Archives of surgery (Chicago, Ill. : 1960)
-
Review Meta Analysis
Effect of perioperative statins on death, myocardial infarction, atrial fibrillation, and length of stay: a systematic review and meta-analysis.
To assess the influence of perioperative statin treatment on the risk of death, myocardial infarction, atrial fibrillation, and hospital and intensive care unit length of stay in statin-naive patients undergoing cardiac or noncardiac surgery. ⋯ Perioperative statin treatment in statin-naive patients reduces atrial fibrillation, myocardial infarction, and duration of hospital stay. Wider use of statins to improve cardiac outcomes in patients undergoing high-risk procedures seems warranted.
-
To characterize contemporary use of tranexamic acid (TXA) in combat injury and to assess the effect of its administration on total blood product use, thromboembolic complications, and mortality. ⋯ The use of TXA with blood component-based resuscitation following combat injury results in improved measures of coagulopathy and survival, a benefit that is most prominent in patients requiring massive transfusion. Treatment with TXA should be implemented into clinical practice as part of a resuscitation strategy following severe wartime injury and hemorrhage.
-
Comparative Study
Predicting in-hospital mortality in patients undergoing complex gastrointestinal surgery: determining the optimal risk adjustment method.
To compare the performance of Charlson/Deyo, Elixhauser, Disease Staging, and All Patient Refined Diagnosis-Related Groups (APR-DRGs) algorithms for predicting in-hospital mortality after 3 types of major abdominal surgeries: gastric, hepatic, and pancreatic resections. ⋯ Different comorbidity algorithms were validated in the surgical setting. The Disease Staging and APR-DRGs algorithms were highly accurate. For commonly used algorithms such as Charlson/Deyo and Elixhauser, the latter showed higher accuracy.
-
Patients with inflammatory bowel disease (IBD) undergoing surgery are at increased risk for postoperative thromboembolism, including deep vein thrombosis (DVT), pulmonary embolism (PE), myocardial infarction, and stroke. ⋯ Patients with IBD are at increased risk for developing postoperative DVT or PE. This risk persists when potential confounding variables are controlled for. Risk of DVT or PE appears to be even higher for patients with IBD who are having nonintestinal surgery. Cardiac and stroke risks do not appear to be increased by IBD. Perhaps standards for DVT and PE prophylaxis in these cases should be reconsidered.