Articles: postoperative-complications.
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J Neurosurg Anesthesiol · Jan 2025
High Intraoperative Serum Lactate Level is Associated with Acute Kidney Injury after Brain Tumor Resection.
Postoperative acute kidney injury (AKI) is associated with poor clinical outcomes. Identification of risk factors for postoperative AKI is clinically important. Serum lactate can increase in situations of inadequate oxygen delivery and is widely used to assess a patient's clinical course. We investigated the association between intraoperative serum lactate levels and AKI after brain tumor resection. ⋯ High intraoperative serum lactate levels were associated with AKI after brain tumor resection.
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Anaesth Intensive Care · Jan 2025
Association of medical emergency team activation in the 24-hour postoperative period with length of stay and in-hospital mortality.
Medical emergency team (MET) activations were designed to improve patient safety and outcomes by providing timely and specialised care to patients experiencing clinical deterioration. The primary objective of this study was to describe the association between MET events in the early (24-h) postoperative period and in-hospital mortality as well as length of stay. A retrospective data linkage study was performed of prospectively collected data from patient administrative data and the MET database at Launceston General Hospital located in Tasmania, Australia. ⋯ Notably, staff concern as a trigger for MET activation was associated with a hazard nearly as great as chest pain. Other MET triggers that reached statistical significance were bleeding, respiratory rate more than 36/min, peripheral oxygen saturations less than 84% and systolic blood pressure less than 80 mmHg. Despite being frequent, MET events should be regarded as a serious marker of an adverse patient journey that may warrant higher resource allocation.
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Subcutaneous emphysema is a common complication of laparoscopic surgery. We aimed to determine the incidence, outcomes, and risk factors of postlaparoscopic subcutaneous emphysema. ⋯ This historical cohort study showed a relatively high incidence of postlaparoscopic subcutaneous emphysema. In addition to previously reported risk factors, female sex and use of the AirSeal Intelligent Flow System were found to be associated with postlaparoscopic subcutaneous emphysema.
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J. Thorac. Cardiovasc. Surg. · Jan 2025
Outcomes of thoracoabdominal aortic aneurysm repair in patients with a prior myocardial infarction.
Many patients undergoing thoracoabdominal aortic aneurysm (TAAA) repair have had a previous myocardial infarction (MI). To address the paucity of data regarding outcomes in such patients, we aimed to compare outcomes after open TAAA repair in patients with and without previous MI. ⋯ Although previous MI was not associated with early mortality after TAAA repair, patients with a previous MI had greater rates of cardiac complications and delayed paraparesis. Patients with a previous MI also trended toward poorer survival.
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Observational Study
Heart failure diagnostic accuracy, intraoperative fluid management, and postoperative acute kidney injury: a single-centre prospective observational study.
The accurate diagnosis of heart failure (HF) before major noncardiac surgery is frequently challenging. The impact of diagnostic accuracy for HF on intraoperative practice patterns and clinical outcomes remains unknown. ⋯ An accurate preoperative diagnosis of heart failure before noncardiac surgery is associated with reduced intraoperative fluid administration and less acute kidney injury. Targeted efforts to improve preoperative diagnostic accuracy for heart failure may improve perioperative outcomes.