Prospective Cohort Study Comparing Varying Doses of Cisatracurium and Atracurium on Intubating Conditions in Patients Undergoing Laparoscopic Cholecystectomy

Introduction: Cisatracurium and atracurium are non-depolarising muscle relaxants belonging to benzylisoquinolinium group. Intubating dose of cisatracurium is found to be safer than atracurium owing to the histamine release and resultant respiratory and cardiac side-effects associated with the latter. However, intubating conditions of twice the ED95 dose (2xED95) of cisatracurium are not as satisfactory as equipotent dose of atracurium because of its higher potency. Aim: To compare the time of onset, intubating conditions and mean duration of action of three and four times ED95 doses (3 and 4xED95) of cisatracurium with 2xED95 dose of atracurium so as to find out an ideal intubating dose of cisatracurium that is comparable with 2xED95 of atracurium. Materials and Methods: The present study was a prospective cohort study that included 102 patients who underwent elective laparoscopic cholecystectomy. They were divided into three groups of 34 each to receive atracurium 0.5 mg/kg (group A), cisatracurium 0.15 mg/kg (group B) or cisatracurium 0.2 mg/kg (group C) for intubation. Onset and duration of neuromuscular block were assessed using Train Of Four (TOF) stimuli. Total time for intubation and mean intubation scores were also noted. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS) software version 18.0. Qualitative data were compared using Chi-square test and quantitative data compared using Analysis of Variance (ANOVA). Results: Onset of neuromuscular blockade in groups A, B and C were 292.06±61.486, 204.71±39.407 and 120.88±37.284 seconds (p-value <0.001), respectively. Mean intubation score was highest in group C along with least intubating time (p-value <0.001). The mean duration of action in groups A, B and C were 40.44±5.275, 48.24±5.888 and 63.38±7.659 minutes, respectively (p-value <0.001). Conclusion: The 3 and 4xED95 doses of cisatracurium are superior to 2xED95 dose of atracurium in providing faster onset of action, better intubating conditions, shorter intubation time and longer duration of action. The 4xED95 dose of cisatracurium may be considered for rapid intubation in two minutes.

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09 / Postoperative quality of recovery (QoR-15) after ambulatory laparoscopic cholecystectomy in patients with deep neuromuscular block. A prospective cohort study

10.26226/morressier.5aeb0ac607b0d6001a79a218 ◽

2018 ◽

Author(s):

Juan Vicente Martinez Giner

Keyword(s):

Cohort Study ◽

Laparoscopic Cholecystectomy ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Neuromuscular Block ◽

Quality Of Recovery ◽

Deep Neuromuscular Block ◽

Postoperative Quality

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Clinical outcomes of colistin in combination with either 6-g sulbactam or carbapenems for the treatment of extensively drug-resistant Acinetobacter baumannii pneumonia with high MIC to sulbactam, a prospective cohort study

10.21203/rs.2.10942/v1 ◽

2019 ◽

Author(s):

Chutchawan Ungthammakhun ◽

Vasin Vasikasin ◽

Dhitiwat Changpradub

Keyword(s):

Cohort Study ◽

Length Of Stay ◽

Acinetobacter Baumannii ◽

Clinical Outcomes ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Mortality Rates ◽

P Value ◽

Drug Resistant ◽

Extensively Drug Resistant

Abstract Background: Extensively drug-resistant Acinetobacter baumannii (XDRAB) is an important cause of nosocomial pneumonia with limited therapeutic options. Colistin based regimen is recommended treatment. Which drugs should be combined with colistin remains uncertain. The aim of this study was to investigate the clinical outcomes of patients with XDRAB pneumonia who were treated with colistin, combined with either 6-g sulbactam or carbapenems, in the setting of high MIC to sulbactam. Methods: In this prospective cohort study, hospitalized patients diagnosed with XDRAB pneumonia in Phramongkutklao Hospital were enrolled. The primary outcome was the 28-day mortality. Secondary outcomes were 7 and 14-day mortality, length of stay, ventilator days and factors associated with mortality. Results: From 1 July 2016 to 30 September 2017, 192 patients were included; 92 received colistin plus sulbactam and 90 received colistin plus carbapenems. Most of the patients were male diagnosed with ventilator associated pneumonia in medical intensive care unit. Overall mortality rates at 7, 14, 28 days were 24.2%, 37.4%, 53.3%, respectively. Mortality rates did not differ between sulbactam group and carbapenems groups at 7 days (19.6% vs. 28.9%, p-value 0.424, adjusted HR 1.277; 95% CI = 0.702-2.322), 14 days (34.8% vs. 40%, p = 0.658, adjusted HR 1.109; 95% CI = 0.703-1.749) and 28 days (51.1% vs. 55.6%, p = 0.857, adjusted HR 1.038; 95% CI = 0.690-1.562). Length of stay, ICU days and ventilator days did not differ. Complications of treatment including acute kidney injury were not statistically different. Conclusions: In XDRAB pneumonia with high MIC to sulbactam, mortality rates were not statistically significant between colistin plus 6-g sulbactam and colistin plus carbapenems. Keywords: XDR A. baumannii pneumonia, mortality rate, colistin based, sulbactam, carbapenems

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Gestational metabolic syndrome and neonatal anthropometric indices: a prospective cohort study

British Journal of Midwifery ◽

10.12968/bjom.2021.29.7.386 ◽

2021 ◽

Vol 29 (7) ◽

pp. 386-391

Author(s):

Zeinab Hatamian ◽

Lida Moghaddam-Banaem ◽

Samira Mokhlesi ◽

Marzieh Saei Ghare Naz

Keyword(s):

Metabolic Syndrome ◽

Cohort Study ◽

Birth Weight ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Linear Regression Analysis ◽

First Trimester ◽

P Value ◽

Anthropometric Parameters ◽

First Trimester Of Pregnancy

Background and aim There is limited knowledge about the effect of maternal metabolic syndrome (MetS) on the anthropometric parameters of newborns. Therefore, the authors aimed to evaluate the association between MetS in the first trimester of pregnancy with weight and height of the newborn. Methods This prospective cohort study was conducted on 455 pregnant women in Tehran during their first trimester of pregnancy. MetS was defined as the coexistence of three or more of the following criteria: fasting blood sugar (FBS) level ≥92 mg/dl, blood pressure ≥130.85 mm/hg, triglyceride ≥150 mg/dl, high density lipoprotein ≤50 mg/dl, and body mass index (BMI) ≥30 kg/m2. All participants were followed up to childbirth. After birth, the baby's weight and height data were collected from the birth certificate. Results Linear regression analysis showed FBS (ß: 0.100, p-value: 0.038), BMI (ß: 0.139, p-value: 0.004), and MetS (ß: -0.122, p-value: 0.015) were significantly associated with birth weight but no statistically significant results were found for birth height. Conclusion MetS and some of its components in pregnancy can affect birth weight of neonates.

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Prevalence and clinical predictors for early post-operative urinary retention in patients undergoing pelvic reconstructive surgeries: a prospective cohort study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20181334 ◽

2018 ◽

Vol 7 (4) ◽

pp. 1452

Author(s):

Annie P. Vijjeswarapu ◽

Vaibhav Londhe ◽

Mahasampath Gowri ◽

Aruna Kekre ◽

Nitin Kekre

Keyword(s):

Cohort Study ◽

Pelvic Organ Prolapse ◽

Urinary Retention ◽

Prospective Cohort Study ◽

Reconstructive Surgery ◽

Prospective Cohort ◽

Pelvic Organ ◽

P Value ◽

Pelvic Reconstructive Surgery ◽

Clinical Predictors

Background: Pelvic organ prolapse (POP) has a significant impact on quality of life. Post-operative voiding dysfunction is seen in 2.5 to 24% of patients following pelvic reconstructive surgery. Risk factors like age of the patient, size of the genital hiatus and stage of prolapse are known to be associated with early post-operative voiding disorders.Methods: This is a prospective cohort study done in Christian Medical College, Vellore over one year. Patients with stage II to IV pelvic organ prolapse who underwent pelvic reconstructive surgery were observed post operatively for covert and overt urinary retention. Inability to void accompanied by pain and discomfort is defined as overt retention. Early post-operative urinary retention (POUR) is retention of urine in the first 72 hours postoperatively. Covert retention is defined as a non-painful bladder with chronic high post void residue. Chi- square test or Fisher’s exact test was used to assess the association between the clinical predictors and early post-operative urinary retention in univariate analysis.Results: In this study, 75 patients were recruited. Nine patients had POUR. Among the patients who had post-operative urinary retention, 77.78% had stage III pelvic organ prolapse (n=7). P value was 0.042. The prevalence of early POUR after pelvic reconstructive surgery was 12.85 % (n=9). A 55.55% had covert retention (n=5) and 44.44% patients had overt retention (n=4).Conclusions: The prevalence of early POUR after pelvic reconstructive surgery was 12.85%. Stage of the prolapse was an independent predictor for early postoperative urinary retention.

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Comparison of surgeon gaze behaviour against objective skill assessment in laparoscopic cholecystectomy-a prospective cohort study

International Journal of Surgery ◽

10.1016/j.ijsu.2020.08.006 ◽

2020 ◽

Vol 82 ◽

pp. 149-155

Author(s):

Keane Evans-Harvey ◽

Simon Erridge ◽

Urvi Karamchandani ◽

Sala Abdalla ◽

Jasmine Winter Beatty ◽

...

Keyword(s):

Cohort Study ◽

Laparoscopic Cholecystectomy ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Skill Assessment ◽

Objective Skill Assessment ◽

Gaze Behaviour

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Laparoscopic cholecystectomy: a prospective cohort study assessing the impact of grade of operating surgeon on operative time and 30-day morbidity

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2017.0171 ◽

2018 ◽

Vol 100 (3) ◽

pp. 178-184 ◽

Cited By ~ 2

Author(s):

H Tafazal ◽

P Spreadborough ◽

D Zakai ◽

N Shastri-Hurst ◽

S Ayaani ◽

...

Keyword(s):

Patient Outcome ◽

Cohort Study ◽

Laparoscopic Cholecystectomy ◽

Hospital Stay ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Operative Time ◽

Gallstone Disease ◽

Surgical Trainees ◽

The Impact

Introduction There is an increasing trend towards day case surgery for uncomplicated gallstone disease. The challenges of maximising training opportunities are well recognised by surgical trainees and the need to demonstrate timely progression of competencies is essential. Laparoscopic cholecystectomy provides the potential for excellent trainee learning opportunities. Our study builds upon previous work by assessing whether measures of outcome are still affected when cases are stratified based on procedural difficulty. Material and methods A prospective cohort study of all laparoscopic cholecystectomies conducted at a district general hospital between 2009 and 2014, performed under the care of a single consultant. The operative difficulty was determined using the Cuschieri classification. The primary endpoint was duration of operation. Secondary endpoints included length of hospital stay, delayed discharge rate and 30-day morbidity. Results A total of 266 laparoscopic cholecystectomies were performed during the study period. Mean operative time for all consultant-led cases was 52.5 minutes compared with 51.4 minutes for trainees (P = 0.67 unpaired t-test). When cases were stratified for difficulty, consultant-led cases were on average 5 minutes faster. Median duration of hospital stay was equivalent in both groups and there was no statistical difference in re-attendance (12.9% vs. 15.3% P = 0.59) or re-admission rates (3.2% vs. 8.1% P = 0.10) at 30 days. Conclusions Our study provides evidence that laparoscopic cholecystectomy provides a good training opportunity for surgical trainees without being detrimental to patient outcome. We recommend that, in selected patients, under consultant supervision, laparoscopic cholecystectomy can be performed primarily by the surgical trainee without impacting on patient outcome or theatre scheduling.

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Staples Versus Sutures for Skin Closure in Standard Four Port Laparoscopic Cholecystectomy: A Prospective Cohort Study

Cureus ◽

10.7759/cureus.13725 ◽

2021 ◽

Author(s):

Farhanul Huda ◽

Bhargav Gajula ◽

Sudhir Singh ◽

Shashank Kumar ◽

Manoj Joshua Lokavarapu ◽

...

Keyword(s):

Cohort Study ◽

Laparoscopic Cholecystectomy ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Skin Closure

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Determinants of Time to Convalescence among COVID-19 Patients at Millennium COVID-19 Care Center in Ethiopia: A prospective cohort study

10.1101/2020.10.07.20208413 ◽

2020 ◽

Cited By ~ 3

Author(s):

Tigist W. Leulseged ◽

Ishmael S. Hassen ◽

Endalkachew H. Maru ◽

Wuletaw C. Zewde ◽

Nigat W. Chamesew ◽

...

Keyword(s):

Cohort Study ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Care Center ◽

Viral Clearance ◽

Rank Test ◽

P Value ◽

Treatment Practice ◽

Viral Shedding ◽

Log Rank Test

ABSTRACTAimTo estimate time to recovery/convalescence and identify determinants among COVID-19 infected patients admitted to Millennium COVID-19 Care Center in Addis Ababa, Ethiopia.MethodsA prospective cohort study was conducted among a randomly selected sample of 360 COVID-19 patients who were on follow up from 2nd June to 5th July 2020. Kaplan Meier plots, median survival times, and Log-rank test were used to describe the data and compare survival distribution between groups. Association between time to recovery/ convalescence and determinants was assessed using the Cox proportional hazard survival model, where hazard ratio, P-value, and 95% CI for hazard ratio were used for testing significance.ResultsThe mean age of the participants was 32.4 years (± 12.5 years). On admission, 86.9 % had mild COVID-19, 78.6% were asymptomatic and 11.4% of the patients had a history of pre-existing co-morbid illness. The Median time to recovery/ convalescence among the study population was 16 days. The log-rank test shows that having non-mild (moderate and severe) disease, having one or more symptoms at presentation, and presenting with respiratory and constitutional symptoms seems to extend the time needed to achieve recovery. The Final Cox regression result shows that the presence of symptom at presentation was found to be a significant factor that affects time to recovery/ convalescence, the rate of achieving recovery/ convalescence among symptomatic patients was 44% lower than patients who were asymptomatic at presentation (HR= 0.560, 95% CI= 0.322-0.975, p-value=0.040).ConclusionsPresence of symptom was found to be associated with delayed viral clearance. This implies symptomatic patients are more likely to be infectious because of the prolonged viral shedding in addition to the presence of a more concentrated virus in the upper respiratory tract that enhances the transmission. Therefore, attention should be given in the isolation and treatment practice of COVID-19 patients with regard to presence of symptom.Key MessagesThe study assessed the time to RT-PCR proven recovery (two consecutive negative viral shedding) and identified determinants that affected the time.Symptomatic infection is associated with delayed viral clearance.The finding of the study could be used to guide the isolation and treatment practice.

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Psychosocial factors and hospitalisations for COVID-19: Prospective cohort study of the general population

10.1101/2020.05.29.20100735 ◽

2020 ◽

Author(s):

George David Batty ◽

Ian Deary ◽

Michelle Luciano ◽

Drew Altschul ◽

Mika Kivimaki ◽

...

Keyword(s):

Cohort Study ◽

Cognitive Function ◽

Psychosocial Factors ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Area Deprivation ◽

P Value ◽

Numerical Reasoning ◽

Statistical Adjustment ◽

And Performance

Objective: To examine the association of a range of psychosocial factors with hospitalisation for COVID-19. Design: Prospective cohort study. Setting: England. Participants: UK Biobank comprises around half a million people who were aged 40 to 69 years at study induction between 2006 and 2010 when information on psychosocial factors and covariates were captured. Main outcome measure: Hospitalisation for COVID-19 in England between 16th March and 26th April 2020 as provided by Public Health England. Results: There were 908 hospitalisations for COVID-19 in an analytical sample of 431,051 people. In age- and sex-adjusted analyses, an elevated risk of COVID-19 was related to disadvantaged levels of education (odds ratio; 95% confidence interval: 2.05; 1.70, 2.47), income (2.00; 1.63, 2,47), area deprivation (2.20; 1.86, 2.59), occupation (1.39; 1.14, 1.69), psychological distress (1.58; 1.32, 1.89), mental health (1.50; 1.25, 1.79), neuroticism (1.19; 1.00, 1.42), and performance on two tests of cognitive function: verbal and numerical reasoning (2.66; 2.06, 3.34) and reaction speed (1.27; 1.08, 1.51). These associations were graded (p-value for trend <=0.038) such that effects were apparent across the full psychosocial continua. After mutual adjustment for these characteristics plus ethnicity, comorbidity, and lifestyle factors, only the relationship between lower cognitive function as measured using the reasoning test and a doubling in the risk of the infection remained (1.98; 1.38, 2.85). Conclusion: A range of psychosocial factors revealed associations with hospitalisations for COVID-19 of which the relation with cognitive function was most robust to statistical adjustment.

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