AI Beats Out Clinicians in Triaging Postoperative Patients for ICU
How good is artificial intelligence in decision-making? Not bad according to findings from a pilot study that was recently presented at the American College of Surgeons Clinical Congress 2019. Findings from the study show AI in the form of a machine-learned algorithm correctly triaged the vast majority of postoperative patients to the intensive care unit in its first proof-of-concept application in a university hospital setting. As it stands now surgical teams typically rely on clinical judgment to decide which patients need postoperative intense care because there is no single set of fixed criteria to make the determination. The result is that clinicians typically over-triage, meaning if they are in doubt, they err on the side of caution and send a patient to intensive care. However, over-triaging may result in admitting a patient to the ICU who doesn't need to be there. "In those cases, the patient may be unnecessarily exposed to multidrug-resistant bacteria and have an increased overall length of stay. On the other hand, under-triaging means a patient that should have been in the ICU is sent to a recovery or step-down unit, and the opportunity for quick rescue of a deteriorating condition is delayed because monitoring is not as intense," Marcovalerio Melis, MD, FACS, an associate professor of surgery, New York University Langone Hospital System, New York City, and coauthor of the pilot study, said in a release. The resulting algorithm included 87 clinical variabl...
Authors: Schulte C, Zeller T Abstract Cardiovascular (CV) risk assessment is based on the utilization of risk scores, enabling clinicians to estimate an individual's risk to develop CV pathologies and events. Such risk scores comprise classic CV risk factors such as smoking, diabetes, hypertension, and blood cholesterol levels. Recently, other CV biomarkers such as cardiac troponins have been suggested and evaluated as alternative biomarkers not only in the acute diagnostic setting of myocardial infarction, but also as markers for risk stratification in the general population. In this review, we summarize the curre...
CONCLUSIONS: CMV infection was not associated with impaired long-term prognosis after HT. PMID: 31806387 [PubMed - as supplied by publisher]
Authors: Hendriksen E, Slagt C PMID: 31807062 [PubMed]
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Conclusions: CPLNs intraoperative assessment is less accurate during IDS compared to previous PDS studies. CPLNs removal during IDS after NACT for stage IV OC could be safely performed to achieve a complete resection. PMID: 31809609 [PubMed - as supplied by publisher]
ConclusionsA positive effect of the Mediterranean diet, and fruit and vegetable intake was observed on hsCRP and the occurrence of effective myocardial reperfusion. These findings confirm the favorable impact of Mediterranean diet adherence not only in primary but also in secondary prevention.
Conclusion: Anterior approach following intraoperative reduction monitored by somatosensory-evoked potentials under general anesthesia for cervical dislocation and locked facets is a relatively safe and effective alternative when cervical alignment is achieved by intraoperative reduction. PMID: 31805759 [PubMed - as supplied by publisher]
Authors: Dahaba AA Abstract Numerous clinical conditions that have a direct effect on electroencephalography (EEG) cerebral function could also directly influence brain function monitors (BFM) indices. There is no conventional comparator technology for BFM assessment. The conventional comparator technology used as a benchmark for assessing BFMs technologies chosen by the UK National Institute for Health and Care Excellence (NICE) to reflect the currently used standards in the National Health Service (NHS), was demarcated as "standard anesthetic clinical monitoring" and precisely defined as "the combi...
In conclusion, the role of the anesthetist should be to supervise endoscopy activities at every level. PMID: 31808663 [PubMed - as supplied by publisher]
Authors: Lionetti V, Barile L Abstract Over the last 20 years increasing number of patients with multimorbidity and polypharmacy underwent different types of elective non-cardiac and cardiac surgery. Despite surgery is safer today than in the past, rate of perioperative major adverse cardiovascular events is still attracting significant attention from both clinicians and researchers. The perioperative myocardial infarction (PMI), a permanent damage of the heart, is a major cause of short and long term morbidity and mortality in current surgical populations. Although it is primarily the result of local myocardial is...
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