Articles: surgery.
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Randomized Controlled Trial Multicenter Study Comparative Study
Dexamethasone for Cardiac Surgery: A Practice Preference-Randomized Consent Comparative Effectiveness Trial.
High-dose corticosteroids have been used to attenuate the inflammatory response to cardiac surgery and cardiopulmonary bypass, but patient outcome benefits remain unclear. The primary aim was to determine whether using dexamethasone was superior to not using dexamethasone to increase the number of home days in the first 30 days after cardiac surgery. The secondary aim was to evaluate efficiency, value, and impact of the novel trial design. ⋯ Among patients undergoing cardiac surgery, high-dose dexamethasone decreased intensive care unit stay but did not increase the number of home days after surgery.
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Review Meta Analysis
Efficacy and safety of intraoperative controlled hypotension: a systematic review and meta-analysis of randomised trials.
While controlled intraoperative hypotension significantly reduces blood loss, existing trials are not adequately powered to investigate safety, particularly myocardial and renal injury.
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Anesthesia and analgesia · Nov 2024
Observational StudyA Prospective Observational Cohort Study of Language Preference and Preoperative Cognitive Screening in Older Adults: Do Language Disparities Exist in Cognitive Screening and Does the Association Between Test Results and Postoperative Delirium Differ Based on Language Preference?
A greater percentage of surgical procedures are being performed each year on patients 65 years of age or older. Concurrently, a growing proportion of patients in English-speaking countries such as the United States, United Kingdom, Australia, and Canada have a language other than English (LOE) preference. We aimed to measure whether patients with LOE underwent cognitive screening at the same rates as their English-speaking counterparts when routine screening was instituted. We also aimed to measure the association between preoperative Mini-Cog and postoperative delirium (POD) in both English-speaking and LOE patients. ⋯ We observed a disparity in the rates LOE patients were cognitively screened before surgery, despite the Mini-Cog being associated with POD in both English-speaking and LOE patients. Efforts should be made to identify barriers to cognitive screening in limited English-proficient older adults.
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Arch Orthop Trauma Surg · Nov 2024
ReviewPatient-reported outcome measures in studies on hallux valgus surgery: what should be assessed.
In recent years, there has been an increasing demand for patient-reported outcome measures (PROMs) to assess the outcome following orthopedic surgery. But, we are lacking a standard set of PROMs to assess the outcome of hallux valgus surgery. The aim of this study was to analyze the chosen patient rated outcome scores used in studies reporting on hallux valgus surgery. ⋯ Level I; systematic review of prospective comparative (level II) and randomized controlled trials (level I).
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Multicenter Study
Frailty and decisional regret after elective noncardiac surgery: a multicentre prospective cohort study.
Frailty is associated with patient surgical-regret at 1 year post-op among older patients, particularly for non-orthopaedic surgery.
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