The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Dec 2022
Meta AnalysisImpact of preoperative glycometabolic status on outcomes in cardiac surgery: Systematic review and meta-analysis.
Historically, impaired glucose metabolism has been associated with early and late complicated clinical outcomes after cardiac surgery; however, such a condition is not specific to subjects with diabetes mellitus and involves a larger patient population. ⋯ Lower levels of glycosylated hemoglobin in patients undergoing cardiac surgery are associated with a lower risk of early and late mortality, as well as in the incidence of postoperative acute kidney injury, neurologic complications, and wound infection, compared with higher levels.
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J. Thorac. Cardiovasc. Surg. · Sep 2022
Meta AnalysisUtility and safety of coronary angiography in patients with acute infective endocarditis who required surgery.
To assess the benefit/risk ratio to perform a coronary angiography (CA) before surgery for infective endocarditis (IE). ⋯ In daily practice, two-thirds of the patients with acute IE who required surgery have a preoperative CA leading to a combined CABG in 18% of the patients. Our results suggest that to perform a preoperative CA in this context is not associated with improved prognosis.
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J. Thorac. Cardiovasc. Surg. · Aug 2022
Meta AnalysisEffect of routine jejunostomy tube insertion in esophagectomy: A systematic review and meta-analysis.
Routine feeding jejunostomy tube post esophagectomy is being revaluated because of its associated postoperative complications. We performed a systematic review and meta-analysis to evaluate the effect of routine feeding jejunostomy tube insertion on mortality and postesophagectomy outcomes. ⋯ Feeding jejunostomy tube after esophagectomy might lead to lower 30-day all-cause mortality with no difference in common postesophagectomy complications. A routine insertion of a jejunostomy tube should be considered at the time of surgery for esophageal cancer resection.
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J. Thorac. Cardiovasc. Surg. · Jul 2022
Review Meta AnalysisRecruitment maneuvers to reduce pulmonary atelectasis after cardiac surgery: A meta-analysis of randomized trials.
Pulmonary atelectasis is a common postoperative complication that may lead to intrapulmonary shunt, refractory hypoxemia, and respiratory distress. Recruitment maneuvers may relieve pulmonary atelectasis in patients undergoing cardiac surgery. We conducted a meta-analysis of randomized controlled trials to evaluate the effectiveness of recruitment maneuvers in these patients. ⋯ Recruitment maneuvers may reduce postoperative pulmonary atelectasis, hypoxic events, and pneumonia and improve Pao2/Fio2 ratios without hemodynamic disturbance in patients undergoing cardiac surgery.
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J. Thorac. Cardiovasc. Surg. · Jun 2022
Meta AnalysisMachine learning improves mortality risk prediction after cardiac surgery: Systematic review and meta-analysis.
Interest in the usefulness of machine learning (ML) methods for outcomes prediction has continued to increase in recent years. However, the advantage of advanced ML model over traditional logistic regression (LR) remains controversial. We performed a systematic review and meta-analysis of studies comparing the discrimination accuracy between ML models versus LR in predicting operative mortality following cardiac surgery. ⋯ The present findings suggest that when compared with LR, ML models provide better discrimination in mortality prediction after cardiac surgery. However, the magnitude and clinical influence of such an improvement remains uncertain.