Improving stamina and mobility with preop walking in surgical patients with frailty traits –OASIS IV: randomized clinical trial study protocol

Frail older surgical patients face more than a two-fold increase in postoperative complications, including myocardial infarction, deep vein thrombosis, pulmonary embolism, pneumonia, ileus, and others. Many of...
Source: BMC Geriatrics - Category: Geriatrics Authors: Tags: Study protocol Source Type: research

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Authors: Gil JA, Goodman AD, Kleiner J, Walsh DF, Kosinski LR, Hsu R Abstract INTRODUCTION: The incidence of geriatric ankle fractures is rising. With the substantial variation in the physiologic and functional status within this age group, our null hypothesis was that mortality and complications of open reduction and internal fixation (ORIF) between patients who are aged 65 to 79 are equivalent to ORIF in patients who are aged 80 to 89. METHODS: Patients with ankle fracture were identified using the International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes. Patients treate...
Source: The Journal of the American Academy of Orthopaedic Surgeons - Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research
A striking feature of COVID-19 is the high frequency of thrombosis, particularly in patients who require admission to intensive care unit because of respiratory complications (pneumonia/adult respiratory distress syndrome). The spectrum of thrombotic events is wide, including in situ pulmonary thrombosis, deep-vein thrombosis and associated pulmonary embolism, as well as arterial thrombotic events (stroke, myocardial infarction, limb artery thrombosis). Unusual thrombotic events have also been reported, e.g., cerebral venous sinus thrombosis, mesenteric artery and vein thrombosis.
Source: Thrombosis Research - Category: Hematology Authors: Tags: Review Article Source Type: research
Objective: To evaluate inpatient outcomes among patients with hip fracture treated during the COVID-19 pandemic in New York City. Design: Multicenter retrospective cohort study. Setting: One Level 1 trauma center and one orthopaedic specialty hospital in New York City. Patients/Participants: Fifty-nine consecutive patients (average age 85 years, range: 65–100 years) treated for a hip fracture (OTA/AO 31, 32.1) over a 5-week period, March 20, 2020, to April 24, 2020, during the height of the COVID-19 crisis. Main Outcome Measurements: COVID-19 infection status was used to stratify patients. The primary o...
Source: Journal of Orthopaedic Trauma - Category: Orthopaedics Tags: Original Article Source Type: research
Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory distress syndrome coronavirus 2. This syndrome generally begins with respiratory symptoms that may progress to single-organ dysfunction (ie, respiratory failure) and then to multiorgan failure and death. In nonpregnant patients admitted to the intensive care unit with COVID-19 pneumonia, the frequency of venous thromboembolic disorders is 25% (20 of 81) detected by ultrasound examination of the lower extremities.1 In another series of 184 patients with confirmed COVID-19 pneumonia, 31% of patients had venous or arterial thromboembolism (defined as ac...
Source: American Journal of Obstetrics and Gynecology - Category: OBGYN Authors: Tags: Letter to the Editors Source Type: research
Authors: Aziz KT, Best MJ, Skolasky RL, Ponnusamy KE, Sterling RS, Khanuja HS Abstract Background: The number of patients with systemic lupus erythematosus (herein, lupus) undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA) is increasing. There is disagreement about the effect of lupus on perioperative complication rates. We hypothesized that lupus would be associated with higher complication rates in patients who undergo elective primary THA or TKA. Methods: Records of more than 6.2 million patients from the National Inpatient Sample who underwent elective primary THA or TKA from 2000 to 2...
Source: Clinics in Orthopedic Surgery - Category: Orthopaedics Tags: Clin Orthop Surg Source Type: research
ConclusionsThe overall VTE rate after CABG has been low. However, the condition has been associated with worse 30-day postoperative outcomes and complications. The independent predictors of VTE development included a history of bleeding disorders, congestive heart failure in the 30 days before surgery, and operative time of ≥310 minutes. Understanding these risk factors should aid physicians in the decisions regarding prophylaxis and treatment.
Source: Journal of Vascular Surgery: Venous and Lymphatic Disorders - Category: Surgery Source Type: research
In this study, approximately 10% of Transient STEMI had no culprit found:Early or late intervention in patients with transient ST ‐segment elevation acute coronary syndrome: Subgroup analysis of the ELISA‐3 trialOne must use all available data, including the ECG, to determine what happened.Final Diagnosis?If the troponin remained under the 99% reference, then it would be unstable angina.  If it rose above that level before falling, it would be acute myocardial injury due to ischemia, which is, by definition, acute MI.  If that is a result of plaque rupture, then it is a type I MI.  The clinical presentat...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
J Knee Surg DOI: 10.1055/s-0039-1693450There is a paucity of literature comparing the relative merits of open arthrotomy versus arthroscopy for the surgical treatment of septic knee arthritis. The primary goal of this study is to compare the risk of perioperative complications between these two surgical techniques. To this end, 560 patients treated for septic arthritis of the native knee with arthroscopy were statistically matched 1:1 with 560 patients treated with open arthrotomy. The outcome measures included major complications, minor complications, mortality, inpatient hospital charges, and length of stay (LOS). Major ...
Source: Journal of Knee Surgery - Category: Orthopaedics Authors: Tags: Original Article Source Type: research
Publication date: Available online 14 June 2019Source: Respiratory Medicine Case ReportsAuthor(s): Takashi Ishiguro, Keisuke Matsuo, Shinya Fujii, Noboru TakayanagiAbstractA 58-year-old man with previous myocardial infarction presented to our hospital with fever, cough, and dyspnea. PCR testing with nasopharyngeal swabs confirmed influenza virus infection, and enhanced computed tomography and transthoracic echocardiography revealed bilateral ground-glass opacities and consolidation, deep venous thrombosis, acute pulmonary artery embolism, and acute arterial embolism that appeared to originate from thrombus in the left vent...
Source: Respiratory Medicine Case Reports - Category: Respiratory Medicine Source Type: research
This study investigated if statins would similarly reduce postoperative arrhythmias in patients undergoing THA. METHODS:: We queried a large Medicare and private-payer database from 2005 to 2012 and identified 12,075 patients who were on a statin prior to THA. We then age and sex matched 34,446 non-statin users who underwent THA. Baseline comorbidities and postoperative complications were obtained and assessed via standard descriptive statistics. RESULTS:: The statin users had more preoperative comorbidities including congestive heart failure, valvular heart disease, pulmonary and renal disease, diabetes, hyperte...
Source: Hip International - Category: Orthopaedics Authors: Tags: Hip Int Source Type: research
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