Early morbidity and mortality after one-stage bilateral THA: Anterior versus posterior approach

The objective of this retrospective study in a uniform patient population was to compare the anterior and posterior approaches for 1B-THA in terms of: 1) early mortality rates, 2) early complications, 3) and 90-day re-admission rates, hospital stay lengths, and blood loss.Hypothesis1B-THA in patients younger than 80 years who have an ASA score of 1 or 2 is associated with no early mortality and with low early morbidity rates regardless of whether the anterior or posterior approach is used.Material and methodsA single-centre retrospective comparative design was used to assess 90-day mortality and morbidity rates in consecutive patients who underwent 1B-THA between 2004 and 2018. The groups managed with the anterior approach (AA) without traction table and posterior approach (PA) were compared. The ASA score was ≤ 2 and age ≤ 80 years in all patients. The groups were comparable for age, sex distribution, ASA score, pre-operative haemoglobin level, and reason for THA.ResultsWe included 55 patients managed via the AA and 82 managed via the PA. No patients died in either group. Early complications occurred in 3 patients in the AA group and 6 in the AP group (p = 0.74). No differences were noted between the two groups for each type of complication. In the AA group, 3 patients experienced major complications (p = 0.06) (2 cerebrovascular events and 1 peri-prosthetic fracture). In the PA group, 6 patients experienced minor complications (1 case eac...
Source: Orthopaedics and Traumatology: Surgery and Research - Category: Orthopaedics Source Type: research

Related Links:

Major hemorrhage is a common presenting diagnosis for admission to the hospital, but it can also occur during hospitalization without provocation or as a complication of anticoagulant use. Full-dose anticoagulant use is known to be the most important risk factor for in-hospital gastrointestinal bleed (GIB) [1]. The ability to distinguish between hemorrhage that develops prior to hospitalization vs. hemorrhage associated with hospitalization is important for accurate quality assessment [2]. Additionally, some hospital-associated conditions, such as pressure ulcer or catheter-associated urinary tract infection, cannot be use...
Source: Thrombosis Research - Category: Hematology Authors: Tags: Letter to the Editors-in-Chief Source Type: research
ConclusionsSufficient nurse staffing and higher professional titles of nurses might contribute to reducing the incidence of major immobility complications. Nurse experience was not related to the incidence of major immobility complications. However, the association between nurse education level and the incidence of major immobility complications requires further investigation.This article is protected by copyright. All rights reserved.
Source: Journal of Nursing Management - Category: Nursing Authors: Tags: Original Article Source Type: research
Conclusionsand recommendations: Based on the data and the literature revision, skin or skeletal traction for patients with proximal femoral fractures should be discouraged as standard practice. This is supported widely in the internationally literature, and consideration of knowledge translation strategies should be made to refine current practice in these settings.
Source: International Journal of Orthopaedic and Trauma Nursing - Category: Nursing Source Type: research
ConclusionsEarly treatment, prevention of associated complications and individualized patient-targeted rehabilitation programs provided by a specialized interdisciplinary team are crucial to optimize the outcome after SCI.
Source: World Journal of Urology - Category: Urology & Nephrology Source Type: research
Rationale: Pelvic exenteration is considered a method to treat central recurrent or persistent gynecologic malignancy after the initial therapy. The postoperative survival rate has been greatly increased by the improvement in the surgical technology and the perioperative management. Yet various complications are still impacting the quality of life. New technologies such as robotic surgery system made it possible to approach radical surgical resection by using a minimally invasive method. Patient concerns: The patient is a 53-year-old female with the cervical adenocarcinoma pelvic recurrence who had undergone the adjuv...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Authors: Rajborirug K, Tumviriyakul H, Suwanno J Abstract Background: Several trials have verified the benefits of stroke unit (SU) in acute stroke care worldwide. Objective: Compare clinical outcomes and costs of care in acute ischemic stroke patients who were ineligible for thrombolytic treatment (recombinant tissue plasminogen activator-rt PA) in a primary stroke center. Material and Method: A prospective study was conducted in acute ischemic stroke patients, aged 15 years old and above, presenting within 72 hours of onset. At discharge, neurological and medical complications, mortality rate, National In...
Source: Journal of the Medical Association of Thailand = Chotmaihet thangphaet - Category: General Medicine Tags: J Med Assoc Thai Source Type: research
Conclusion: The prevalence of complications was high. The findings are important for future quality improvement of the rehabilitation trajectory and for further studies that explore the high frequency of complications.
Source: Journal of Neuroscience Nursing - Category: Neuroscience Tags: Article Source Type: research
Rigid cervical spine (Csp) immobilization is commonly used in patients presenting to the Emergency Department with blunt trauma. Common practice guidelines such as the NEXUS rule do not allow Csp clearance for intoxicated patients. Such patients are often subject to prolonged Csp immobilization even after negative computed tomography (CT) imaging which subjects them to risks including aspiration, pneumonia, deep vein thrombosis, pressure ulcers, increased agitation and more.
Source: The Journal of Emergency Medicine - Category: Emergency Medicine Authors: Tags: Abstract Source Type: research
Decreased mobilization of hospitalized patients results in hospital-acquired functional decline and worse patient outcomes, including pressure injuries (formerly called pressure ulcers or decubitus; Edsberg et  al., 2016), injury from falls, hospital-acquired pneumonia, delirium, venous thromboembolism, increased rehabilitation need, prolonged hospitalization, and increased medical care costs (Chandrasekaran, Ariaretnam, Tsung,&Dickison, 2009; de Morton, Keating,&Jeffs, 2007; Kalisch, Lee,&Dabney, 2014; Kamel, Iqbal, Mogallapu, Maas,&Hoffmann, 2003; Liu, Almaawiy, Moore, Chan,&Straus, 2013; Mudge, ...
Source: Nursing Outlook - Category: Nursing Authors: Source Type: research
ConclusionClinical nurses have relatively positive attitudes but inadequate knowledge regarding major immobility complications. Improved knowledge and attitudes regarding major immobility complications may contribute to reducing these complications. Relevance to clinical practiceNursing managers should implement measures to improve nurses’ knowledge and attitudes regarding major immobility complications to reduce the incidence of these complications in bedridden patients.This article is protected by copyright. All rights reserved.
Source: Journal of Clinical Nursing - Category: Nursing Authors: Tags: Original Article Source Type: research
More News: Anesthesia | Anesthesiology | Blood Transusion | Hospitals | Orthopaedics | Pressure Sores | Rehabilitation | Study | Thrombosis