Severe Hyperkalemia: Can the Electrocardiogram Risk Stratify for Short-term Adverse Events?

Abstract BACKGROUND To reduce treatment-related adverse events in pediatric and young-adult patients with brain tumors, proton beam radiotherapy (PBT) has recently been performed instead of conventional X-ray radiotherapy. However, whether PBT is as effective as X-ray radiotherapy has not been sufficiently investigated, especially in patients receiving whole-ventricular irradiation. METHODS We report a retrospective observation of 15 patients with intracranial germ cell tumors (GCT), who received PBT at our institution from April 2014 to September 2019. We evaluated their clinical course, short-term adverse events, and prognosis. RESULTS/ CONCLUSION Fifteen patients (9 males and 6 females; median age 13 years) who received PBT following induction chemotherapy were analyzed. Nine patients received 23.4–27.0 GyE of whole-ventricular irradiation due to GCT in the pituitary gland, pineal body, or hypothalamic area. Three patients received 23.4 GyE of whole-brain irradiation: one of them had boost irradiation for basal ganglia. Three patients received 30.6 GyE of craniospinal irradiation (CSI). Six of the 15 patients experienced nausea (grade 2, according to the CTCAE version 4.0). Four patients, including two who received CSI, showed myelosuppression: decrease in white blood cell count, lymphocyte cell count, and neutrophil count (grade 3). No other severe short-term adverse events of >grade 2 was observed in any of the patients. At a median follow-up of 21 months (2-62 months) after irradiation. all patients are alive without recurrence. Our results may be encouraging and further investigations with a larger scale is warranted.

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Short-term risk stratification using CADILLAC risk score in patients with ST elevation myocardial infarction

European Heart Journal ◽

10.1093/ehjci/ehaa946.1352 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

T Satou ◽

H Kitahara ◽

K Ishikawa ◽

T Nakayama ◽

Y Fujimoto ◽

...

Keyword(s):

Myocardial Infarction ◽

High Risk ◽

Adverse Events ◽

Risk Score ◽

Risk Group ◽

Risk Groups ◽

Low Risk ◽

Short Term ◽

Recurrent Myocardial Infarction ◽

St Elevation

Abstract Background The recent reperfusion therapy for ST-elevation myocardial infarction (STEMI) has made the length of hospital stay shorter without adverse events. CADILLAC risk score is reportedly one of the risk scores predicting the long-term prognosis in STEMI patients. Purpose To invenstigate the usefulness of CADILLAC risk score for predicting short-term outcomes in STEMI patients. Methods Consecutive patients admitted to our university hospital and our medical center with STEMI (excluding shock, arrest case) who underwent primary PCI between January 2012 and April 2018 (n=387) were enrolled in this study. The patients were classified into 3 groups according to the CADILLAC risk score: low risk (n=176), intermediate risk (n=87), and high risk (n=124). Data on adverse events within 30 days after hospitalization, including in-hospital death, sustained ventricular arrhythmia, recurrent myocardial infarction, heart failure requiring intravenous treatment, stroke, or clinical hemorrhage, were collected. Results In the low risk group, adverse events within 30 days were significantly less observed, compared to the intermediate and high risk groups (n=13, 7.4% vs. n=13, 14.9% vs. n=58, 46.8%, p<0.001). In particular, all adverse events occurred within 3 days in the low risk group, although adverse events, such as heart failure (n=4), recurrent myocardial infarction (n=1), stroke (n=1), and gastrointestinal bleeding (n=1), were substantially observed after day 4 of hospitalization in the intermediate and high risk groups. Conclusions In STEMI patients with low CADILLAC risk score, better short-term prognosis was observed compared to the intermediate and high risk groups, and all adverse events occurred within 3 days of hospitalization, suggesting that discharge at day 4 might be safe in this study population. CADILLAC risk score may help stratify patient risk for short-term prognosis and adjust management of STEMI patients. Initial event occurrence timing Funding Acknowledgement Type of funding source: None

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Comparative Assessment of Short-Term Adverse Events in Acute Heart Failure With Cystatin C and Other Estimates of Renal Function

JACC Heart Failure ◽

10.1016/j.jchf.2014.06.014 ◽

2015 ◽

Vol 3 (1) ◽

pp. 40-49 ◽

Cited By ~ 25

Author(s):

W.H. Wilson Tang ◽

Matthias Dupont ◽

Adrian F. Hernandez ◽

Adriaan A. Voors ◽

Amy P. Hsu ◽

...

Keyword(s):

Heart Failure ◽

Renal Function ◽

Adverse Events ◽

Acute Heart Failure ◽

Cystatin C ◽

Comparative Assessment ◽

Short Term

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EP.WE.14Prognostic significance of metabolic syndrome in patients undergoing carotid artery revascularisation: A systematic review and meta-analysis

British Journal of Surgery ◽

10.1093/bjs/znab308.001 ◽

2021 ◽

Vol 108 (Supplement_7) ◽

Author(s):

Shahab Hajibandeh ◽

Shahin Hajibandeh

Keyword(s):

Myocardial Infarction ◽

Systematic Review ◽

Adverse Events ◽

Meta Analysis ◽

Prognostic Significance ◽

Long Term Outcomes ◽

Short Term ◽

All Cause Mortality ◽

Major Adverse Events

Abstract Aims to evaluate prognostic significance of metabolic syndrome (MetS) in patients undergoing carotid artery revascularisation. Methods A systematic review and meta-analysis was performed in compliance with PRISMA standards to evaluate prognostic significance of MetS in patients undergoing carotid endarterectomy or carotid stenting. Short-term (<30 days) postoperative outcomes (all-cause mortality, stroke or transient ischaemic attack (TIA), myocardial infarction, major adverse events) and long-term outcomes (restenosis, all-cause mortality, stroke or TIA, myocardial infarction, major adverse events) were considered as outcomes of interest. Random effects modelling was applied for the analyses. Results Analysis of 3721 patients from five cohort studies showed no difference between the MetS and no MetS groups in terms of the following short-term outcomes: all-cause mortality (OR: 1.67,P=0.32), stroke or TIA (OR: 2.44,P=0.06), myocardial infarction (OR: 1.01,P=0.96), major adverse events (OR: 1.23, P = 0.66). In terms of long-term outcomes, MetS was associated with higher risk of restenosis (OR: 1.75,P=0.02), myocardial infarction (OR: 2.12,P=0.04), and major adverse events (OR: 1.30, P = 0.009) but there was no difference between the two groups in terms of all-cause mortality (OR: 1.11, P = 0.25), and stroke or TIA (OR: 1.24, P = 0.33). The quality and certainty of the available evidence were judged to be moderate. Conclusions The best available evidence suggest that although MetS may not affect the short-term postoperative morbidity and mortality outcomes in patients undergoing carotid revascularisation, it may result in higher risks of restenosis, myocardial infarction and major adverse events in the long-term. Evidence from large prospective cohort studies are required for more robust conclusions.

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Cardiogenic Shock and Short-Term Mechanical Circulatory Support Options in the Current Era: Focus on Adverse Events

Journal of Cardiac Failure ◽

10.1016/j.cardfail.2018.07.454 ◽

2018 ◽

Vol 24 (8) ◽

pp. S127

Author(s):

Iosif Taleb ◽

Antigone Koliopoulou ◽

Anwar Tandar ◽

Stephen McKellar ◽

Jose Nativi-Nicolau ◽

...

Keyword(s):

Adverse Events ◽

Cardiogenic Shock ◽

Mechanical Circulatory Support ◽

Circulatory Support ◽

Short Term

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Short-Term Reactions to Acupuncture Treatment and Adverse Events Following Acupuncture: A Cross-Sectional Survey of Patient Reports in Korea

The Journal of Alternative and Complementary Medicine ◽

10.1089/acm.2009.0181 ◽

2009 ◽

Vol 15 (12) ◽

pp. 1275-1283 ◽

Cited By ~ 29

Author(s):

Seong-Uk Park ◽

Chang-Nam Ko ◽

Hyung-Sup Bae ◽

Woo-Sang Jung ◽

Sang-Kwan Moon ◽

...

Keyword(s):

Adverse Events ◽

Acupuncture Treatment ◽

Short Term ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Patient Reports

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USEFULNESS OF GASTRIC SUBMUCOSAL DISSECTION DEPTH TO EVALUATE SKILL ACQUIREMENT IN SHORT TERM TRAINING COURSES IN ESD: AN EXPERIMENTAL STUDY

Arquivos de Gastroenterologia ◽

10.1590/s0004-2803.201800000-58 ◽

2018 ◽

Vol 55 (3) ◽

pp. 221-229 ◽

Cited By ~ 1

Author(s):

Kendi YAMAZAKI ◽

Eduardo Guimarães Hourneaux de MOURA ◽

Mariana Matera VERAS ◽

Luiz Henrique MESTIERI ◽

Paulo SAKAI

Keyword(s):

Experimental Study ◽

Adverse Events ◽

Learning Curve ◽

Intraoperative Complications ◽

Gastric Body ◽

Short Term ◽

Roc Curve Analysis ◽

The Third ◽

Submucosal Dissection ◽

Training Courses

ABSTRACT BACKGROUND: Endoscopic submucosal dissection (ESD) is a complex endoscopic procedure, with high rates of adverse events and technical difficulties. To overcome that problem, many training centers published the importance of animal models for skill acquirement in ESD. However, no study has used the submucosal dissection depth (DSUB) as a parameter to evaluate the learning curve in ESD, which might be a relevant factor since an optimal resection plane is important to achieve a curative resection and avoid intraoperative complications. OBJECTIVE: This study aimed to assess ESD skill acquirement after short-term training sessions by evaluating the submucosal dissection depth (DSUB) and the association with adverse events. METHODS: This experimental study included 25 experienced endoscopists in therapeuthic procedures (>5years) and 75 specimens resected by ESD (three resections / endoscopist). Learning parameters (resection time, size, en bloc resection rate, bleeding, perforation and submucosal dissection depth) were prospectively evaluated. The percentages of DSUB of all specimens resected were calculated. RESULTS: All specimens were resected from the gastric body (n=75). The mean size of the resected specimens was 23.97±7.2 mm. The number of adverse events, including bleeding, perforation, and death, were 17 (22.67%), 3 (4%), and 0 cases, respectively. The average mean time by the third dissection decreased from 28.44±9.73 to 18.72±8.81 min (P<0.001). The proportion of DSUB in the bleeding and non-bleeding group were respectively 37.97%±21.13% and 68.66%±23.99%, indicating a significant association between DSUB and bleeding incidence (P<0.001). The ROC curve analysis indicated a cut-off point of 61% (sensitivity, 64%; specificity, 94%) of submucosal dissection depth associated with bleeding. Therefore, when ESD was performed at a depth of >61% of the submucosal layer, the risk for bleeding during the procedure decreased (PPV, 0.97; 95% CI, 0.85-0.99). CONCLUSION: Improvement in the learning curve in ESD and a better cognitive ability were seen by the third dissection in these short term training courses. And a significant association between DSUB and the risk of bleeding.

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