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Specialty: Orthopaedics
Condition: Renal Failure

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Total 25 results found since Jan 2013.

Intraoperative hypotensive resuscitation for patients undergoing laparotomy or thoracotomy for trauma: Early termination of a randomized prospective clinical trial
Conclusion: This study was unable to demonstrate that hypotensive resuscitation at a target MAP of 50 mm Hg could significantly improve 30-day mortality. Further study is necessary to fully realize the benefits of hypotensive resuscitation. LEVEL OF EVIDENCE: Therapeutic study, level II.
Source: The Journal of Trauma: Injury, Infection, and Critical Care - May 21, 2016 Category: Orthopaedics Tags: AAST 2015 Plenary Papers Source Type: research

Are Cardiac Complications Associated With Other Adverse Events? A Look at 56,000 Orthopaedic Trauma Patients.
Authors: Yarlagadda M, Shen M, Abraham A, Mousavi I, Sethi MK Abstract The purpose of this study was to identify those complications for which patients with adverse cardiac events are at risk within the 30-day postoperative period following treatment oforthopaedic trauma cases. This was a retrospective cohort study of orthopaedic trauma patients in the United States between 2006 and 2013. A total of 56,336 patients meeting any one of 89 CPT codes in the American College of Surgeons National Surgical Quality Improvement Program database were used. The main outcome measure was myocardial infarction or cardiac arrest ...
Source: Journal of surgical orthopaedic advances - November 30, 2018 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Modifying Risk Factors: Strategies that Work Diabetes Mellitus
An estimated 29.1 million Americans, representing 9.3% of the population, have diabetes with a projected increase to 48.3 million Americans by 2050. [1,2] Chronic hyperglycemia associated with diabetes is an established cause of retinopathy, nephropathy, neuropathy and vascular disease. [3] These chronic disease states lead in turn to significant sequelae, such as stroke, cardiovascular disease, renal failure and chronic wounds.
Source: The Journal of Arthroplasty - March 28, 2016 Category: Orthopaedics Authors: Louis S. Stryker Source Type: research

Embedding a trauma hospitalist in the trauma service reduces mortality and 30-day trauma-related readmissions
CONCLUSION: Our study provides evidence that embedding a hospitalist on the trauma service reduces mortality and trauma-related readmissions. A reason for these improved outcomes may be related to THOSP “vigilance.” LEVEL OF EVIDENCE: Therapeutic/care management study, level IV.
Source: The Journal of Trauma: Injury, Infection, and Critical Care - June 22, 2016 Category: Orthopaedics Tags: Original Articles Source Type: research

Incidence And Risk Factors For 30-Day Readmissions After Hip Fracture Surgery.
CONCLUSIONS: The overall rate of readmission following hip fracture surgery was moderate. Surgeons should consider discharge optimization in the at risk cohorts identified here, particularly patients with multiple medical comorbidities or an elevated ASA class, and should focus on wound complications and fall risks in order to minimize readmissions. Further, quality-reporting metrics should account for the risk factors identified here, in order to prevent penalties against surgeons who take on complex patients. PMID: 27528853 [PubMed - in process]
Source: Iowa orthopaedic journal - August 19, 2016 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

Risk Factors for 30-Day Unplanned Readmission and Major Perioperative Complications After Spine Fusion Surgery in Adults: A Review of the National Surgical Quality Improvement Program Database
Conclusion. This study provides benchmark rates of 30-day readmission based on diagnosis and procedure codes from a high-quality database for adult spinal fusion patients and showed increased rates of 30-day unplanned readmission and major perioperative complications for patients with specific risk factors. Targeted preoperative planning on modifiable risk factors with proportional reimbursement may promote higher-quality healthcare. Level of Evidence: 3
Source: Spine - October 1, 2016 Category: Orthopaedics Tags: Health Services Research Source Type: research

Medical Complications After Adult Spinal Deformity Surgery: Incidence, Risk Factors, and Clinical Impact
Conclusion. Risk factors for the development of postoperative medical complications after correction of ASD include smoking, hypertension, and duration of symptoms. Patients who have one or more of these risk factors should be identified and informed during informed consent of their increased risks. They should be optimized preoperatively, and followed closely during the postoperative period. Level of Evidence: 3
Source: Spine - November 12, 2016 Category: Orthopaedics Tags: Deformity Source Type: research

Coagulation Profile as a Risk Factor for 30-Day Morbidity and Mortality Following Posterior Lumbar Fusion
Study Design. A retrospective cohort study. Objective. The aim of this study was to identify associations between abnormal coagulation profile and postoperative morbidity and mortality in patients undergoing posterior lumbar fusion (PLF). Summary of Background Data. The literature suggests that abnormal coagulation profile is associated with postoperative complications, notably the need for blood transfusion. However, there is little research that directly addresses the influence of coagulation profile on postoperative complications following PLF. Methods. The American College of Surgeons National Surgical Quality Impro...
Source: Spine - June 15, 2017 Category: Orthopaedics Tags: Surgery Source Type: research

Safety of a High-Dose Tranexamic Acid Protocol in Complex Adult Spinal Deformity: Analysis of 100 Consecutive Cases
Conclusions This is the first study to demonstrate the use of high-dose TXA in a complex ASD population. Larger prospective studies are needed to assess the efficacy and safety of high-dose TXA in ASD. Level of Evidence Level IV, therapeutic.
Source: Spine Deformity - November 4, 2017 Category: Orthopaedics Source Type: research

The Association of Delirium with Perioperative Complications in Primary Elective Total Hip Arthroplasty.
Conclusions: Delirium is an independent risk factor for major and minor perioperative complications after primary elective THA. PMID: 30174803 [PubMed - in process]
Source: Clinics in Orthopedic Surgery - September 5, 2018 Category: Orthopaedics Tags: Clin Orthop Surg Source Type: research

Comparative Analysis of Short-Term Postoperative Complications in Outpatient Versus Inpatient Total Ankle Arthroplasty: A Database Study
This study evaluated the complication rates in inpatient versus outpatient TAA. It analyzed data from the National Surgical Quality Improvement Program for 591 patients who received TAA. Postoperative complication rates were compared between 66 outpatients and 535 inpatients. Frequencies of the following complications were analyzed: wound complications, pneumonia, hematologic complications (pulmonary embolism and deep vein thrombosis), renal failure, stroke, and return to the operating room within 30days. Unadjusted direct comparisons of the cohorts revealed higher complication rates in the inpatient cohort. Inpatients had...
Source: The Journal of Foot and Ankle Surgery - October 11, 2018 Category: Orthopaedics Source Type: research

30-Day adverse events, length of stay and re-admissions following surgical management of pelvic/acetabular fractures
ConclusionPatients with ASA grade > II, greater co-morbidity burden and prolonged operative times were likely to experience adverse events and have a longer length of stay. Surgeons can utilize this data to risk stratify patients so that appropriate pre-operative and post-operative medical optimization can take place.
Source: Journal of Clinical Orthopaedics and Trauma - February 14, 2019 Category: Orthopaedics Source Type: research

Can Elective Spine Surgery Be Performed Safely Among Nonagenarians?: Analysis of a National Inpatient Database in Japan
Study Design. Retrospective cohort study. Objective. To compare morbidity and mortality between nonagenarians and other older adult patients who underwent elective spine surgery. Summary of Background Data. There is a lack of information of the perioperative risks of nonagenarians undergoing spine surgery. Methods. Data of patients aged ≥65 years who underwent elective spine surgery from July 2010 to March 2013 were extracted from the Diagnosis Procedure Combination database, a nationwide administrative inpatient database in Japan. Clinical outcomes included mortality, occurrence of major complications (cardia...
Source: Spine - February 14, 2019 Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research

Effect of Heart Failure With Preserved Ejection Fraction on Perioperative Outcomes in Patients Undergoing Hip Fracture Surgery.
CONCLUSION: HFpEF confers a significant perioperative risk of MACCE in patients undergoing hip fracture surgery. PMID: 31259845 [PubMed - as supplied by publisher]
Source: The Journal of the American Academy of Orthopaedic Surgeons - July 3, 2019 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research