Articles: postoperative-complications.
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Anaesth Intensive Care · Jan 2025
Association of medical emergency team activation in the 24-hour postoperative period with length of stay and in-hospital mortality.
Medical emergency team (MET) activations were designed to improve patient safety and outcomes by providing timely and specialised care to patients experiencing clinical deterioration. The primary objective of this study was to describe the association between MET events in the early (24-h) postoperative period and in-hospital mortality as well as length of stay. A retrospective data linkage study was performed of prospectively collected data from patient administrative data and the MET database at Launceston General Hospital located in Tasmania, Australia. ⋯ Notably, staff concern as a trigger for MET activation was associated with a hazard nearly as great as chest pain. Other MET triggers that reached statistical significance were bleeding, respiratory rate more than 36/min, peripheral oxygen saturations less than 84% and systolic blood pressure less than 80 mmHg. Despite being frequent, MET events should be regarded as a serious marker of an adverse patient journey that may warrant higher resource allocation.
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Pituitary neoplasms account for 15% of all intracranial neoplasms and affect 20% of the population. Disparities in treatment and outcomes may exist across racial, socioeconomic, and insurance groups, warranting further investigation. ⋯ Despite advancements in endoscopic endonasal pituitary surgery, disparities in access and outcomes persist across racial, socioeconomic, and insurance groups. These findings underscore the need for targeted interventions to address these inequalities and ensure equitable access to quality care.
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Preoperative anaemia is associated with poor postoperative outcomes; however, few studies have reported its prevalence in developing countries and its association with significant postoperative outcomes. ⋯ Institutional Review Board Registration number 40522820000005327 (Brazilian CEP/CONEP System, available in https://plataformabrasil.saude.gov.br/ ).
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Multicenter Study
Polygenic Score for the Prediction of Postoperative Nausea and Vomiting: A Retrospective Derivation and Validation Cohort Study.
Postoperative nausea and vomiting (PONV) is a key driver of unplanned admission and patient satisfaction after surgery. Because traditional risk factors do not completely explain variability in risk, this study hypothesized that genetics may contribute to the overall risk for this complication. The objective of this research is to perform a genome-wide association study of PONV, derive a polygenic risk score for PONV, assess associations between the risk score and PONV in a validation cohort, and compare any genetic contributions to known clinical risks for PONV. ⋯ Standardized polygenic risk was associated with PONV in all three of the study's models, but the genetic influence was smaller than exerted by clinical risk factors. Specifically, a patient with a polygenic risk score greater than 1 SD above the mean has 2 to 3% greater odds of developing PONV when compared to the baseline population, which is at least an order of magnitude smaller than the increase associated with having prior PONV or motion sickness (55%), having a history of migraines (17%), or being female (83%) and is not clinically significant. Furthermore, the use of a polygenic risk score does not meaningfully improve discrimination compared to clinical risk factors and is not clinically useful.