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Preoperative Pulmonary Risk Stratification

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1. Preoperative Pulmonary Risk Stratification

Preoperative Pulmonary Risk Stratification Preoperative Pulmonary Risk Stratification Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 (...) Preoperative Pulmonary Risk Stratification Preoperative Pulmonary Risk Stratification Aka: Preoperative Pulmonary Risk Stratification , Perioperative Pulmonary Complication Risk Factors II. Indications regarding pulmonary surgical risk for elective non-cardiac surgery Review with patient if benefits of procedure outweigh risks III. Risk Factors: Perioperative Pulmonary Complication Risk Factors by Patient Factors (Odds Ratio) Current Smoking: 1.4 American College of Anesthesiologists (ASA) Class II

2018 FP Notebook

2. A Risk Stratification Model for Cardiovascular Complications during the 3-Month Period after Major Elective Vascular Surgery (PubMed)

A Risk Stratification Model for Cardiovascular Complications during the 3-Month Period after Major Elective Vascular Surgery The Revised Cardiac Risk Index (RCRI) is an extensively used simple risk stratification tool advocated by the European Society of Cardiology and European Society of Anesthesiology (ESC/ESA).The aim of this study was to find the best model for predicting 3-month cardiovascular complications in elective major vascular surgical patients using preoperative clinical assessment (...) (AUC 0.909, p<0,001). By adding NT pro-BNP concentrations to the RCRI+hs TnI+V-POSSSUM combination we obtained the model with the best predictive power for 3-month cardiac complications (AUC 0.963, p<0,001).We need to improve preoperative risk assessment in participants scheduled for major vascular surgery by combining their clinical scores with biomarkers. Therefore, it is possible to identify patients at risk of cardiovascular complications who need adequate preoperative diagnosis and treatment.

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2018 BioMed research international

3. Preoperative or Postoperative Therapy for the Management of Patients with Stage II or III Rectal Cancer

; 25Gy in 5 fractions) RT alone followed by surgery guided by the risk of adverse effects. ? Patients eligible for preoperative RT+/-CT should also be considered for adjuvant CT. Postoperative Therapy ? Patients with resected stage II or III rectal cancer who have not received preoperative RT should be offered postoperative therapy with concurrent CRT in addition to fluoropyrimidine-based CT. The evidence reviewed demonstrates that this treatment improves survival and reduces local recurrence rates (...) presuppose adequate preoperative staging investigations, including transrectal ultrasound and/or magnetic resonance imaging (MRI) with surface or endorectal coil to assess the T category, MRI with surface or endorectal coil to assess the N category, a good digital rectal exam, computerized axial tomography (CAT) scan or MRI to assess the mesorectal margin, CAT scan or MRI of the abdomen to assess for potential metastatic or stage IV disease, and chest x-ray for pulmonary imaging. ? Potential inaccuracies

2019 Cancer Care Ontario

4. Risk Stratification for Major Postoperative Complications in Patients Undergoing Intra-abdominal General Surgery Using Latent Class Analysis. (PubMed)

Risk Stratification for Major Postoperative Complications in Patients Undergoing Intra-abdominal General Surgery Using Latent Class Analysis. Preoperative risk stratification is a critical element in assessing the risks and benefits of surgery. Prior work has demonstrated that intra-abdominal general surgery patients can be classified based on their comorbidities and risk factors using latent class analysis (LCA), a model-based clustering technique designed to find groups of patients (...) to classify patients undergoing intra-abdominal general surgery based on preoperative risk factors, and the classes are independently associated with postoperative complications. However, model performance is not uniform across individual complications, resulting in variations in the utility of preoperative risk stratification tools depending on the complication evaluated.

2017 Anesthesia and Analgesia

5. Speckle-tracking Echocardiography Improves Pre-Operative Risk Stratification Prior to the Total Cavopulmonary Connection (PubMed)

Speckle-tracking Echocardiography Improves Pre-Operative Risk Stratification Prior to the Total Cavopulmonary Connection Single-ventricle patients with elevated pulmonary vascular resistance (PVR) or end-diastolic pressure (EDP) are excluded from undergoing total cavopulmonary connection (TCPC). However, a subset of patients deemed to be at acceptable risk experience prolonged length of stay (LOS) after TCPC. Routine assessment of ventricular function has been inadequate in identifying (...) these high-risk patients. Speckle-tracking echocardiography (STE) is a novel method for assessment of myocardial deformation that may be useful in single-ventricle patients. The aim of this study was to perform a contemporary preoperative risk assessment for prolonged LOS to determine whether STE improves risk stratification before TCPC.Our single institution's perioperative data were retrospectively collected. The primary outcome was postoperative LOS >14 days. Longitudinal and circumferential STE

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2017 Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography

6. ASA Classification as a Risk Stratification Tool in Adult Spinal Deformity Surgery: A Study of 5805 Patients (PubMed)

red blood cell transfusion (OR = 1.3), postoperative sepsis (OR = 2.7), and urinary tract infection (OR = 1.6).This is the first study evaluating the role of ASA class in ASD surgery with a large patient database. Use of ASA class as a metric for preoperative health was verified and the association of ASA class with postoperative morbidity and mortality in ASD surgery suggests its utility in refining the risk stratification profile and improving preoperative patient counseling for those (...) ASA Classification as a Risk Stratification Tool in Adult Spinal Deformity Surgery: A Study of 5805 Patients Retrospective analysis of prospectively collected data.Adult spinal deformity (ASD) surgery is a highly complex procedure that has high complication rates. Risk stratification tools can improve patient management and may lower complication rates and associated costs. The goal of this study was to identify the independent association between American Society of Anesthesiologists (ASA

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2017 Global spine journal

7. Do pulmonary function tests improve risk stratification before cardiothoracic surgery? (PubMed)

Do pulmonary function tests improve risk stratification before cardiothoracic surgery? To assess the added value of pulmonary function tests (PFTs) and different classifications of chronic obstructive pulmonary disease (COPD) to the Society of Thoracic Surgeons (STS) risk model using a clinical definition of lung disease for predicting outcomes after cardiothoracic (CT) surgery.We evaluated consecutive patients who underwent nonemergency cardiac surgery and underwent PFTs before CT surgery. We (...) used the STS risk model 2.73 to estimate the postoperative risk for respiratory failure (RF; defined as the need for mechanical ventilation for ≥72 hours, or reintubation), prolonged postoperative stay (PPLS; defined as >14 days), and 30-day all-cause mortality. We plotted the receiver operating characteristics curve for STS score for each adverse event, and compared the resulting area under the curve (AUC) with the AUC after adding PFT parameters and COPD classifications.Of the 1412 patients

2015 Journal of Thoracic and Cardiovascular Surgery

8. Preoperative Pulmonary Risk Stratification

Preoperative Pulmonary Risk Stratification Preoperative Pulmonary Risk Stratification Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 (...) Preoperative Pulmonary Risk Stratification Preoperative Pulmonary Risk Stratification Aka: Preoperative Pulmonary Risk Stratification , Perioperative Pulmonary Complication Risk Factors II. Indications regarding pulmonary surgical risk for elective non-cardiac surgery Review with patient if benefits of procedure outweigh risks III. Risk Factors: Perioperative Pulmonary Complication Risk Factors by Patient Factors (Odds Ratio) Current Smoking: 1.4 American College of Anesthesiologists (ASA) Class II

2015 FP Notebook

9. Risk Stratification in Lung Resection (PubMed)

Risk Stratification in Lung Resection Surgery is considered the best treatment option for patients with early stage lung cancer. Nevertheless, lung resection may cause a variable functional impairment that could influence the whole cardio-respiratory system with potential life-threatening complications. The aim of the present study is to review the most relevant evidences about the evaluation of surgical risk before lung resection, in order to define a practical approach for the preoperative (...) exercise test is recommended. Patients with VO2max >20 mL/kg/min are regarded to be at low risk, while those with VO2max <10 mL/kg/min at high risk. Values of VO2max between 10 and 20 mL/kg/min require further risk stratification by the VE/VCO2 slope. A VE/VCO2 <35 indicates an intermediate-low risk, while values above 35 an intermediate-high risk.The recent scientific evidence confirms that the cardiologic evaluation, the pulmonary function test with DLCO measurement, and the cardiopulmonary exercise

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2016 Current surgery reports

10. Risk stratification for the development of respiratory adverse events following vascular surgery using the Society of Vascular Surgery's Vascular Quality Initiative. (PubMed)

Risk stratification for the development of respiratory adverse events following vascular surgery using the Society of Vascular Surgery's Vascular Quality Initiative. Postoperative respiratory adverse events (RAEs) are associated with high rates of morbidity and mortality in general surgery, however, little is known about these complications in the vascular surgery population, a frail subset with multiple comorbidities. The objective of this study was to describe the contemporary incidence (...) included in the risk prediction score were age, body mass index, smoking status, congestive heart failure severity, chronic obstructive pulmonary disease severity, degree of renal insufficiency, ambulatory status, transfer status, urgency, and operative type. The predicted compared with the actual RAE incidence were highly correlated, with a correlation coefficient of 0.943 (P < .0001) and a c-statistic = 0.818. RAEs had a significantly higher rates of in-hospital mortality (25.4% vs 1.2%; P < .0001

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2016 Journal of Vascular Surgery

11. Development and Validation of a Risk Stratification Score for Children With Congenital Heart Disease Undergoing Noncardiac Surgery. (PubMed)

, and those recorded in the 2014 database in a validation cohort. The primary outcome variable for our analysis was the incidence of in-hospital mortality. We used univariable and multivariable logistic regression to determine the preoperative predictors for in-hospital mortality and designed the risk stratification score.Among the 183,423 children included in the 2012, 2013, and 2014 American College of Surgeons National Surgical Quality Improvement Program database, we included 4375 children with major (...) , P < .001), inotropic support (OR: 2.05, 95% CI: 1.40-3.01, P < .001), preoperative cardiopulmonary resuscitation (OR: 2.46, 95% CI: 1.32-4.57, P < .004), acute or chronic kidney injury (OR: 4.42, 95% CI: 2.00-9.75, P < .001), and mechanical ventilation (OR: 7.80, 95% CI: 5.42-11.21, P < .001). We created a risk stratification score ranging from 0 to 10 that showed very good calibration and discrimination in the validation cohort (area under the curve: 0.831 [95% CI: 0.787-0.875]), corresponding

2016 Anesthesia and Analgesia

12. Office-Based Spirometry: A New Model of Care in Preoperative Assessment for Low-Risk Lung Resections. (PubMed)

Office-Based Spirometry: A New Model of Care in Preoperative Assessment for Low-Risk Lung Resections. Formal pulmonary function testing with laboratory spirometry (LS) is the standard of care for risk stratification before lung resection. LS and handheld office spirometry (OS) are clinically comparable for forced expiratory volume in 1 second and forced vital capacity. We investigated the safety of preoperative risk stratification based solely on OS.Patients at low-risk for cardiopulmonary (...) and continuous paired outcome data.There were 66 prospectively enrolled patients who received OS and underwent pulmonary resection, and 1,290 patients received preoperative LS, resulting in 52 propensity score-matched pairs (83%). There were no deaths and two 30-day readmissions per group. The major morbidity risk was similar in each group (7.7%). All analyses of discordant pair morbidity had p exceeding 0.56. There was no association between length of stay and exposure to OS vs LS (p = 0.31). The estimated

2017 Annals of Thoracic Surgery

13. Routine preoperative testing in adults undergoing elective non-cardiothoracic surgery

National Institute for Health and Disability Insurance NRKP / CNPQ National Council for Quality Promotion OIS Optimal Information Size OR Odds Ratio OSA Obstructive Sleep Apnoea PCNL Percutaneous Nephrolithotomy PT Prothrombin Time PTT Partial Thromboplastin Time RBC Red Blood Cell RCT Randomized Controlled Trial RR Relative Risk RRR Relative Risk Reduction SD Standard Deviation SIRS Systemic Inflammatory Response Syndrome 8 Routine preoperative testing KCE Report 280 SR Systematic Review SUN Serum (...) in patients with abnormal ECG as those with normal ECG (OR = 0.63, 95%CI 0.28 to 1.42). Due to serious imprecision and high risk of bias, the level of evidence was very low. 26 Routine preoperative testing KCE Report 280 Secondly, a multicentre prospective cohort study (Van Klei 2007) including 2 967 patients found a postive association between right bundle branch block and postoperative myocardial infarction risk (OR = 2.1, 95%CI 1.0 to 4.41), while left bundle branch block was associated with a higher

2017 Belgian Health Care Knowledge Centre

14. Pulmonary artery perfusion versus no perfusion during cardiopulmonary bypass for open heart surgery in adults. (PubMed)

randomized controlled trials (RCTs) should provide long-term follow-up and patient stratification by preoperative lung function and other documented risk factors for mortality. One study that is awaiting classification (epub abstract with preliminary results) may change the results of this review when full study details have been published. (...) ) that compared pulmonary artery perfusion versus no perfusion during CPB in adult patients (≧ 18 years).Two independent review authors extracted data, conducted fixed-effect and random-effects meta-analyses, and calculated risk ratios (RRs) or odds ratios (ORs) for dichotomous outcomes. For continuous data, we have presented mean differences (MDs) and 95% confidence intervals (CIs) as estimates of the intervention effect. To minimize the risk of systematic error, we assessed risk of bias of included trials

2018 Cochrane

15. A Preoperative Scale for Determining Surgical Readmission Risk After Total Hip Replacement. (PubMed)

). They were used to create the Readmission After Total Hip Replacement Risk Scale, which was applied to the validation cohort and explained 89.1% of readmission variability in that cohort.Data derived from patients in the New York and California State Inpatient Database were reliably able to explain readmission variability for patients in the Florida and Washington State Inpatient Database at a rate of 89.1% based on known preoperative risk factors. Risk-stratification models, such as the Readmission (...) A Preoperative Scale for Determining Surgical Readmission Risk After Total Hip Replacement. Total hip replacement is a commonly performed orthopedic procedure for the treatment of painful arthritis, osteonecrosis, or fracture.To develop and verify a scale for predicting readmission rates for total hip replacement patients and allow for the development and implementation of readmission risk-reduction strategies.Discharge data on 268 518 patients from New York and California (derivation cohort

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2016 JAMA surgery

16. Impact of Preoperative Chronic Kidney Disease in 2,531 High-Risk and Inoperable Patients Undergoing Transcatheter Aortic Valve Replacement in the PARTNER Trial. (PubMed)

, the transapical approach, a lower ejection fraction, oxygen-dependent chronic obstructive pulmonary disease, liver disease, and male sex.Preoperative severe RD is a significant predictor for 1-year mortality in TAVR patients. Careful risk stratification by the heart team is required in patients with severe preprocedural RD.Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved. (...) Impact of Preoperative Chronic Kidney Disease in 2,531 High-Risk and Inoperable Patients Undergoing Transcatheter Aortic Valve Replacement in the PARTNER Trial. Although preoperative renal dysfunction (RD) is associated with increased mortality and morbidity after surgical aortic valve replacement, its impact on clinical outcomes after transcatheter aortic valve replacement (TAVR) is less defined.TAVR patients in the PARTNER (Placement of Aortic Transcatheter Valves) trial with a calculable

2016 Annals of Thoracic Surgery

17. Symptomatic Pulmonary Embolus After Joint Arthroplasty: Stratification of Risk Factors. (PubMed)

Symptomatic Pulmonary Embolus After Joint Arthroplasty: Stratification of Risk Factors. Prophylaxis for pulmonary embolism (PE) after total joint arthroplasty (TJA) presents the clinical dilemma of balancing the risk of postoperative thrombotic risk and anticoagulation-related complications such as bleeding, hematoma formation, and infection. Risk stratification of patients undergoing TJA is needed to tailor prophylaxis based on thrombotic and bleeding risk.The purpose of this study (...) was to identify the preoperative comorbidities that were associated with an increased risk of symptomatic PE after joint arthroplasty in a large group of patients who had TJAs and who were treated with either aspirin or warfarin.We conducted a retrospective study of 26,391 primary and revision TJAs performed at our institution between January 2000 and April 2011. A total of 24,567 patients received warfarin prophylaxis for 6 weeks (targeted international normalized ratio of 1.5-2.0) and 1824 patients received

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2013 Clinical Orthopaedics and Related Research

18. Biomarkers, Blood Pressure, BIS: Risk Stratification/Management of Patients at Cardiac Risk in Major Noncardiac Surgery

Biomarkers, Blood Pressure, BIS: Risk Stratification/Management of Patients at Cardiac Risk in Major Noncardiac Surgery Biomarkers, Blood Pressure, BIS: Risk Stratification/Management of Patients at Cardiac Risk in Major Noncardiac Surgery - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum (...) number of saved studies (100). Please remove one or more studies before adding more. Biomarkers, Blood Pressure, BIS: Risk Stratification/Management of Patients at Cardiac Risk in Major Noncardiac Surgery (BBB) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our

2015 Clinical Trials

19. Preoperative Risk Stratification Reduces the Incidence of Perioperative Complications After Total Knee Arthroplasty. (PubMed)

Preoperative Risk Stratification Reduces the Incidence of Perioperative Complications After Total Knee Arthroplasty. The purpose of this study was to validate a screening and management protocol to identify and reduce risk of renal, pulmonary, and delirium complications. A cohort study comparing incidence of perioperative complications on a consecutive series of patients undergoing total knee arthroplasty with a historical control group was conducted. The study cohort was evaluated (...) prospectively to identify and reduce noncardiac medical complications. Medical records were reviewed for in-hospital complications. There were 623 patients in the study cohort and 493 patients in the control population. There was a statistically significant decrease in the incidence of delirium (control, 10.4% vs study, 0.8%; P = .0001), renal (4.9% vs 0.6%, P = .0001), cardiac (16.3% vs 2.1%, P = .0001), and pulmonary complications (5.7% vs 0.8%, P = .0001) in the screened patients vs control. Preoperative

2012 Journal of Arthroplasty

20. A propose of pulmonary dysfunction stratification after valve surgery by physiotherapeutic assistance level (PubMed)

A propose of pulmonary dysfunction stratification after valve surgery by physiotherapeutic assistance level a) to propose and implement an evaluation system; b) to classify the pulmonary involvement and determine levels of physical therapy; c) to check the progress postoperatively.Patients underwent physiotherapy assessment preoperatively, postoperatively and after 5 days of intervention. They were classified into three levels of care: level 1 - low risk of complication; Level 2 - medium risk (...) ; Level 3 - high risk. We used analysis of variance and Kruskal-Wallis and analysis of variance for repeated measures or Friedman. Chi-square test or Fisher for proportions. We considered statistical significance level P<0.05.We studied 199 patients, 156 classified within level 1, 32 at level 2 and 11 at level 3. Thoracoabdominal motion and auscultation changed significantly postoperatively, persisting at levels 2 and 3 (P<0.05). Oxygenation and respiratory rate changed at levels 2 and 3

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2015 Revista brasileira de cirurgia cardiovascular : órgão oficial da Sociedade Brasileira de Cirurgia Cardiovascular

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