Articles: cations.
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To assess rates of surgical complications and postoperative readmission in diabetic patients with and without active perioperative prescriptions for GLP-1 RA medications. ⋯ An active perioperative GLP-1 RA prescription in patients with diabetes was associated with significant reductions in risk-adjusted readmission, wound dehiscence, and hematoma, and no difference in infection and bleeding rates. Further study is warranted to elucidate any causal association.
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The win ratio analysis method might provide new insight on the impact of positive end-expiratory pressure (PEEP) on clinical outcomes. ⋯ Clinicaltrials.gov (study identifier NCT03937375).
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The integration of enhanced recovery after surgery (ERAS) protocols into the peri-operative management of video-assisted thoracic surgery (VATS) has facilitated rapid patient recovery, enabling discharge within 48 h. However, postoperative pulmonary complications (PPCs) postdischarge pose significant concerns for patient welfare. Despite the established utility of lung ultrasound (LUS) in diagnosing the causes of dyspnoea, the effectiveness of quantitative LUS in predicting PPCs after VATS remains uncertain. ⋯ LUSS on POD 1 emerged as an independent risk factor for PPCs in fast-track VATS patients and reliably predicted the occurrence of PPCs within 30 days of hospital discharge.
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Anesthesia and analgesia · Dec 2024
The Impact of Medicaid Expansion on Congenital Heart Surgery Outcomes: Data From the Society of Thoracic Surgeons Database.
The Affordable Care Act expanded Medicaid eligibility and increased public insurance coverage for children across the United States. As only a subset of states adopted expansion of coverage, disparities in insurance coverage between expansion and nonexpansion states emerged. We examined the association between Medicaid expansion and cardiac surgery outcomes to understand the impact of Medicaid expansion in a medically complex pediatric population. We hypothesized that expansion of Medicaid eligibility would be associated with greater improvement in surgical outcomes. ⋯ There was an overall decline in congenital heart surgery mortality over time; however, states that expanded Medicaid eligibility did not experience a greater improvement in mortality relative to states that did not expand eligibility. Similarly, there was no significant difference in major complications or PLOS related to Medicaid expansion. Further studies are needed to examine long-term outcomes and the larger spectrum of accessibility to congenital cardiac care which may benefit from insurance coverage.