British journal of anaesthesia
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Multicenter Study Comparative Study
Using the 6-minute walk test to predict disability-free survival after major surgery.
The 6-min walk test (6MWT) is a common means of functional assessment. Its relationship to disability-free survival (DFS) is uncertain. ⋯ Of the risk assessment tools analysed, the DASI was the most predictive of DFS. The 6MWT was safe and comparable with cardiopulmonary exercise testing for all predictive assessments. Future research should aim to determine the optimal 6MWT distance thresholds for risk prediction.
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Letter Observational Study
Residual neuromuscular block in paediatric anaesthesia.
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Randomized Controlled Trial Multicenter Study
Patient coping and expectations predict recovery after major orthopaedic trauma.
Persistent post-surgical pain and associated disability are common after a traumatic fracture repair. Preliminary evidence suggests that patients' beliefs and perceptions may influence their prognosis. ⋯ NCT00788398.
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Observational Study
Development and evaluation of an obstetric quality-of-recovery score (ObsQoR-11) after elective Caesarean delivery.
Whilst validated quality-of-recovery (QoR) tools exist for general surgery, there is no specific obstetric equivalent. We aimed to develop and evaluate a modified QoR score after elective Caesarean delivery. ⋯ The ObsQoR-11 provides a valid, reliable, and responsive global assessment of recovery after elective Caesarean delivery.
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Thrombocytopenia is a common perioperative clinical problem. While global haemostasis is influenced by many patient- and procedure-related factors, the contribution of thrombocytopenia to bleeding risk is difficult to predict, as platelet count does not linearly correlate with likelihood of bleeding. Thus, the widely used definition of thrombocytopenia and grading of its severity have limited clinical utility. ⋯ The benefits and risks of preoperative platelet transfusions should be assessed on a patient-by-patient basis, and alternatives to platelet transfusion should be considered. In non-emergent surgeries or in postoperative thrombocytopenic patients, haematology consultation should be considered to guide diagnostics and management. We present a pragmatic approach to the evaluation of perioperative thrombocytopenia.