Articles: postoperative-complications.
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Multicenter Study
Risk Analysis and Outcomes of Postoperative Renal Failure After Aortic Valve Surgery in the United States.
Postoperative renal failure (RF) compromises early outcomes in cardiac surgery. In contrast, long-term survival and progression of RF after aortic valve replacement (AVR) with or without coronary artery bypass graft surgery (CABG) remain undefined. ⋯ Postoperative RF after AVR with or without CABG was associated with higher early and late mortality, which further increased with a new requirement for dialysis. Once postoperative RF develops, preoperative renal dysfunction does not increase early mortality; however, it predicts late survival. Preoperative renal function is associated with progression of postoperative RF to dialysis.
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J. Thorac. Cardiovasc. Surg. · Apr 2020
Multicenter Study Observational StudyPostoperative atrial fibrillation: Sex-specific characteristics and effect on survival.
We sought to fill important gaps in the existing evidence regarding new-onset atrial fibrillation (AF) after coronary artery bypass graft surgery (CABG) by comparing the incidence, characteristics, and effect on long-term survival between men and women. ⋯ In our study, women had lower adjusted risk of post-CABG AF and experienced shorter episodes. The adjusted risk of long-term mortality was 56% greater among patients who developed post-CABG AF compared with those who did not. The effect of post-CABG AF on long-term survival did not differ between the sexes.
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Multicenter Study Observational Study
Safety of hospital discharge before return of bowel function after elective colorectal surgery.
Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function. ⋯ Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients.
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Anesthesia and analgesia · Apr 2020
Multicenter Study Observational StudyA Multinational Observational Study Exploring Adherence With the Kidney Disease: Improving Global Outcomes Recommendations for Prevention of Acute Kidney Injury After Cardiac Surgery.
The Kidney Disease: Improving Global Outcomes (KDIGO) guidelines recommend a bundle of different measures for patients at increased risk of acute kidney injury (AKI). Prospective, single-center, randomized controlled trials (RCTs) have shown that management in accordance with the KDIGO recommendations was associated with a significant reduction in the incidence of postoperative AKI in high-risk patients. However, compliance with the KDIGO bundle in routine clinical practice is unknown. ⋯ In patients after cardiac surgery, compliance with the KDIGO recommendations was low in routine clinical practice.
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The Enhanced Recovery After Surgery (ERAS) care protocol has been shown to improve outcomes compared with traditional care in certain types of surgery. ⋯ An increase in adherence to the ERAS program was associated with a decrease in postoperative complications, although only a few ERAS items were individually associated with improved outcomes.