Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Apr 2014
Observational StudyBlack Box Warning: Is Ketorolac Safe for Use After Cardiac Surgery?
In 2005, after the identification of cardiovascular safety concerns with the use of nonsteroidal anti-inflammatory drugs (NSAIDs), the FDA issued a black box warning recommending against the use of NSAIDs following cardiac surgery. The goal of this study was to assess the postoperative safety of ketorolac, an intravenously administered NSAID, after cardiac surgery. ⋯ Ketorolac appears to be well-tolerated for use when administered selectively after cardiac surgery. Although a black box warning exists, the data highlights the need for further research regarding its perioperative administration.
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J. Cardiothorac. Vasc. Anesth. · Apr 2014
The Problem of Controlling for Imperfectly Measured Confounders on Dissimilar Populations: A Database Simulation Study.
Observational database research frequently relies on imperfect administrative markers to determine comorbid status, and it is difficult to infer to what extent the associated misclassification impacts validity in multivariable analyses. The effect that imperfect markers of disease will have on validity in situations in which researchers attempt to match populations that have strong baseline health differences is underemphasized as a limitation in some otherwise high-quality observational studies. The present simulations were designed as a quantitative demonstration of the importance of this common and underappreciated issue. ⋯ In situations in which large baseline health disparities exist between populations, matching on imperfect markers of disease may result in strong bias away from the null hypothesis.
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J. Cardiothorac. Vasc. Anesth. · Apr 2014
Preoperative Urinary Neutrophil Gelatinase-Associated Lipocalin and Outcome in High-Risk Heart Failure Patients Undergoing Cardiac Surgery.
To investigate the ability of early urinary neutrophil gelatinase-associated lipocalin to predict postoperative complications in adult patients with ventricular dysfunction undergoing cardiac surgery. ⋯ In a cohort of high-risk cardiac surgery patients, preoperative urinary neutrophil gelatinase-associated lipocalin value provided prognostic information that was independent of the onset of acute kidney injury or of preoperative renal function.