Drivers of hospital length of stay in 56,000 orthopaedic trauma patients: The impact of postoperative cardiac events

Douleh, Diana G.; Yarlagadda, Mahesh; Shen, Michelle; Williams, Gerard; Mousavi, Idine; Sethi, Manish K.

doi:10.1016/j.jcot.2017.02.003

Cited by 3 publications

(1 citation statement)

References 12 publications

(13 reference statements)

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“…Postoperative cardiac events are frequent complications for patients undergoing various non-cardiac surgery [7], contributing to substantial morbidity and mortality and excessive hospital costs and length of stay [8][9][10][11]. Their incidence ranged from 1-16%, depending on the study population, the procedure types, and the de nition of myocardial events [10,[12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Incidence and Risk Factors for Symptomatic Myocardial Ischemia After Posterior Decompressive Surgery for Degenerative Lumbar Disorders

Liu¹,

Zhang²,

Yang³

et al. 2021

Preprint

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Background: This study aimed to determine the incidence of symptomatic myocardial ischemia (PSMI) after posterior decompressive surgery for degenerative lumbar disorders and identify its risk factors. Methods: 256 patients who underwent the posterior decompressive surgery and were discharged from the hospital between January 2011 and December 2016 were enrolled in this study, according to the inclusion and exclusion criteria. Subjects were divided into two groups by the occurrence of PSMI: the PSMI group and the N-PSMI group. Three sets of factors were analyzed to investigate potential risk factors for PSMI. Patient characteristics included age, gender, body mass index, smoking, drinking, venous thrombosis of lower extremities, comorbidities, visual analog scale, hemoglobin, electrolytes. Preoperative cardiac functional variables included electrocardiogram, ventricular ejection fraction, history of ischemic attack, previous cardiac surgery. Perioperative variables included surgical strategy, surgery time, blood loss, intraoperative aortic injury, intraoperative maximum heart rate, arterial blood pressure, postoperative temperature, daily liquid intake and output volume, electrolytes glucose, drug allergy, and postoperative visual analog scale. Univariate analyses followed by the multivariate logistic regression model were employed to identify the risk factors for PSMI. Results: PSMI was developed in 23 of 256 patients (8.9%) before discharge. Univariate analyses revealed that patients with onset of PSMI were older, more likely to have undergone cardiac surgery, with less daily liquid intake volume, and less intravenous infusion (p < 0.05). Logistic regression analysis revealed that age > 52 years, heart rate > 81 Bpm, daily liquid intake < 2140 mL, and cardiac surgery history were independently associated with PSMI after posterior decompressive surgery for degenerative lumbar disorders.Conclusions: The incidence of PSMI after posterior decompressive surgery for degenerative lumbar disorders was 8.9%; senior, fast heart rate, insufficient daily liquid intake, and cardiac surgery history are potential risk factors and should be carefully evaluated before an operation.

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Section: Introductionmentioning

confidence: 99%

Incidence and Risk Factors for Symptomatic Myocardial Ischemia After Posterior Decompressive Surgery for Degenerative Lumbar Disorders

Liu¹,

Zhang²,

Yang³

et al. 2021

Preprint

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Are Medicare's “Comprehensive Care for Joint Replacement” Bundled Payments Stratifying Risk Adequately?

Cairns

Moskal

Eskildsen

et al. 2018

The Journal of Arthroplasty

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Perioperative adverse cardiac events in maxillofacial surgery: A systematic review and meta-analysis

Chohan,

Liu,

Chowdhury

2024

Indian Journal of Anaesthesia

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Background and Aims: Maxillofacial surgeries, including procedures to the face, oral cavity, jaw, and head and neck, are common in adults. However, they impose a risk of adverse cardiac events (ACEs). While ACEs are well understood for other non-cardiac surgeries, there is a paucity of data about maxillofacial surgeries. This systematic review and meta-analysis report the incidence and presentation of perioperative ACEs during maxillofacial surgery. Methods: We included primary studies that reported on perioperative ACEs in adults. To standardise reporting, ACEs were categorised as 1. heart rate and rhythm disturbances, 2. blood pressure disturbances, 3. ischaemic heart disease and 4. heart failure and other complications. The primary outcome was ACE presentation and incidence during the perioperative period. Secondary outcomes included the surgical outcome according to the Clavien–Dindo classification and trigeminocardiac reflex involvement. STATA version 17.0 and MetaProp were used to delineate proportion as effect size with a 95% confidence interval (CI). Results: Twelve studies (34,227 patients) were included. The incidence of perioperative ACEs was 2.58% (95% CI 1.70, 3.45, I 2 = 96.17%, P = 0.001). Heart rate and rhythm disturbances resulted in the greatest incidence at 3.84% among the four categories. Most commonly, these ACEs resulted in intensive care unit admission (i.e. Clavien–Dindo score of 4). Conclusion: Despite an incidence of 2.58%, ACEs can disproportionately impact surgical outcomes. Future research should include large-scale prospective studies that may provide a better understanding of the contributory factors and long-term effects of ACEs in patients during maxillofacial surgery.

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Drivers of hospital length of stay in 56,000 orthopaedic trauma patients: The impact of postoperative cardiac events

Cited by 3 publications

References 12 publications

Incidence and Risk Factors for Symptomatic Myocardial Ischemia After Posterior Decompressive Surgery for Degenerative Lumbar Disorders

Incidence and Risk Factors for Symptomatic Myocardial Ischemia After Posterior Decompressive Surgery for Degenerative Lumbar Disorders

Are Medicare's “Comprehensive Care for Joint Replacement” Bundled Payments Stratifying Risk Adequately?

Perioperative adverse cardiac events in maxillofacial surgery: A systematic review and meta-analysis

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