Perioperative complications and mortality in elderly patients following surgery for femoral fracture: prospective observational study

ConclusionsIncreasing age and number of preoperative complications, in addition to ASA classification III or IV, were independent factors of increased risk of death in the population studied. The mortality rate was 30.8%, and infection followed by septic shock was the leading cause of death.ResumoJustificativa e objetivosO manejo perioperatório das fraturas de fêmur em pacientes idosos tem sido estudado com o intuito de determinar causas modificáveis de complicações e óbito. Este estudo tem por objetivo avaliar taxa de mortalidade e suas causas na população idosa com Fratura de fêmur (FF). Avaliamos também complicações perioperatórias e sua associação com mortalidade pós-operatória.MétodoNeste estudo prospectivo e observacional, avaliamos 182 pacientes, por questionário e prontuário eletrônico, desde o momento da internação até um ano após a cirurgia. Análises estatísticas pelo modelo multivariado de riscos proporcionais de Cox e curvas de Kaplan-Meier foram realizadas para detectar fatores independentes de mortalidade.ResultadosCinquenta e seis pacientes (30.8%) vieram a óbito em um ano de pós-operatório, sendo que a principal causa determinada de óbito foi infecção seguida de choque séptico. A principal complicação, tanto pr&eacu...
Source: Brazilian Journal of Anesthesiology - Category: Anesthesiology Source Type: research

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BACKGROUND Early appropriate antibiotic therapy is an important component of the Surviving Sepsis Guidelines bundles that are associated with decreased in-hospital mortality. National antibiotic guidelines for the treatment of sepsis in Sweden have been available since 2008. Compliance with these guidelines is largely unknown, and whether it translates to improved patient outcome has not been studied. OBJECTIVE To assess mortality and its relationship to compliance with Swedish antibiotic guidelines. A secondary aim was to assess the effect of timing of antibiotic administration and mortality. DESIGN A registry-bas...
Source: European Journal of Anaesthesiology - Category: Anesthesiology Tags: Intensive care medicine Source Type: research
ConclusionInterventional paediatric catheterisation has grown remarkably in Morocco. These procedures have become the treatment of choice for many cardiac lesions, and serve as alternatives or adjuncts to surgical treatment.
Source: Archives of Cardiovascular Diseases Supplements - Category: Cardiology Source Type: research
Publication date: Available online 2 January 2020Source: Anesthesiology ClinicsAuthor(s): Nibras Bughrara, Stephanie Cha, Radwan Safa, Aliaksei Pustavoitau
Source: Anesthesiology Clinics - Category: Anesthesiology Source Type: research
In conclusion, the application of VA-ECMO in this model of peritonitis-induced refractory vasodilatory septic shock aggravated hemodynamic deterioration. Our findings contribute to increasing equipoise with respect to the clinical utility of VA-ECMO in refractory vasodilatory shock.
Source: Shock - Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research
Conclusions: StO2 prognosticates survival and favorable/unfavorable outcomes in neurological patients with sepsis. The role of rSO2 in predicting survival in milder form of sepsis is doubtful.
Source: Journal of Neurosurgical Anesthesiology - Category: Anesthesiology Tags: Clinical Reports Source Type: research
In an acute endotoxic septic shock sheep model, we studied the effects of esmolol (an ultrashort acting ß1‐selective adrenoceptor antagonist) administration on renal blood flow and the static and dynamic renal autoregulation during acute septic shock. Our data reveal that both the resuscitated endotoxin shock and the β‐blocker infusion left the renal autoregulation parameters unchanged. However, esmolol reduced the perfusion pressure to critical values thereby significantly reducing renal blood flow. AbstractClinical data suggests that heart rate (HR) control with selective β1‐blockers may improve car...
Source: Physiological Reports - Category: Physiology Authors: Tags: ORIGINAL RESEARCH Source Type: research
Publication date: December 2019Source: Anaesthesia Critical Care &Pain Medicine, Volume 38, Issue 6Author(s): Marc Leone, Gary Duclos, Vincent Bruckert, Sharon Einav
Source: Anaesthesia, Critical Care and Pain Medicine - Category: Anesthesiology Source Type: research
Conclusions In apost hoc analysis of the ADRENAL trial participants who fulfilled either the Sepsis-3 or the APROCCHSS inclusion criteria, a continuous infusion of hydrocortisone did not result in a lower 90-day mortality than placebo in septic shock.
Source: Anesthesiology - Category: Anesthesiology Source Type: research
We report a case of a 59-year-old female patient with vegetative native mitral valve endocarditis caused by Stenotrophomonas maltophilia (SM). She had hemodialysis-dependent chronic renal failure, but no immunosuppressive disease. Echocardiography showed mobile vegetation on her native mitral valve. Right femoral artery embolectomy and mitral valve replacement were performed simultaneously. She awakened from anesthesia, but she passed away due to septic shock complications. To the best of our knowledge, this was the first case in whom native mitral valve endocarditis caused by SM was observed (despite of absence of any imm...
Source: Revista Brasileira de Cirurgia Cardiovascular - Category: Cardiovascular & Thoracic Surgery Source Type: research
ConclusionIn this large observational study using a national clinical database, obese patients undergoing PD for head of pancreas cancer had increased risk of postoperative complications and mortality in comparison to controls.
Source: The American Journal of Surgery - Category: Surgery Source Type: research
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