Articles: postoperative-complications.
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Review Comparative Study
Comparative analysis of general and regional anesthesia applications in geriatric hip fracture surgery.
This study compares the outcomes of general anesthesia (GA) and regional anesthesia (RA) in geriatric hip fracture surgery to determine optimal anesthesia strategies for this population. ⋯ RA emerges as a preferable choice for geriatric hip fracture surgery, offering improved safety profiles, enhanced recovery trajectories, and better postoperative cognitive outcomes compared to GA. These findings underscore the importance of anesthesia selection in optimizing surgical outcomes and patient safety in elderly populations. Future research should focus on prospective trials to validate these results and refine anesthesia protocols tailored to elderly hip fracture patients.
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Observational Study
Analysis of factors affecting early necrosis of the affected finger after surgery in patients with reimplantation of severed fingers.
The study aimed to investigate the factors associated with early necrosis of the finger after reimplantation of broken fingers. Sixty-seven cases of reimplantation of severed fingers in our hospital between January 2023 and December 2023 were retrospectively analyzed. All patients underwent reimplantation of severed fingers and were divided into early necrosis group and non-necrosis group according to the presence or absence of early necrosis of the finger body 7 days after surgery. ⋯ Multifactorial analysis showed that smoking history (OR = 7.255, 95% CI: 1.767-29.782), little finger (OR = 7.040, 95% CI: 1.897-26.130), preoperative ischemia ≥ 8 hours (OR = 15.714, 95% CI: 3.095-79.798), vasospasm (OR = 5.850, 95% CI: 1.563-21.894), crush injury (OR = 5.667, 95% CI: 1.393-23.059), postoperative infection (OR = 5.600, 95% CI: 1.544-20.312), and postoperative hypothermia of the skin (OR = 7.096, 95% CI: 1.872-26.906) were the necrotic post-replantation necrosis after amputation of the finger high-risk factors (OR > 1, P < .05). The risk of early necrosis of the affected finger after reimplantation of an amputated finger is closely related to smoking history, pinky size, preoperative ischemic time of more than 8 hours, vasospasm, crush injuries, postoperative infections, and postoperative hypothermic skin temperature. Preventive measures need to be taken in advance to reduce the risk of necrosis in the affected finger.
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This study analyzes the prognostic factors of thrombosis in patients with hematological diseases after peripherally inserted central catheter (PICC) surgery. We conducted a retrospective analysis of 223 patients with hematological diseases who underwent PICC catheterization between January 2017 and June 2021. These patients were categorized into the thrombotic group and non-thrombotic group based on the occurrence of thrombosis following PICC catheterization. ⋯ Furthermore, the multivariate analysis demonstrated that catheter infection, diabetes, history of thrombosis, fibrinogen degradation products (FDP), antithrombin III (AT-III) and D-dimer were all independent factors of thrombosis in patients with hematological diseases after PICC. The AUC areas of the working characteristic curves of FDP, AT-III, and D-dimer in predicting post PICC thrombosis in patients with hematological diseases were 0.744, 0.651, and 0.595, respectively. Hematological diseases patients with catheter infection, diabetes, history of thrombosis, FDP > 3.24 mg/L, AT-III < 93%, or D-dimer > 2.41 µg/mL are prone to thrombosis after PICC surgery.
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To explore the association of socioeconomic status (SES) and race/ethnicity with perioperative metrics within the Enhanced Recovery After Surgery (ERAS) framework to identify gaps for equity-informed improvements. ⋯ Low SES was linked to lower compliance with important process measures, higher infectious and all in-hospital complication rates, and longer LOS. Despite high rates of protocol compliance, Black race/ethnicity showed an association with increased odds of respiratory complications and extended LOS. Adjustments to perioperative protocols could address such disparities, helping to improve postoperative outcomes of colorectal surgeries.