. The decannulation rate at discharge was 46.3%. Conclusion: Percutaneous tracheostomy is a safe alternative to open tracheostomies in the community setting for appropriately selected patients.


2018 ◽  
Vol 21 (4) ◽  
pp. 340-346 ◽  
Author(s):  
Julien Guillaumin ◽  
Ryan MB Gibson ◽  
Isabelle Goy-Thollot ◽  
John D Bonagura

Objectives Thrombolytic therapy is a treatment of choice for people with acute ischemic events, but is uncommonly administered for feline aortic thromboembolism (FATE). This study reports selected clinical data and outcomes of acute FATE treated with tissue plasminogen activator (TPA). A reference group treated with current standard of care (SOC) was analyzed for comparison. Methods This was a retrospective study of FATE in two academic hospitals. TPA-treated cats with two or more limbs (n = 16) affected were compared with a SOC-treated group with two or more limbs affected (n = 38). A limb score based on motor function and pulse quality was calculated for each group. Results Limb score and proportion of congestive heart failure at admission was similar in both groups. Time from FATE to admission was shorter in the TPA group, with a median of 3 h (range 0–6 h) vs 6 h (range 0–48 h; P = 0.0004). The most common regimen received for TPA was 1 mg/kg over 1 h. Other treatments were similar to those of the SOC group and included analgesia, thromboprophylaxis and furosemide. Documented complications for TPA-treated cats included reperfusion injury (5/10) and acute kidney injury (AKI; 3/10). Discharge proportion rate was 44% (TPA) vs 29% (SOC; P = 0.351). There were no differences in short-term survival rate (56.2% vs 39.5%; P = 0.369), clinical improvement (56.2% vs 31%; P = 0.122), rates of reperfusion injury (50% vs 50%; P = 1.00) or AKI (30% vs 27%; P = 1.00) between the TPA-treated and SOC groups, respectively. Conclusions and relevance Survival and complication rates of TPA-treated cats and SOC-treated cats for acute FATE were similar.


2021 ◽  
Vol 20 (4) ◽  
pp. 249-253
Author(s):  
Gabriela Alcalde Pereira ◽  
Caroline de Carvalho Garcia ◽  
Marcia Almeida Lima ◽  
José Carlos Baldocchi Pontin ◽  
Andrea Dias Lamas Mafra

ABSTRACT Objectives: To identify the main hospital outcomes of patients undergoing surgical correction of neuromuscular scoliosis and to assess complication rates and achievement of mobility goals after the use of a managed protocol. Methods: This is a longitudinal, retrospective study, with data obtained six months after the application of a protocol in 103 patients of both sexes submitted to surgical correction of neuromuscular scoliosis, at a tertiary level hospital in São Paulo, between June and December 2018 (pre-protocol) and between May and September 2019 (post-protocol). Data from patients who had previously undergone other orthopedic spine surgeries were excluded. In addition to the data for epidemiological characterization of the underlying diseases, the clinical characteristics and complications were analyzed. Results: Of the 103 patients evaluated, there was a predominance of females (53.4%) and a mean age of 14.9 years. The most frequent diagnosis was cerebral palsy, the mean angle of curvature was 75°, and the most frequently observed comorbidities were lung diseases (25%). The protocol was partially adhered to by professionals and after its implementation, there was a significant decrease in pain and the systemic inflammatory response syndrome (SIRS), prevention of immobility and a low rate of infection. Conclusions: The use of a protocol focused on patients undergoing correction of neuromuscular scoliosis led to reduced complications of SIRS and reduced pain; kept the surgical site infection rate low, and prevented short-term immobility. Level of evidence III; Retrospective study.


Author(s):  
Chad Best ◽  
Ann Brearley ◽  
Philippe Gaillard ◽  
Warren Regelmann ◽  
Joanne Billings ◽  
...  

2006 ◽  
Vol 42 (1) ◽  
pp. 51-56 ◽  
Author(s):  
Brenda Jo Salinardi ◽  
Kenneth R. Harkin ◽  
Barret J. Bulmer ◽  
James K. Roush

Dogs and cats that had a percutaneous endoscopic gastrostomy (PEG) tube or surgically placed gastrostomy (SPG) tube inserted were retrospectively analyzed to compare complication rates and the severity of complications. Complication rates and severity scores were not significantly different when the PEG tube group was compared to the SPG tube group in either dogs or cats. Only when data from dogs and cats were combined did PEG tubes have a significantly higher complication rate and significantly greater complication severity scores.


Author(s):  
Shashank Kanchan ◽  
Vikash Raj ◽  
Dinesh Agarwal ◽  
Richa .

<p class="abstract"><strong>Background:</strong> An unstable intertrochanteric fracture in osteoporotic elderly patients presents a very challenging problem to the surgeons. This category of patients if kept in bed for long tends to have many complications like deep vein thrombosis, pneumonia, bed sores, etc. Surgeon’s worldwide face difficulty in getting a good anatomical reduction and do not allow early mobility to these patients because of risk of loss of reduction and implant cut out. The purpose of our study is to study the usefulness of arthroplasty in these patients in terms of better functional outcomes and no increase in complication rates.</p><p class="abstract"><strong>Methods:</strong> It was a retrospective study involving 25 patients (17 females, 8 males) with mean age of 76±2.3 years having intertrochanteric femur fractures (AO type A 2.2 and above) with osteoporosis operated upon with bipolar hemiarthroplasty at IQ City Medical College and NM Hospital between January 2015 and January 2017.<strong></strong></p><p class="abstract"><strong>Results:</strong> All the patients were followed up for a period of 1 year. We had a mean operative time of 75 min (range 55-125 min) with an average blood loss of 450 ml. 4 of our patients required postoperative blood transfusion. All patients walked on 2<sup>nd</sup> postoperative day. We had a mean Harris hip score of 82 and mean VAS of 1 at the end of 1 year.</p><p class="abstract"><strong>Conclusions:</strong> Hemiarthroplasty done in cases of unstable intertrochanteric femur fractures in elderly patients with osteoporotic bones allows early weight bearing thus improves the final functional outcomes. Further randomized trials are required before deriving any conclusions.</p>


2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Joseph Kyu-hyung Park ◽  
Jinhyun Kim ◽  
Jong-Ho Kim ◽  
Seokchan Eun

Excision is the gold standard for lipomas. Patients desire minimal scars, but minimal incisions can increase complications and produce hypertrophic scars. We propose an algorithmic method named the minimal one-third incision and four-step extraction method (MOTIF) for lipoma excision. This retrospective study analyzed lipomas surgically excised using the MOTIF method at our institution between January 2016 and December 2018. A total of 112 lipomas were included. The complication rates and Vancouver Scar Scale (VSS) for three different size groups (<3 cm, 3 ~ 6 cm, >6 cm) were compared. Complete excision of all palpable lipomas was achieved with this approach. There were two seromas, two hematomas, and one postoperative nerve injury. There was no difference in complication rates and VSS between the three size groups. The MOTIF method is a cost-effective, reliable, and cosmetically pleasing method that can be applied to all lipomas regardless of size and location.


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