Articles: postoperative-complications.
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Pancreatoduodenectomy (PD) may occasionally be indicated for complete removal of periampullary (duodenal and ampullary) adenomas (PAs). As compared with malignant indications, PD for benign or pre-malignant disease is often associated with increased morbidity. While the Spigelman classification assesses malignancy risk for familial adenomatous polyposis (FAP)-related duodenal adenomas, no malignancy risk score (MRS) exists for non-FAP related PAs. We developed a MRS for non-FAP related PAs undergoing PD to weigh risk of malignancy and postoperative morbidity. ⋯ This novel MRS stratifies the risk of malignancy in non-FAP related PAs managed with PD. This score can be used to counsel patients who may require PD for complete tumor removal about their risk of harboring malignancy and their risk of major postoperative complications.
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To investigate the determining risk factors for 1-year postoperative mortality in elderly patients with hip fracture and to assess the efficacy of the age-adjusted Charlson comorbidity index (ACCI) in predicting the risk of death. This study adopted a retrospective analysis method to focus on 652 elderly patients who underwent hip fracture surgery between January 2018 and November 2022 in our hospital. By systematically combing the patients' medical records, relevant data were collected and analyzed in depth for their association with morbidity and mortality rates within 1 year. ⋯ The ACCI excelled in predicting the risk of 1-year postoperative mortality, with an AUC of 0.912 for its prediction model and a specificity and sensitivity of 0.834 and 0.871, respectively, when the threshold was set at 5.5. The results of this study emphasize that age, ACCI, and postoperative pneumonia are key risk factors affecting the survival of elderly patients with hip fracture at 1-year postoperatively. ACCI, as an effective predictive tool, can provide an important reference for the clinical assessment of patients' postoperative risk and help precision medical decision-making.
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Esophageal cancer is a relatively common malignant tumor of the digestive tract. Patients with esophageal cancer show a high incidence of aspiration after surgery, which has a serious impact on their prognosis and rehabilitation. Nevertheless, while existing and past endeavors have concentrated on enhancing the diagnostic and therapeutic strategies for esophageal cancer, the necessity of preventing pneumonia caused by postoperative aspiration remains to be adequately addressed. ⋯ Clinically, it is necessary to select appropriate assessment tools for the swallowing function. Research indicates that the application of risk prediction models can better assess aspiration in patients after esophageal cancer surgery, bridge gaps in qualitative analysis, and alter the clinical outcomes of patients. Predictive models for dysphagia screening in patients after esophagectomy have significant clinical advantages and exhibit good clinical applicability.
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Observational Study
Intra-Operative Hypotension is an Important Modifiable Risk Factor for Major Complications in Spinal Fusion Surgery.
Retrospective observational cohort. ⋯ III.
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Meta Analysis
Do Obese Patients Have Worse Outcomes in Adult Spinal Deformity Surgeries? A Meta-Analysis.
A meta-analysis study. ⋯ Nonobese patients undergoing ASD corrective surgery are associated with fewer implant-related complications, a lower EBL, shorter LOS, and a higher likelihood of being discharged home compared with their obese counterparts.