Articles: postoperative-complications.
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Multicenter Study
A Breakthrough Improvement Collaborative Significantly Reduces Hospital Stay after Elective Colectomy for Cancer Across a Healthcare System.
This multicenter study aimed to assess (1) the effect of an improvement collaborative on enhanced recovery after surgery (ERAS) protocol adherence after elective colectomy and (2) the association between adherence and patient outcomes. ⋯ A peer-constructed improvement collaborative effectively increases adherence to an ERAS protocol in individual hospitals. Across time, length of stay and postoperative complications decreased significantly, and a dose-response relationship was observed.
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Chinese medical journal · Oct 2022
Multicenter StudyAnalysis of risk factors associated with endoscopic retrograde cholangiopancreatography for patients with liver cirrhosis: a multicenter, retrospective, clinical study.
Endoscopic retrograde cholangiopancreatography (ERCP) is the endoscopic modality of choice for the treatment of biliary and pancreatic diseases. However, patients with cirrhosis, particularly those with decompensated cirrhosis, are believed to be at increased risk for complications associated with ERCP. There is a paucity of literature describing the outcomes of ERCP for patients with cirrhosis. This study aimed to investigate the outcomes of ERCP for cirrhosis patients, especially adverse events, and evaluated its safety and efficacy. ⋯ Compared with the general population of patients undergoing ERCP, patients with cirrhosis were more prone to postoperative pancreatitis and cholangitis. TBIL levels and Child-Pugh scores were risk factors for postoperative complications in patients with cirrhosis.
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Multicenter Study Observational Study
The application value of preoperative fat-free mass index within Global Leadership Initiative on Malnutrition-defined malnutrition criteria for postoperative outcomes in patients with esophagogastric cancer.
The present study aimed to investigate the prognostic value of the preoperative fat-free mass index (FFMI) for postoperative outcomes in patients undergoing esophagogastric cancer surgery and to explore the role of the FFMI in the Global Leadership Initiative on Malnutrition (GLIM) criteria. ⋯ The FFMI has an important role in the diagnosis of malnutrition using the GLIM criteria. In this study, a decreased preoperative FFMI was closely associated with postoperative complications in patients with esophagogastric cancer.
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Randomized Controlled Trial Multicenter Study
Long Term Outcomes of Parenchyma-Sparing and Oncologic Resections in Patients with Non-Functional Pancreatic Neuroendocrine Tumors <3cm in a Large Multi-Center Cohort.
The role of parenchyma-sparing resections (PSR) and lymph node dissection in small (<3 cm) nonfunctional pancreatic neuroendocrine tumors (PNET) is unlikely to be studied in a prospective randomized clinical trial. By combining data from 4 high-volume pancreatic centers we compared postoperative and long-term outcomes of patients who underwent PSR with patients who underwent oncologic resections. ⋯ In small <3 cm nonfunctional PNETs, PSRs and lymph node-sparing resections are associated with lower blood loss, shorter operative times, and lower complication rates when compared to oncologic resections, and have similar long-term oncologic outcomes.
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Anesthesia and analgesia · Sep 2022
Multicenter StudyRisk Factors and Consequences of Acute Kidney Injury After Noncardiac Surgery in Children.
Postoperative acute kidney injury (AKI) is a serious complication that is associated with prolonged hospital stay, high risk of short-term postsurgical mortality, need for dialysis, and possible progression to chronic kidney disease. To date, very little data exist on the risk of postoperative AKI among children undergoing noncardiac surgical procedures. We used data from a large multicenter cohort to determine the factors associated with AKI among children who underwent inpatient noncardiac surgical procedures and its impact on the postoperative course. ⋯ Independent preoperative risk factors for AKI in children undergoing inpatient noncardiac surgery were hematologic disorder, preoperative sepsis, ASA physical status ≥III, inotropic support, gastrointestinal disease, ventilator dependency, and steroid use. Children with AKI were 10 times more likely to die and nearly 3 times more likely to require an extended hospital stay, relative to their peers without AKI.