Irish journal of medical science
-
Fondaparinux is a synthetic anticoagulant that inhibits thrombosis by suppressing factor Xa. The efficacy of fondaparinux for orthopedic surgeries has been revealed by several foreign studies; however, relevant evidence in Chinese patients is lacking. This study intended to investigate the occurrence rate and risk factors of in-hospital venous thromboembolism (VTE), major bleeding, and death in patients receiving fondaparinux after orthopedic surgery or trauma surgery. ⋯ The occurrence rates of in-hospital VTE, major bleeding, and death were 2.5%, 21.8%, and 0.0%, respectively. The multivariate logistic regression analysis revealed that only age (> 60 years vs. ≤ 60 years) (odd ratios (OR) = 3.380, P = 0.013) was independently correlated with increased risk of in-hospital VTE. Additionally, osteoarthritis diagnosis (OR = 3.826, P < 0.001), femoral head necrosis diagnosis (OR = 1.809, P = 0.034), hip replacement (vs. internal fracture fixation) (OR = 2.199, P = 0.007), knee replacement (vs. internal fracture fixation) (OR = 2.781, P = 0.002), and serum creatinine (abnormal vs. normal) (OR = 1.677, P = 0.012) were independently linked to a higher risk of in-hospital major bleeding. Moreover, the common adverse events included pain (56.6%), wound bleeding (23.0%), increased drainage (5.2%), etc. CONCLUSION: Fondaparinux realizes low occurrence rates of in-hospital VTE and major bleeding with tolerable adverse events in patients receiving orthopedic surgery or trauma surgery.
-
Measuring and monitoring safety (MMS) is critical to the success of safety improvement efforts in healthcare. However, a major challenge to improving safety is the lack of high quality information to support performance evaluation. ⋯ There are a wide range of methods of MMS in Irish hospitals. It is suggested that there is a need to identify those methods of MMS that are particularly useful in reducing harm and supporting action and improvement and do not place a large burden on healthcare staff to either use or interpret.
-
Observational Study
Comparison of syncope risk scores in predicting the prognosis of patients presenting to the emergency department with syncope.
Various scores have been derived for the assessment of syncope patients in the emergency department (ED). ⋯ The CSRS may be used as a safety risk score for a 30-day risk of MACE and mortality after discharge from the emergency department.
-
Slow gait speed (GS) is a marker of functional decline and overall poor health status and could be considered as possible sarcopenia. Early detection with modified treatable causes is likely to lessen adverse health outcomes in older adults. ⋯ Slow gait speed was frequent among older patients in an outpatient setting indicating of a high prevalence of patients with poor physical performance and impending frailty. Increasing age, presence of CVA, and cognitive decline were associated with slow GS. Interventions concentrating on the amendable factors might help to reduce unfavorable health consequences.
-
We aim to evaluate the impact of the COVID-19 pandemic on ocular oncology in Ireland, comparing uveal melanoma trends in 2019 to 2020. ⋯ More advanced disease is suggested by the increased mean basal diameter and tumour thickness, extra-scleral extension and longer duration of brachytherapy. Time from diagnosis to treatment was not delayed in 2020.