Articles: post-operative.
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To assess postoperative pain intensity in adults, the numeric rating scale (NRS) is used. This scale has shown acceptable psychometric features, although its scale properties need further examination. We aimed to evaluate scale properties of the NRS using an item response theory (IRT) approach. ⋯ Response categories on the NRS are ordered but have different widths. The interval scale properties of the NRS should be questioned. In dealing with missing linearity in pain intensity ratings using the NRS, IRT methods may be helpful.
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Multicenter Study Observational Study
Lung Ultrasound Score on Postoperative Day One is predictive of the occurrence of Pulmonary Complications After Major Abdominal Surgery: A Multi-Center Prospective Observational Study.
Postoperative pulmonary complications after major abdominal surgery are frequent and carry high morbidity and mortality. Early identification of patients at risk of pulmonary complications by lung ultrasound may allow the implementation of preemptive strategies. The authors hypothesized that lung ultrasound score would be associated with pulmonary postoperative complications. The main objective of the study was to evaluate the performance of lung ultrasound score on postoperative day 1 in predicting pulmonary complications after major abdominal surgery. Secondary objectives included the evaluation of other related measures for their potential prediction accuracy. ⋯ An elevated lung ultrasound score on postoperative day 1 is associated with the occurrence of pulmonary complications within the first 10 days after major abdominal surgery.
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Anesthesia and analgesia · Mar 2024
Association of Obstructive Sleep Apnea With Postoperative Delirium in Procedures of Moderate-to-High Complexity: A Hospital-Registry Study.
Patients suffering from obstructive sleep apnea (OSA) experience chronic sleep disturbances and desaturation, factors that have been associated with postoperative delirium and that can be aggravated after anesthesia for complex procedures. We investigated whether OSA is associated with delirium after anesthesia, and whether this association is modified by procedural complexity. ⋯ Compared to non-OSA patients, a history of OSA is associated with a higher risk after high-complexity procedures such as cardiac or thoracic surgery but not after procedures of moderate complexity.
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Sleep disturbances in the peri-operative period have been associated with adverse outcomes, including postoperative delirium (POD). However, research on sleep quality during the immediate postoperative period is limited. ⋯ The poor subjective sleep quality on the night of operative day was independently associated with increased POD risk, especially in certain subpopulations. Optimising peri-operative sleep may reduce POD. Further research should investigate potential mechanisms and causal relationships.
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Patients undergoing cardiac surgery are subject to infectious complications that adversely affect outcomes. Rapid identification is essential for adequate treatment. Procalcitonin (PCT) is a noninvasive blood test that could serve this purpose, however its validity in the cardiac surgery population is still debated. We therefore performed a systematic review and meta-analysis to estimate the accuracy of PCT for the diagnosis of postoperative bacterial infection after cardiac surgery. ⋯ These results suggest that PCT may be used to help rule out infection after cardiac surgery. The optimal threshold of 3 ng/mL identified in this work should be confirmed with large, well-designed randomized trials that evaluate the test's impact on health outcomes and on the use of antibiotic therapy. PROSPERO Registration number CRD42023415773. Registered 22 April 2023.