The Annals of thoracic surgery
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Enhanced Recovery After Surgery (ERAS) is a perioperative patient management strategy that is being adopted rapidly across surgical specialties worldwide. Components of ERAS work collaboratively throughout the perioperative course to achieve significant benefits for both the patient and the entire health care system. The use of ERAS in cardiac surgery (ERAS-C) could lead to similar improvements, but currently, use of ERAS-C programs is lacking and not well defined. ⋯ This review presents pertinent current research related to the implementation of ERAS programs in the field of cardiac surgery and provides a call to action for further investigation and adaption of ERAS in cardiac surgery.
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Review Meta Analysis
CHA2DS2-VASc Score for Identifying Patients at High Risk of Postoperative Atrial Fibrillation After Cardiac Surgery: A Meta-analysis.
Postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery, resulting in an increased risk of morbidity and longer hospital stay. Pharmacologic prophylaxis has been recommended to improve the outcome in patients at high risk of developing POAF after cardiac surgery. Several studies have applied the CHA2DS2-VASc (Congestive heart failure, Hypertension Age [≥65 = 1 point, ≥75 = 2 points], Diabetes, and Stroke/transient ischemic attack (2 points)-vascular disease [peripheral arterial disease, previous myocardial infarction, aortic atheroma]) score in the risk stratification of POAF but yielded contradicting results. This study aims to determine the association between CHA2DS2-VASc score and POAF and further to explore its discriminative ability for the prediction of POAF. ⋯ The CHA2DS2-VASc score has relatively good performance in predicting POAF after cardiac surgery and may help identify the patients at high risk of POAF.
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Data from administrative claims and cancer registries have an ever-expanding role in thoracic surgery health services and health policy research. However, their strengths, limitations, and appropriate applications are often poorly understood, leading to errors in study design and data interpretation. The intent of this review is to discuss relevant and crucial considerations when conducting research with some of the most common national thoracic surgery data sources. ⋯ An appreciation of the strengths, limitations, and differences between various sources of data from administrative, hospital-based, and population-based cancer registries is equally essential for investigators to improve the quality and accuracy of their research and for readers to properly interpret the results of such studies.
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Computed Tomography-Assessed Skeletal Muscle Mass as a Predictor of Outcomes in Lung Cancer Surgery.
Sarcopenia is characterized by loss of skeletal muscle and strength, associated with aging, poor nutrition, sedentary lifestyle, and long-term illness. We sought to evaluate the current evidence on the prevalence of sarcopenia assessed by computed tomography (CT) imaging in patients undergoing lung cancer resection and its predictive value for perioperative and long-term outcomes. ⋯ Sarcopenia can be frequently detected in patients undergoing lung cancer resection with the use of CT-based muscle measurements. Sarcopenia was associated with greater risk of perioperative complications and worse long-term prognosis.
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As the largest congenital and pediatric cardiac surgical clinical data registry in the world, The Society of Thoracic Surgeons Congenital Heart Surgery Database (STS CHSD) serves as a platform for reporting of outcomes and for quality improvement. In addition, it is an important source of data for clinical research and for innovations related to quality measurement. ⋯ The STS, through its Workforce for National Databases and the STS Research Center and Workforce on Research Development provides multiple pathways through which investigators may propose and perform outcomes research projects based on STS CHSD data. This report reviews research published within the past year.