Articles: postoperative-complications.
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This study examined clinical outcomes associated with 3 types of noncontiguous cervical surgeries - anterior cervical discectomy and fusion (ACDF), cervical disc arthroplasty (CDA), and hybrid cervical surgery (HCS) - to improve surgeon decision-making. ⋯ There may be no clinically meaningful difference in many clinical outcomes for different non-contiguous surgical interventions for non-contiguous cervical degenerative disc disease (CDDD). However, complication rates, such as dysphagia and ASD, appear higher for non-contiguous ACDF as compared to non-contiguous CDA or HCS.
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Numerous models have been developed to predict acute kidney injury (AKI) after noncardiac surgery, yet there is a lack of independent validation and comparison among them. ⋯ We identified three models with fair discrimination and potential clinical utility after recalibration for assessing the risk of acute kidney injury after noncardiac surgery.
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Review Meta Analysis
Characteristics associated with effectiveness in postoperative delirium research: a systematic review of randomised controlled trials with meta-regression and meta-analysis.
Postoperative delirium remains prevalent despite extensive research through randomised trials aimed at reducing its incidence. Understanding trial characteristics associated with interventions' effectiveness facilitates data interpretation. ⋯ PROSPERO (CRD42023413984).
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Editorial Review
Predictive modelling for postoperative acute kidney injury: big data enhancing quality or the Emperor's new clothes?
The increased availability of large clinical datasets together with increasingly sophisticated computing power has facilitated development of numerous risk prediction models for various adverse perioperative outcomes, including acute kidney injury (AKI). The rationale for developing such models is straightforward. ⋯ Some of the purported benefits of predictive modelling, particularly when applied to postoperative AKI, might not fare well under detailed scrutiny. Future research should address existing limitations and seek to demonstrate both benefit to patients and value to healthcare systems from implementation of these models in clinical practice.
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Minerva anestesiologica · Sep 2024
ReviewThe clinical value of nonpharmacological interventions for preventing postoperative delirium: a narrative review.
Postoperative delirium (POD) is a prevalent perioperative complication among elderly individuals and is a cause of significant detrimental consequences for both individuals and society. Pharmacological and nonpharmacological prevention methods/therapies have been proposed to mitigate the risk of POD. Nevertheless, the efficacy of pharmacological interventions is controversial, and some of them cause side effects. ⋯ The former is aimed at increasing cognitive reserve, thus decreasing the incidence rate of POD. Noncognitive interventions, including sensory stimuli (music therapy, odor enrichment), improving sleep disturbances, physical activity, acupuncture and transcranial magnetic/direct current stimulation, are aimed at decreasing the risk factors for POD. This review provides a comprehensive overview of recently reported nonpharmacological mono-component interventions for preventing POD and briefly describes their clinical value.