Outcomes after non-cardiac surgery: mortality, complications, disability, and rehospitalization

Amato, Bruno; Santoro, M Giannotti; Giugliano, Giuseppe; Servillo, Giuseppe; Nardo, Veronica Di; Domenico, Lorenza Di; Compagna, Rita; Izzo, Raffaele

doi:10.4081/monaldi.2017.840

Cited by 3 publications

(3 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Older age is a predictor of an increased risk of postoperative complications, prolonged hospitalization and mortality. Italian researchers indicate that it is necessary to pre-assess the nutritional status of patients due to the relationship between nutritional status and high risk of postoperative complication [27].…”

Section: Discussionmentioning

confidence: 99%

Nutritional Status of Elderly Patients after Coronary Artery Bypass Surgery

Ścisło

Bizoń

Walewska

et al. 2019

IJERPH

View full text Add to dashboard Cite

Surgical trauma can result in immobilization of biological material, degradation of muscle proteins, synthesis of acute-phase proteins in the liver, occurrence of catabolism phase and anabolism simultaneously, and as a consequence weight loss and nutritional deficiencies. The aim of this study was to assess the nutritional status of patients with ischemic heart disease subjected to coronary artery bypass surgery and physical activity and postoperative complications. The analysis among 96 men included total number of lymphocytes (TNL), body mass index (BMI), case history of a patient and results of laboratory tests. The activities of daily living (ADL) and the mini nutritional assessment (MNA) questionnaires were used. According to TNL, before the procedure malnutrition occurred in 46% of patients. BMI revealed overweight in 62.5% and obesity in 26.0%. After the surgery, no changes were observed. According to MNA, 59% of patients before the surgery were at risk of malnutrition. After the operation, the number of people at risk of malnutrition increased by 50% (p < 0.0001). The correlation was noted between BMI and patients’ efficiency in the fifth day after the surgery (p = 0.0031). Complications after the surgery occurred in 35.4% of patients. After the surgery, the risk of malnutrition increased, decreased activity and complications occurred more frequently in people with underweight, obesity, and overweight than in people with normal BMI.

show abstract

Section: Discussionmentioning

confidence: 99%

Nutritional Status of Elderly Patients after Coronary Artery Bypass Surgery

Ścisło

Bizoń

Walewska

et al. 2019

IJERPH

View full text Add to dashboard Cite

show abstract

“…The first series reported in the literature dates back to 1908 (Rolland) [8]: it describes 40 cases of hepatic artery aneurysms, mainly attributable to infectious origins, mostly in young patients. The advent of ultrasound, for both the diagnosis of abdominal pathologies and the control of pregnant women, has contributed to the early identification of aneurysmal dilations of the hepatic artery in an increasing number of cases [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Surgical treatment for common hepatic aneurysm. Original one-step technique

et al. 2020

Self Cite

View full text Add to dashboard Cite

IntroductionHepatic artery aneurysms are rare, and their treatment represents a challenge for the surgeons.Materials and methodsA new technique is presented for common hepatic artery (CHA) aneurysm: it requires minimal vascular surgical dissection and only one linear vascular stapler is applied at the bottom of aneurysm. Aneurysm exclusion is easily obtained, which allowed retrograde thrombosis. Liver blood supply is ensured to the right and left hepatic artery, through the gastroduodenal artery, and can be previously monitored, with temporary clamping of the section area, by visual control, enzyme evaluation and intraoperative ultrasound examination. We reported an open surgical treatment, with simultaneous removal of hepatic and adrenal metastases, secondary to colon cancer.ResultsThe duration of vascular surgery was 30 min and did not involve complications. Postoperative controls confirmed the efficacy of the procedure.DiscussionThis original technique can be added to the various open and endovascular techniques so far described for the treatment of a CHA aneurysm. It is advisable as open surgery, mostly in case of associated pathologies.ConclusionsThe authors believe that this “one shot” technique by vascular staple of the distal part of CHA is minimally invasive and effective to obtain the exclusion of the aneurysm.

show abstract

“…Functional decline during hospital stays has been welldocumented in older adults [1][2][3][4][5][6][7] . After 3 months post hospitalization for acute medical illness, up to 11% of older adults experienced mortality and 40% reported new activities of daily living (ADL) disabilities.…”

Section: Introductionmentioning

confidence: 99%

Debility Risk Model as a Predictor for Postsurgical Outcomes

Hanna

Nandra

Kustera

et al. 2020

The American Surgeon

View full text Add to dashboard Cite

Background Decreased patient functional status is associated with higher rates of postoperative morbidity and mortality. The Vizient program recently implemented a debility risk model to identify patients with impaired functional status. We examined the relationship between this novel model and inpatient postsurgical outcomes in a large urban tertiary care center. Methods The Vizient database was accessed to compare surgical outcomes between patients coded with debility and patients without debility between January 2017 and December 2018. Data for each surgical specialty were obtained, and a chi-squared analysis was used to detect differences in readmission rates, mortality, and postoperative complications (defined by Vizient). These complications include pneumonia, postoperative infection, anesthesia complications, and shock. Results We found patients with debility have a higher mortality rate (3%) than patients without debility (2%) across all surgical specialties ( P = .0103). Patients with debility have a higher 30-day readmission rate (16%) than those without debility (8%) across all specialties ( P < .0001). Patients with debility had a higher rate of inpatient complications for neurosurgery (12.11% vs. 8%, P = .008), trauma surgery (11.9% vs. 6%, P =.025), general surgery (17.67% vs. 7%, P = .013), and cardiac surgery (47.06% vs. 18%, P =.0025). Conclusions Our study supports the use of the Vizient debility code to predict postsurgical outcomes and risk stratify patients. By extension, functional status assessments in preoperative evaluation of patients remain important. Further, studies can build upon this data to measure the impact of preoperative, outpatient debility assessments in surgical patients.

show abstract

Outcomes after non-cardiac surgery: mortality, complications, disability, and rehospitalization

Cited by 3 publications

References 12 publications

Nutritional Status of Elderly Patients after Coronary Artery Bypass Surgery

Nutritional Status of Elderly Patients after Coronary Artery Bypass Surgery

Surgical treatment for common hepatic aneurysm. Original one-step technique

Debility Risk Model as a Predictor for Postsurgical Outcomes

Contact Info

Product

Resources

About