Association of Risk Factors for the Mortality and Morbidity of Stoma Closure

2021 ◽  
Vol 15 (11) ◽  
pp. 3153-3154
Author(s):  
Dileep Kumar ◽  
Samina Karim ◽  
Shafqat Ullah ◽  
Muhammad Hanif ◽  
Abdul Rasheed Zai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Anterior Wall ◽  
Vascular Supply ◽  
Stoma Closure ◽  
Time Duration ◽  
Mortality And Morbidity ◽  
Duration Of Surgery ◽  
Surgical Difficulty ◽  
American Society ◽  
Medical University

Background: Anastomal leakage is a main surgical difficulty and requires stoma closure. Objective: To find associated risks for mortality and morbidity of stoma closure. Study Design: Retrospective cohort study Place and Duration of Study: Department of Surgery Ward 2, Jinnah Sindh Medical University/Jinnah Postgraduate Medical Centre Karachi from 1st July 2020 to 30th June 2021. Methodology: One hundred and twenty patients undergone rectal carcinoma surgeries were enrolled. The complications were graded by Clavien-Dindo classification system. The stoma closure was done by two different methods; the anterior wall technique or resection with anastomosis. Time duration of surgery, scoring by American Society of Anaesthesiologists was done and clinical and demographic information documented. Results: There were 62.5% males while 37.5% females and mean age was 65.5±8.5 years range between 31 to 72 years. Vascular blood supply affected leaking anastomaly. No significant effect of stoma type or closing technique was seen. However the time of stoma (p=0.044) and ASA score closure was a main risk for causing complications and increasing morbidity or mortality chances. Conclusion: Time of closure, American Society of Anaesthesiologists score as well as vascular supply are risk factors for morbidity or mortality in stoma closure. Keywords: Surgical stoma closure, Risk factors, Morbidity, Mortality

Evaluating the Prognostic Value of Selected Prognostic Scales in Patients Operated on Due to Peritonitis

2014 ◽  
Vol 86 (9) ◽  
Author(s):  
Katarzyna Paduszyńska ◽  
Krzysztof Kaczka ◽  
Agnieszka Dworzyńska ◽  
Karol Sieniawski ◽  
Lech Pomorski
Keyword(s):  
Risk Factors ◽  
Multiple Organ Failure ◽  
Prognostic Value ◽  
Prognostic Index ◽  
Multiple Organ ◽  
Oncological Surgery ◽  
Course Of Disease ◽  
Organ Failure Score ◽  
American Society ◽  
Medical University

Abstractwas to assess the usefulness of prognostic scales: ASA (American Society of Anesthesiologist), MPI (Meinheim Peritonitis Index), MOFS (the Multiple Organ Failure Score) and SPI (the Simple Prognostic Index) in the prognosis of the course of disease in patients operated on for peritonitis.The study was conducted in the Clinical Department of General and Oncological Surgery of the Medical University in Łódź between January 2009 to December 2010. During this period 263 patients were operated on for peritonitis. Before surgery all patients were classifed into particular groups according to the above mentioned prognostic scales according to their criteria.There were 29 (11%) deaths. ASA ≥4 (p<0.0001), MPI >30 (p<0.0001) MOFS ≥2 (p<0.0001), SPI II, III, IV (p<0.0001) were important risk factors of death.1. ASA, MPI, MOFS and SPI scales are of high signifcance in predicting the outcome in patients operated on for peritonitis. 2. The ASA scale in spite and due to its simplicity is adequate enough to be used in everyday practice in patients operated on for peritonitis. 3. The MPI scale is most suitable in the scientifc aims and in comparing the outcomes of patients operated on for peritonitis.

scholarly journals Study on risk factors for mortality and morbidity in patients undergoing surgery for colorectal cancer

2019 ◽  
Vol 6 (8) ◽  
pp. 2766
Author(s):  
Varsha Kane ◽  
Mahesh C. Talpallikar
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Operative Time ◽  
Mortality And Morbidity ◽  
Colon And Rectal Cancer ◽  
Co Morbidity ◽  
Duration Of Surgery ◽  
Causes Of Mortality ◽  
Estimated Risk ◽  
Based Medicine

Background: The goal of surgery for colorectal cancer is cure, but post-operative mortality occurs. In evidence-based medicine, knowledge of the estimated risk associated with an operation might be an important factor to consider when a surgeon and patient consider surgery. This study aims to identify co-morbidity and causes of mortality in relation to direct technical complications of surgery.Methods: All consecutive patients who underwent surgery for colorectal cancer were included. Co-morbidity was determined. The postoperative course was studied and cause of death within 30 days was determined. The clinical and pathologic characteristics of patients were recorded by using detailed questionnaire.Results: 50 consecutive patients who underwent surgery for colon and rectal cancer were studied, out of which 3 died (6.45%). Most common cause for mortality was anastomotic leak and faecal peritonitis. 3 patients did not have any co-morbidities. In 14 patients (28%), duration of surgery was <3 hours, while in 36 patients (72%) operative time was >3 hours. No significant association was found between mode of surgery.Conclusions: The knowledge of independent perioperative risk factors responsible would help the surgeons to take the appropriate measures and shorten the stay and reduce post op mortality and morbidity.

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)

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.

Effect of Age, Gender, Side and Impaction Types on Surgical Difficulty During Mandibular Third Molar Extraction.

2018 ◽  
Vol 17 (2) ◽  
pp. 11
Author(s):  
Krishna Gopal Bhuju ◽  
Sujita Shrestha ◽  
Riwaj Karki ◽  
Sameer Aryal
Keyword(s):  
Third Molar ◽  
Objective Measure ◽  
Operation Time ◽  
Significance Level ◽  
Third Molar Extraction ◽  
Mandibular Third Molar ◽  
Duration Of Surgery ◽  
Surgical Difficulty ◽  
Effect Of Age ◽  
Molar Extraction

<p><strong>Aim</strong>: To study the effect of age, gender, side and impaction types on surgical difficulty during mandibular third molar extraction through the data collected over a period of one year by single maxillofacial surgeon. All the extractions were performed under the same environment and conditions.</p><p><strong>Methods</strong>: Descriptive clinical study of 401 patients was carried out between the ages of 16 to 45years. Age, gender, impaction side and impaction types (according to the winter classification) were recorded on proforma. Duration of surgery for each patient was recorded after starting incision to the completion of suture which was divided into less than 10 minutes (mild), 11 to 20 minutes (moderate) and above 21 minutes (severe). Pearson’s Chi-square test was used for data analysis and significance level was less than or equal to 0.05.</p><p><strong>Results</strong>: Among 401 participants, 225 (56.1%) were male and 176 (43.9%) were female. Mean age was 31.5 years and mean operation time was 17.59 minutes. After statistical analysis there was a significant correlation among gender and side of impaction where <em>p </em>value is 0.043 0.048 respectively.</p><p><strong>Conclusion</strong>: There is a statistically significant correlation between gender and side of impaction with duration of surgery which is considered as the objective measure of surgical difficulty whereas age and impaction types didn’t show any significant correlation. </p>

scholarly journals Incidence, Risk Factors, and Outcomes of Preterm and Early Term Births: A Population-Based Register Study

2021 ◽  
Vol 18 (11) ◽  
pp. 5865
Author(s):  
Salma Younes ◽  
Muthanna Samara ◽  
Rana Al-Jurf ◽  
Gheyath Nasrallah ◽  
Sawsan Al-Obaidly ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Mortality ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Population Based ◽  
Incidence Rates ◽  
Large For Gestational Age ◽  
Mortality And Morbidity ◽  
Early Term ◽  
Incidence Risk

Preterm birth (PTB) and early term birth (ETB) are associated with high risks of perinatal mortality and morbidity. While extreme to very PTBs have been extensively studied, studies on infants born at later stages of pregnancy, particularly late PTBs and ETBs, are lacking. In this study, we aimed to assess the incidence, risk factors, and feto-maternal outcomes of PTB and ETB births in Qatar. We examined 15,865 singleton live births using 12-month retrospective registry data from the PEARL-Peristat Study. PTB and ETB incidence rates were 8.8% and 33.7%, respectively. PTB and ETB in-hospital mortality rates were 16.9% and 0.2%, respectively. Advanced maternal age, pre-gestational diabetes mellitus (PGDM), assisted pregnancies, and preterm history independently predicted both PTB and ETB, whereas chromosomal and congenital abnormalities were found to be independent predictors of PTB but not ETB. All groups of PTB and ETB were significantly associated with low birth weight (LBW), large for gestational age (LGA) births, caesarean delivery, and neonatal intensive care unit (NICU)/or death of neonate in labor room (LR)/operation theatre (OT). On the other hand, all or some groups of PTB were significantly associated with small for gestational age (SGA) births, Apgar <7 at 1 and 5 minutes and in-hospital mortality. The findings of this study may serve as a basis for taking better clinical decisions with accurate assessment of risk factors, complications, and predictions of PTB and ETB.

Patients’ Awareness Of The Prevention And Treatment Of Colorectal Cancer*

2015 ◽  
Vol 87 (9) ◽  
Author(s):  
Łukasz Dziki ◽  
Anna Puła ◽  
Konrad Stawiski ◽  
Barbara Mudza ◽  
Marcin Włodarczyk ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Treatment Process ◽  
Significant Negative Correlation ◽  
Study Group ◽  
Case Record ◽  
High Incidence ◽  
Prevention And Treatment ◽  
Major Factors ◽  
Medical University

Abstractwas to assess patients’ awareness of the prevention and treatment of colorectal cancer.Patients diagnosed with colorectal cancer, hospitalised at the Department of General and Colorectal Surgery of the Medical University in Łódź during the period from January 2015 to April 2015, were asked to complete a questionnaire concerning their families’ medical case record, factors predisposing them to the development of colorectal cancer, the tests applied in diagnostics, and the treatment process. The questionnaire comprised 42 closed-ended questions with one correct answer. A statistical analysis of all answers was carried out.The study group consisted of 30 men and 20 women aged 27–94 years old. A strong, statistically significant negative correlation between a patient’s age and his/her awareness of the prevention and treatment of colorectal cancer was noted (p<0.001; r= −0.51). The study demonstrated a statistically significant relationship between the occurrence of neoplasms in a patient’s family (p=0.009) or, more specifically, the occurrence of colorectal cancer (p=0.008), and the awareness of the prevention programme. The women’s group was characterised by statistically significantly greater awareness of colonoscopy as a screening examination (p=0.004).Patients need more information on colorectal cancer, its risk factors, prevention, the treatment process, and postoperative care. Lack of awareness of the colorectal cancer issue can be one of the major factors contributing to the high incidence of this disease.

scholarly journals Occurrence, associated risk factors, and treatment of surgical site infections in Pakistan

2020 ◽  
Vol 18 ◽  
pp. 205873922096054
Author(s):  
Faiz Ullah Khan ◽  
Yu Fang ◽  
Zakir Khan ◽  
Farman Ullah Khan ◽  
Zafar Iqbal Malik ◽  
...  
Keyword(s):  
Risk Factors ◽  
Transurethral Resection ◽  
Surgical Site Infections ◽  
Exploratory Laparotomy ◽  
Cross Sectional Study ◽  
Surgical Patients ◽  
Related Factors ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Associated Risk Factors

Globally, surgical site infections are one of the common infections which lead to a large amount of mortality and morbidity in postsurgical care. The risk for surgical site infection is multidimensional which includes mainly; patient, surgery, and hospital-related factors. This study is aimed to determine the burden of SSIs along with contributed risk factors. A prospective observational cross-sectional study was conducted in one of the largest public-sector hospitals in Pakistan. A total of 412 patients were recruited in the study with full consent and monitored for 30 days after surgery with direct and indirect surveillance. Overall, in seven different surgical procedures the incidence (29.8%) rate of SSI was observed; in appendectomy ( n = 17, 4.1%), exploratory laparotomy ( n = 51, 12.6%), laparoscopic cholecystectomy ( n = 12, 2.90%), mesh repair ( n = 17, 4.01%), thyroidectomy (5, 1.2%), transurethral resection of the prostate ( n = 11, 2.6%), and transurethral resection of the bladder (10, 2.4%). The average SSI rate in every single procedure was about 18 (4.27%) per surgical procedure out of 123 (29.85%) SSI cases. Types of SSI identified were superficial, deep incisional and organ/space ( n = 76, 18.4%, n = 23, 5.5%, and n = 24, 5.7%). Incidence of SSIs during admission, at readmission, and post-surveillance cases were ( n = 50, 12.1%, n = 25, 6.0% and n = 48, 11.6%). Associated risk factors found contributed to the incidence of SSI ( p < 0.05). Pre-operative ( n = 348, 84.5%) and 6 (1.5%) surgical patients did not received the post-operative antibiotics. The P. aeruginosa ( n = 15, 12.1%) and S. aureus (13, 10.5%). Cefoperazone and sulbactam were the most prescribed antibiotics. Associated risk factors and treatment outcomes of surgical patients have a direct association with the incidence of SSI. Hospital-based antimicrobial stewardship, implementation of surgical guidelines, patient care, and education are needed to develop at wards level in hospitals.

scholarly journals Liver Cancer in Guatemala: An Analysis of Mortality and Incidence Trends From 2012 to 2016

2019 ◽  
pp. 1-8 ◽  
Author(s):  
Alba J. Kihn-Alarcón ◽  
María F. Toledo-Ponce ◽  
Angel Velarde ◽  
Ximing Xu
Keyword(s):  
Risk Factors ◽  
Liver Cancer ◽  
Secondary Analysis ◽  
Mortality And Morbidity ◽  
Incidence Trends ◽  
The North ◽  
B Virus ◽  
Morbidity Data ◽  
Associated Risk Factors ◽  
Late Stages

PURPOSE Guatemala has the highest mortality and incidence of liver cancer in Central and South America. The aim of this study is to describe the extent of liver cancer in the country from 2012 to 2016 and the associated risk factors. METHODS A secondary analysis was performed using liver cancer mortality and morbidity data and data on risk factors, such as hepatitis B virus infection, cirrhosis, and alcoholism. RESULTS Analysis revealed that liver cancer causes approximately 20% of cancer deaths in the country, is more frequent in the population older than age 65 years old, and is increasing in those age 30 to 44 years. More than 25% of deaths occurred in the North and West regions. The incidence of major risk factors for development of liver cancer has decreased. CONCLUSION The high mortality of liver cancer compared with its incidence indicates that most patients are diagnosed at late stages. To reduce the burden of liver cancer, creation of strategies for earlier detection is needed.

Breast Cancer Care: Developments in 1998

1998 ◽  
Vol 5 (4) ◽  
pp. 338-345
Author(s):  
John Horton
Keyword(s):  
Breast Cancer ◽  
Cancer Care ◽  
Metastatic Breast ◽  
The United States ◽  
Axillary Node ◽  
Standards Of Care ◽  
Sources Of Information ◽  
Breast Cancer Care ◽  
Mortality And Morbidity ◽  
American Society

Background Breast cancer is a significant cause of mortality and morbidity worldwide, although death rates in the United States and some other countries are beginning to fall. Methods Several sources of information in 1998, including publications and presentations at the 1998 meeting of the American Society of Clinical Oncology, are pertinent to contemporary breast cancer care. Results It is now possible to prescribe hormonal therapy that will reduce the incidence of breast cancer. Methods are available to reduce the morbidity from axillary node dissection, and improvements in adjuvant therapy and management of metastatic breast cancer are now at hand. Conclusions The information presented provides a broad-based platform for new standards of care for breast cancer that will serve as a sound base for further progress in this important disease.

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