Articles: postoperative-complications.
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Multicenter Study Observational Study
Ulinastatin treatment mitigates glycocalyx degradation and associated with lower postoperative delirium risk in patients undergoing cardiac surgery: a multicentre observational study.
Ulinastatin (UTI), recognized for its anti-inflammatory properties, holds promise for patients undergoing cardiac surgery. This study aimed to investigate the relationship between intraoperative UTI administration and the incidence of delirium following cardiac surgery. ⋯ UTI administration may mitigate glycocalyx degradation, potentially lowering the risk of POD in cardiac surgery patients, offering valuable insights for future interventions to prevent POD and enhance patient outcomes. Trial registration number ClinicalTrials.gov (No. NCT06268249). Retrospectively registered 4 February 2024.
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Multicenter Study
Development and validation of an EHR-based risk prediction model for geriatric patients undergoing urgent and emergency surgery.
Clinical determination of patients at high risk of poor surgical outcomes is complex and may be supported by clinical tools to summarize the patient's own personalized electronic health record (EHR) history and vitals data through predictive risk models. Since prior models were not readily available for EHR-integration, our objective was to develop and validate a risk stratification tool, named the Assessment of Geriatric Emergency Surgery (AGES) score, predicting risk of 30-day major postoperative complications in geriatric patients under consideration for urgent and emergency surgery using pre-surgical existing electronic health record (EHR) data. ⋯ We developed a model to accurately predict major postoperative complications in geriatric patients undergoing urgent or emergency surgery using the patient's own existing EHR data. EHR implementation of this model could efficiently support clinicians' surgical risk assessment and perioperative decision-making discussions in this vulnerable patient population.
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Eur J Trauma Emerg Surg · Jan 2025
Multicenter StudyImpact of preoperative frailty on outcomes in patients subjected to emergency laparotomy: a prospective study.
Emergency laparotomy (EL) is a high-risk procedure, especially in frail patients. This study investigates the prevalence of frailty in referral facilities, evaluates the impact of frailty on postoperative morbidity and mortality, and assesses the long-term effect of EL on patients' functional status. ⋯ The 180-day mortality after EL is significantly higher for patients on higher levels of frailty. Likewise, the preoperative frailty has a significant negative impact on postoperative outcomes both short- and long-term.
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Background and Objectives: Although breast surgery has undergone a drastic de-escalation in recent decades, axillary dissection is still indicated in some selected cases. Unfortunately, in 3-85% of cases, complications such as seroma formation occur, highlighting the need for more accurate hemostasis systems. The aim of this study is to evaluate the effectiveness of absorbable polysaccharide hemostatic such as HaemocerTM in preventing postoperative seroma. ⋯ The duration of axillary drainage placement was shorter in the experimental group (7 ± 3 days) compared to the control group (10 ± 1 days) with a statistically significant difference (0.037). During the US follow-up, on days 7, 15, and 30, the number of patients affected by seroma and the volumes were lower in the experimental group. Conclusions: The adsorbable hemostatic powder proved to be effective both in reducing the volume of drained fluid postoperatively and in decreasing the number and volume of reported seromas during the US follow-up.
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J. Cardiothorac. Vasc. Anesth. · Jan 2025
Randomized Controlled Trial Multicenter StudyLevosimendan in Patients with Low Cardiac Output Syndrome After Cardiac Surgery: A Substudy of the Multicenter Randomized CHEETAH Trial.
To test the hypothesis that levosimendan administration in patients with low cardiac output syndrome after cardiac surgery is associated with improved long-term (5-year follow-up) outcomes. ⋯ Among patients requiring hemodynamic support after cardiac surgery with CPB, perioperative levosimendan infusion did not affect long-term survival (1-5 years) compared with placebo. Levosimendan also had no effect on major clinical outcomes such as AKI, ICU stay, hospital stay, and 30-day mortality.