Articles: postoperative-complications.
-
J Coll Physicians Surg Pak · Dec 2024
Clinical Insights and Outcomes in Community-Acquired Acute Bacterial Meningitis versus Postoperative Bacterial Meningitis.
To compare the demographics, clinical characteristics, and in-hospital mortality rates between community-acquired bacterial meningitis cases and postoperative bacterial meningitis. ⋯ Postoperative meningitis, Central nervous system infection, Cerebrospinal fluid, Antibiotics.
-
Multicenter Study Observational Study
Continuous nursing care improving outcomes of patients after percutaneous coronary intervention.
Percutaneous coronary intervention (PCI) is an effective method for the treatment of coronary heart disease. Cardiac rehabilitation and continuous nursing management after discharge are the key to ensure the quality of treatment and the quality of life of patients. This study aimed to explore the significance of WeChat platform in continuous care after PCI. ⋯ The improvement of life style, such as smoking cessation (P = .001) and alcohol withdrawal (P = .003), was significantly better than that of the control group. The continuous nursing group was better than the control group in improving psychological status based on the Hamilton's depression scale. Continuous nursing care based on WeChat platform could reduce the incidence of complications of patients after PCI, alleviate patients' depression, and improve patients' quality of life.
-
Observational Study
Risk factors of acute urinary retention after spine surgery.
Acute postoperative urinary retention (APOUR) is 1 of the most common complications of spinal surgery, impacting both postoperative care and the patients' quality of life. This study is designed to investigate the risk factors and the incidence of APOUR after spinal surgery in Taiwan. We conducted a retrospective analysis using the Taiwanese National Health Insurance Research Database (NHIRD), a nationwide cohort of patients who underwent spinal surgery from the year 2000 to 2013. ⋯ Multivariate logistic regression analysis revealed that age (adjusted odds ratio [OR] = 1.02, 95% CI = 1.01-1.02), male gender (adjusted OR = 1.35, 95% CI = 1.10-1.60) and undergoing spinal surgery more than 2 times (adjusted OR = 4.78, 95% CI = 2.49-9.20) were statistically significant risk factors for APOUR after spinal surgery. The results of this retrospective cohort study suggest that patients undergoing spinal surgery more than 2 times, male gender and advanced age are significantly associated with an increased risk of APOUR after spinal surgery. This information may assist surgeons to identify patients who have a high risk of APOUR after spinal surgery and proactively provide them with early intervention.
-
Observational Study
Impact of surgeon volume on the risk of complications following volar locking plating of unstable distal radius fracture.
Complications following volar locking plating (VLP) of distal radius fracture (DRF) are frequent. Increasing evidence has shown an inverse relationship between increased surgeon experience and fewer complications in a variety of surgeries, and this study aimed to verify whether this relationship existed when specified in the DRF surgically treated with VLP. Patients with an unstable DRF surgically treated by VLP in our institution between January 2016 and December 2021 were included. ⋯ Low-volume was associated with an increase in the risk of general complications by 4.8 times (95% confidential interval, 2.9-8.2). Subgroup analyses showed that this trend was intensified for AO type C fracture (odds ratio, 5.9), slightly mitigated for type B (odds ratio, 3.7), but not significant for type A. The finding highlighted the need to maintain 8 cases/year to improve the complications of DRFs, and for severe cases, centralized treatment is recommended.
-
Randomized Controlled Trial
Association between thoracic epidural anesthesia and driving pressure in adult patients undergoing elective major upper abdominal surgery: a randomized controlled trial.
Thoracic epidural anesthesia (TEA) is associated with a knowledge gap regarding its mechanisms in lung protection and reduction of postoperative pulmonary complications (PPCs). Driving pressure (ΔP), an alternative indicator of alveolar strain, is closely linked to reduced PPCs with lower ΔP values. We aim to investigate whether TEA contributes to lung protection by lowering ΔP during mechanical ventilation. ⋯ Compared to GA, TEA-GA can reduce intraoperative ΔP in patients undergoing major upper abdominal surgery, especially those undergoing laparoscopic surgery. However, compared to GA combined with ΔP-guided ventilation, TEA-GA combined with ΔP-guided ventilation does not reduce the risk of PPCs. There was no significant difference in the total use of various vasoactive drugs between the two groups.