Articles: postoperative-complications.
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Postoperative outcomes of 31 afebrile patients who had responded to treatment for intra-abdominal sepsis were compared based on the presence or absence of leukocytosis (WBC count greater than 10,000/cu mm) at the conclusion of antibiotic therapy. In 68% of the patients who had leukocytosis, postoperative septic complications developed within two months of their operation. In patients without leukocytosis, complications developed in only 8.3%. Afebrile patients who exhibit leukocytosis but have responded clinically to treatment are at risk for postoperative infection and multisystem failure.
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A retrospective review was made of 30 patients who had failed multiple traditional surgical procedures for low-back pain, sciatic pain, or both. The most common cause of the poor results appeared to be failure of initial selection, even though all patients appeared to meet traditional indications for operative intervention. Psychosocial problems (eg, drug abuse, alcoholism, marital discord, personality disturbances) were prevalent, but were not initially recognized. Thoughtful assessment of patients being considered for initial lumbar spine surgery, which includes objective psychological testing, may reduce the incidence of unsuccessful lumbar spine surgery.