Zentralblatt für Chirurgie
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Hospital-acquired infections affect 7% to 10% of hospitalized patients and account for approximately 80,000 deaths per year in the United States. Of all infections acquired in the hospital, more than 20% occur in intensive care unit patients. ⋯ The focus of this paper is to review the epidemiology of hospital-acquired infections that occur in the surgical ICU, particularly ventilator associated pneumonia, catheter-associated urinary tract infection, and catheter-related bloodstream infection, and to discuss ICU-related prevention strategies. By implementing effective preventative measures and maintaining strict surveillance of ICU infections, we hope to affect the associated morbidity, mortality, and cost that our patients and society bare.
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Comparative Study
[Does Charlson-comorbidity index correlate with short-term outcome in patients with gastric cancer?].
Because of the high prevalence of coexisting medical conditions in patients with gastrointestinal cancer, clinical investigators often need to adjust for comorbidity when assessing the effect of comorbidity on patient outcome. Comorbidity in cancer has been shown to be a major determinant in treatment selection and survival. However, none of the comorbidity studies in patients with gastric cancer reported in the literature have been performed using the Charlson comorbidity index. The purpose of this study was to examine the applicability of the CCI and usefulness of the CCI as a predictor in patients with gastric cancer and to examine whether it correlates with short- term outcome in these patients. ⋯ The method of classifying comorbidity by CCI provides a simple, readily applicable and valid method of estimating risk of death from comorbid disease for use in longitudinal studies and in outcomes research from administrative databases. In gastric cancer, however, the CCI was found not to be a valid prognostic indicator.
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The aim of this study was to perform a risk analysis on the basis of routinely documented variables (age, sex, ASA-classification, priority of operation, malignant disease, intraperitoneal or intrathoracic operation and duration of operation) to identify surgical patients who benefit from a more complex risk assessment. ⋯ The ASA-classification is a good instrument for the assessment of perioperative mortality. Its predictive power can substantially be improved in the classes 2 to 4 by the variables age, duration of operation, intraperitoneal or intrathoracic operation, priority of operation, and malignant disease.
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Sequestration is defined as an area of abnormal pulmonary tissue not connected with the bronchial tree, supplied by an aberrant systemic artery and without a normal pulmonary function. Extralobar (ELS) and intralobar (ILS) forms are distinguished. During the year 2002 the authors diagnosed and operated upon two cases of the intralobar form of pulmonary sequestration, and in last 25 years five cases - 4 x ILS and 1 x ELS. ⋯ In one case the diagnosis was made on the basis of angiography and computer tomography, in the other case it was made on the basis of multidetector CT angiography (MDCTA). Both findings were treated by primary surgical intervention lobectomy. The postoperative course was uneventful.