Journal articles on the topic 'Cardiovascular system Surgery Risk factors Japan'
To see the other types of publications on this topic, follow the link: Cardiovascular system Surgery Risk factors Japan.
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'Cardiovascular system Surgery Risk factors Japan.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
Morikane, K. "Epidemiology and risk factors associated with surgical site infection following surgery on thoracic aorta." Epidemiology and Infection 146, no. 14 (July 11, 2018): 1841–44. http://dx.doi.org/10.1017/s0950268818001930.
Full textAbstract:
AbstractSurgical site infection (SSI) following cardiovascular surgery has been well documented, possibly owing to its highly invasive nature, but SSI following surgery on the thoracic aorta has not. This study aimed to describe the epidemiology and assess risk factors associated with the latter in Japan using a national database for SSI. Data on surgery on thoracic aorta performed between 2012 and 2014 were extracted from the Japan Nosocomial Infections Surveillance (JANIS) database. Risk factors were assessed initially by univariate analysis, and then entered into a logistic regression model for final evaluation. The cumulative incidence of SSI was 4.1% (146/3538) and staphylococci were the most frequent pathogens isolated. Factors such as the duration of operation, emergency surgery and male gender were significantly associated with SSI. These findings differ from previous studies on open heart and coronary artery bypass surgery, in which the American Society of Anesthesiologists (ASA) score was significantly associated with SSI, but gender was not. This study suggests that risk stratification in the JANIS system might be improved by incorporating additionally identified factors for risk adjustment, when comparing the incidence of SSI between hospitals.
2
Ohtsu, Hiroshi, Akihiko Shimomura, Sakiko Miyazaki, Naohiro Yonemoto, Shinichiro Ueda, Chikako Shimizu, and Kazuhiro Sase. "Cardiotoxicity of adjuvant chemotherapy with trastuzumab: a Japanese claim-based data analysis." Open Heart 9, no. 2 (August 2022): e002053. http://dx.doi.org/10.1136/openhrt-2022-002053.
Full textAbstract:
ObjectiveAdjuvant chemotherapy with trastuzumab improves the postoperative life expectancy of women with early-stage breast cancer. Although trastuzumab is reportedly cardiotoxic, quantification based on real-world evidence is lacking. Therefore, in this study, we aimed to analyse trastuzumab cardiotoxicity using a nationwide claim-based database.MethodsIn this retrospective study, we used data from a nationwide claims database (Japan Medical Data Center, Tokyo, Japan) under the universal healthcare system. Women with breast cancer who underwent initial surgery were included. Patients with recurrent or advanced-stage breast cancer, with a history of heart failure, receiving neoadjuvant chemotherapy or a preoperative history of less than 6 months were excluded. Propensity score (PS) was calculated using logistic regression based on age, cardiovascular risk factors, radiotherapy and concomitant anthracyclines (AC).ResultsWe identified 12 060 eligible patients (mean age 50.8±8.56 years) between January 2010 and December 2019. After 1:2 PS matching (trastuzumab users, TZ, n=1005; non-users, NT, n=2010), Cox proportional hazards model analysis showed that the rate of heart failure development within 18 months postoperative was significantly higher in the TZ group than in the NT group (adjusted HR 2.28, 95% CI 1.38 to 3.77). Baseline cardiac evaluation in the combined AC/TZ cases was 27.2% preoperative, 66.0% pre-AC and 86.6% pre-TZ, respectively.ConclusionTrastuzumab cardiotoxicity remained relevant in the claim-based analysis adjusted for AC effects. Further collaborative studies in cardio-oncology with real-world data are warranted to improve the rate of baseline cardiovascular risk assessment in patients with cancer scheduled for cardiotoxic cancer treatment.
3
Kurazumi, Hiroshi, Masaya Takahashi, and Shigeru Ikenaga. "Outcomes of cardiovascular surgery for chronic dialysis patients in current Japan." Asian Cardiovascular and Thoracic Annals 27, no. 6 (June 19, 2019): 464–70. http://dx.doi.org/10.1177/0218492319859147.
Full textAbstract:
Background The number of dialysis patients in Japan is rising, with an increasing number requiring cardiovascular surgery. Methods We investigated the short- and long-term outcomes in 70 dialysis patients among a total of 1124 who underwent cardiovascular surgery in our hospital between 2004 and 2016. We investigated outcomes following open surgery and identified factors that affected the prognosis. We also compared the long-term survival rate with the survival rate of the Japanese dialysis population. Results The long-term survival rate was 70.6%, 51.1%, and 19.2% after 3, 5, and 10 years, respectively. The causes of long-term death were heart disease in 8 patients, cerebrovascular disease in 7, cachexia in 3, infection in 2, and other causes in 3. The freedom from cardiac death was 88.7%, 77.9%, and 54.9% after 3, 5, and 10 years, respectively. Multivariate analysis using Cox’s proportional hazard model showed that a history of atherosclerosis obliterans (hazard ratio 5.4, p = 0.05) and mediastinitis (hazard ratio 10.2, p = 0.03) were risk factors for death in long-term follow-up, and a history of atherosclerosis obliterans was an independent risk factor for cardiac death in long-term follow-up (hazard ratio 5.3, p = 0.01). Five-year survival of the study subjects was comparable to that of the Japanese dialysis population. Conclusions The prognosis for dialysis patients after open surgery was equivalent to that of Japanese dialysis patients in general. A high proportion of late postoperative deaths were due to heart disease. Patients with atherosclerosis obliterans had a poor prognosis.
4
Morikane, Keita, Hitoshi Honda, and Satowa Suzuki. "Factors Associated With Surgical Site Infection Following Gastric Surgery in Japan." Infection Control & Hospital Epidemiology 37, no. 10 (July 19, 2016): 1167–72. http://dx.doi.org/10.1017/ice.2016.155.
Full textAbstract:
BACKGROUNDSurgical site infection (SSI) following gastric surgery has not been well documented.OBJECTIVETo describe and assess factors associated with SSI following gastric surgery in Japan using a Japanese national database for healthcare-associated infections.DESIGNA retrospective nationwide surveillance-based study.SETTINGJapanese healthcare facilities.METHODSData on gastric surgeries performed between 2012 and 2014 were extracted from the Japan Nosocomial Infections Surveillance. Gastric surgery was divided into 3 types of procedures: total gastrectomy (GAST-T), distal gastrectomy (GAST-D), and other types of gastric surgery (GAST-O). The incidence of and factors associated with SSI following gastric surgery were assessed by the 3 types of procedures.RESULTSThe cumulative incidence of SSI following gastric surgery was 8.8% (3,156/36,052). The incidence of SSI following GAST-T (12.4%) was significantly higher than that following GAST-D (7.01%) or GAST-O (7.84%). Besides the 4 conventional risk factors for predicting SSI, additional risk factors were identified. Male sex was significantly associated with SSI following all types of gastric surgery, but the effect of the association was substantially different (adjusted odds ratio, 1.52, 1.47, and 1.28 for GAST-T, GAST-D, and GAST-O, respectively). The effect of an emergency operation was similar. Age was also identified as a risk factor, but the most suitable modification of age as a variable differed.CONCLUSIONSThe incidence and factors associated with SSI following 3 types of gastric surgery differed. To accurately compare hospital performance in SSI prevention following gastric surgery, dividing surgical procedures in the surveillance system into 3 types should be considered.Infect Control Hosp Epidemiol 2016;1–6
5
Fujita, Tomoyuki, Hiroyuki Yamamoto, Junjiro Kobayashi, Satsuki Fukushima, Hiroaki Miyata, Kizuku Yamashita, and Noboru Motomura. "Mitral valve surgery for ischemic papillary muscle rupture: outcomes from the Japan cardiovascular surgery database." General Thoracic and Cardiovascular Surgery 68, no. 12 (June 25, 2020): 1439–46. http://dx.doi.org/10.1007/s11748-020-01418-y.
Full textAbstract:
Abstract Background Ischemic papillary muscle rupture (PMR) is a catastrophic complication following acute myocardial infarction (AMI). We evaluated early outcomes of PMR by using data from the Japan Cardiovascular Surgery Database, a nationwide Japanese registry. Methods We retrospectively analyzed data from 196 patients diagnosed with PMR following AMI in Japan between January 2014 and December 2017. Risk factors for operative mortality and severe complications following mitral valve surgery were analyzed. Results The 30-day and hospital mortality rates were 20% and 26%, respectively. Chronic hemodialysis, abrupt rupture after AMI, resuscitation before surgery, and preoperative venoarterial extracorporeal membrane oxygenation were associated with mortality. Mitral valve replacement was chosen mainly (90%) for surgical correction of mitral regurgitation in these patients. There was no significant difference in short-term outcomes between mitral valve replacement versus mitral valve repair, despite non-matched characteristics in background between the treatment groups. Concomitant coronary artery bypass grafting had no impact on short-term outcomes. Conclusions Information derived from the nationwide database of patients with AMI-associated PMR show that PMR is a rare condition in the modern era. However, PMR is a severe disease with a mortality rate as high as 26%. The severity of the condition is associated with the risk for poor outcomes.
6
Abe, Tomonobu, Hiroyuki Yamamoto, Hiroaki Miyata, Noboru Motomura, Yoshiyuki Tokuda, Kazuo Tanemoto, Akihiro Usui, and Shinichi Takamoto. "Patient trends and outcomes of surgery for type A acute aortic dissection in Japan: an analysis of more than 10 000 patients from the Japan Cardiovascular Surgery Database." European Journal of Cardio-Thoracic Surgery 57, no. 4 (December 3, 2019): 660–67. http://dx.doi.org/10.1093/ejcts/ezz323.
Full textAbstract:
Abstract OBJECTIVES To evaluate the background trends and surgical outcomes for more than 10 000 patients with acute type A dissection in Japan in a recent 8-year period. METHODS Data on replacement of the ascending aorta and/or aortic arch for acute type A dissection were collected from the Japan Cardiovascular Surgery Database from 2008 to 2015. Linear-by-linear association tests or Cuzick’s test for trend was used to evaluate group trends over time. The results were calculated for ascending or hemiarch replacement and arch replacement. A multivariable logistic regression model was used to calculate the risk-adjusted operative mortality rate. RESULTS A total of 11 843 patients were included. The overall 30-day mortality and operative mortality rates were 7.6% and 9.5%, respectively. The number of surgically treated cases increased from 2436 patients in 2008–2009 to 3533 in 2014–2015, a 45.0% increase. A trend analysis revealed significant changes in patient characteristics with time, including increasing age and rate of preoperative renal failure. Despite worsening risk factors, the unadjusted operative mortality rate with arch replacement showed a significant downward trend (P = 0.01; test of trend). The risk-adjusted mortality rate showed a downward trend both in ascending aorta or hemiarch replacement and arch replacement, although the trend was not statistically significant (P > 0.05). CONCLUSIONS Unadjusted and adjusted operative deaths have shown a decreasing trend, although patients undergoing surgery for acute type A dissection have demonstrated worsening of risk factors, such as age and renal failure. The number of surgeries performed for acute type A dissection significantly increased throughout the study period in Japan.
7
Morikane, Keita, Hitoshi Honda, Takuya Yamagishi, Satowa Suzuki, and Mayumi Aminaka. "Factors Associated with Surgical Site Infection in Colorectal Surgery: The Japan Nosocomial Infections Surveillance." Infection Control & Hospital Epidemiology 35, no. 6 (June 1, 2014): 660–66. http://dx.doi.org/10.1086/676438.
Full textAbstract:
Objective.Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). This study aims to assess factors associated with SSI after colorectal surgery in Japan, using a Japanese national database for HAIs.Design.A retrospective nationwide surveillance-based study.Setting.Japanese healthcare facilities.Methods.Data on colon and rectal surgeries performed from 2008 through 2010 were extracted from a national monitoring system for healthcare-associated infections, the Japan Nosocomial Infections Surveillance (JANIS). Factors associated with SSI after colon and rectal surgery were assessed using multivariate logistic regression.Results.The cumulative incidence of SSI for colon and rectal surgery was 15.0% (6,691 of 44,751) and 17.8% (3,230 of 18,187), respectively. Traditional risk factors included in the National Nosocomial Infections Surveillance (NNIS) modified risk index were significant in predicting SSI in the final model for both colon and rectal surgery. Among the additional variables routinely collected in JANIS were factors independently associated with the development of SSI, such as male sex (adjusted odds ratio [aOR], 1.20 [95% confidence interval (CI), 1.14–1.27]), ileostomy or colostomy placement (aOR, 1.13 [95% CI, 1.04–1.21]), emergency operation (aOR, 1.40 [95% CI, 1.29–1.52]), and multiple procedures (aOR, 1.22 [95% CI, 1.13–1.33]) for colon surgery as well as male sex (aOR, 1.43 [95% CI, 1.31–1.55]), ileostomy or colostomy placement (aOR, 1,63 [95% CI, 1.51–1.79]), and emergency operation (aOR, 1.43 [95% CI, 1.20–1.72]) for rectal surgery.Conclusions.For colorectal operations, inclusion of additional variables routinely collected in JANIS can more accurately predict SSI risk than can the NNIS risk index alone.Infect Control Hosp Epidemiol 2014;35(6):660–666
8
Yamauchi, Takashi, Hiroshi Takano, Hiroaki Miyata, Noboru Motomura, and Shinichi Takamoto. "Risk Factors for Mortality and Morbidity of Surgical Aortic Valve Replacement for Aortic Stenosis ― Risk Model From a Japan Cardiovascular Surgery Database ―." Circulation Reports 1, no. 3 (March 8, 2019): 131–36. http://dx.doi.org/10.1253/circrep.cr-19-0010.
Full text
9
Leca, Bianca Maria, Ionuț Stanca, Suzana Florea, Simona Fica, and Anca Elena Sîrbu. "Impact of weight loss on the cardiovascular system after bariatric surgery." Problems of Endocrinology 62, no. 5 (September 22, 2016): 43. http://dx.doi.org/10.14341/probl201662543.
Full textAbstract:
Introduction. Obesity is a chronic disease with a great impact on the cardiovascular system through its association with type II diabetes, hypertension, dyslipidemia, metabolic syndrome (MetS) and also through direct alterations in cardiac performance and morphology. Recent long term studies prove that substantial weight loss obtained via bariatric surgery is capable of improving cardiac risk factors associated with severe obesity, decreasing the mortality rates.Aim: to assess the long-term changes in cardiovascular risk and cardiac structure in obese patients who had lost weight after laparoscopic sleeve gastrectomy (LSG).Methods. Fifty-two severe obese patients (44±9 years, 57.7% women, BMI=45±8 kg/m2) underwent clinical and biochemical examination and Doppler echocardiograms before and 5 years after LSG.Results. Pre-operatively, 78.4% of patients were hypertensive, 46.2% had diabetes, 73.1% MetS and 44.2% presented left ventricle hypertrophy (LVH), reflecting high cardio-metabolic risk. The patients reassessment was made 61.7±10.5 months after LSG, when a decrease in BMI of 21.9±10% was achieved (p<0.001). The prevalence of hypertension (64.7%), diabetes (32.7%) and MetS (28.8%) decreased compared to the pre-operative examination (p=0.019, p<0.001, p=0.036). An increase in left ventricle mass and left ventricle mass index (LVMI) (p<0.001) and in the prevalence of LVH (57.7%-p=0.001) was recorded. Patients were divided into two groups based on the decrease in LVMI (positive response-38.5%) or increase in LVMI post-surgery (negative response-61.5%), compared with pre-operative values. The group of patients with negative response had lost less weight (p=0.006), had a poor glycemic control (p=0.022), and higher systolic (p=0.004) and diastolic (p=0.030) pressure values compared to the first evaluation.Conclusion. The increase of LVMI after LSG indicates that this study should continue, including a larger number of patients. It is important to identify the factors that can predict an inappropriate response to surgery, in order to prevent and treat them.
10
Koga, Masatoshi, Toshiyuki Uehara, Nobuyuki Yasui, Yasuhiro Hasegawa, Kazuyuki Nagatsuka, Yasushi Okada, and Kazuo Minematsu. "Factors Influencing Cooperation Among Healthcare Providers in a Community-Based Stroke Care System in Japan." Journal of Stroke and Cerebrovascular Diseases 20, no. 5 (September 2011): 413–23. http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2010.02.012.
Full text
11
Okamoto, Yuko, Toru Miyoshi, Keishi Ichikawa, Yoichi Takaya, Kazufumi Nakamura, and Hiroshi Ito. "Cardio-Ankle Vascular Index as an Arterial Stiffness Marker Improves the Prediction of Cardiovascular Events in Patients without Cardiovascular Diseases." Journal of Cardiovascular Development and Disease 9, no. 11 (October 25, 2022): 368. http://dx.doi.org/10.3390/jcdd9110368.
Full textAbstract:
Several studies have reported that the cardio-ankle vascular index (CAVI), a non-invasive measurement of arterial stiffness, is associated with the incidence of cardiovascular events. We investigated whether adding CAVI to a risk score improves the prediction of cardiovascular events in the setting of primary prevention. This retrospective observational study included consecutive 554 outpatients with cardiovascular disease risk factors but without known cardiovascular disease (68 ± 9 years, 64% men). The CAVI was measured using the VaSera vascular screening system. Major adverse cardiovascular events (MACE) included cardiovascular death, myocardial infarction, stroke, hospitalization for heart failure, and coronary revascularization. During a median follow-up of 4.3 years, cardiovascular events occurred in 65 patients (11.7%). Multivariate Cox analysis showed that abnormal CAVI (>9.0) was significantly associated with the incidence of MACE (hazard ratio 2.31, 95% confidence interval 1.27–4.18). The addition of CAVI to the Suita score, a conventional risk score for coronary heart disease in Japan, significantly improved the C statics from 0.642 to 0.713 (p = 0.04). In addition to a conventional risk score, CAVI improved the prediction of cardiovascular events in patients with cardiovascular disease risk factors but without known cardiovascular diseases.
12
Dalton, J. E., C. J. Lehr, P. R. Gunsalus, D. D. Gunzler, and M. Valapour. "A Simple Scoring System for Lung Transplant Waitlist Mortality Risk Factors." Journal of Heart and Lung Transplantation 41, no. 4 (April 2022): S143—S144. http://dx.doi.org/10.1016/j.healun.2022.01.337.
Full text
13
Pushkarev, G. S., and S. T. Matskeplishvili. "Psychosocial risk factors in cardiac practice." Patologiya krovoobrashcheniya i kardiokhirurgiya 25, no. 4 (December 28, 2021): 30. http://dx.doi.org/10.21688/1681-3472-2021-4-30-40.
Full textAbstract:
<p>Cardiovascular diseases (CVD) remain the leading cause of death in Russia. Apart from conventional modified risk factors, population health, including CVD progression and related death, is influenced by psychosocial risk factors (PS RF). In theory, the role of PS RF can be explained by the significant changes in death rates within the Russian population during social and economic alterations. However, the significance of primary CVD RF has remained unchanged since the Soviet times. Nonetheless, PS RF does not receive much attention in our country. Thus, the current review aimed to introduce specialists focusing primarily on PS RF, such as low socioeconomic status, social isolation and low levels of social support, depressive disorders and personality traits (hostility and type D personality), which are now undoubtedly closely associated with unfavourable prognosis in patients with CVD. This summary also discusses the main pathophysiological mechanisms that may facilitate the progression of CVD, which include the activation of the hypothalamic–pituitary–adrenal axis, sympathoadrenal system with increased cardiovascular reactivity, endothelial function, inflammatory markers, platelets, coagulation factors, fibrinogen and lifestyle-associated factors. Thus, PS RF have considerable practical significance, not only for individual risk estimation but also in primary and secondary interventions for the prevention of CVD.</p><p>Received 4 May 2021. Revised 6 June 2021. Accepted 11 June 2021.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest: </strong>Authors declare no conflict of interest.</p><p><strong>Contribution of the authors: </strong>The authors contributed equally to this article.</p>
14
Agienko, A. S., I. L. Strokolskaya, V. Yu Heraskov, and G. V. Artamonova. "Epidemiology of cardiovascular risk factors and the medical care appealability." Complex Issues of Cardiovascular Diseases 11, no. 4 (January 9, 2023): 79–89. http://dx.doi.org/10.17802/2306-1278-2022-11-4-79-89.
Full textAbstract:
Highlights. Unique epidemiological data were obtained on the effectiveness of preventive services of healthcare organizations in relation to cardiovascular diseases, adherence to lifestyle modification recommendations, and presence of risk factors for cardiovascular diseases in these citizens.Aim. To assess healthcare services uptake in large industrial Siberian region, as well as the adherence of population to lifestyle modification recommendations (epidemiological data).Methods. The study included 729 residents of Kemerovo and Kemerovo region. The assessment of the main risk factors for cardiovascular diseases was carried out in accordance with the Russian recommendations for cardiovascular prevention. Uptake and adherence to lifestyle modification recommendations was assessed using the Health System Assessment Questionnaire of the International Prospective Study of Urban and Rural Epidemiology.Results. Among the 729 study participants, the urban population is represented by 67.3%, rural – 32.6%. The population was majority represented by women (69.7%). The mean age of participants was 59.0 (51.0; 65.0) years. Smokers accounted for 18.6% of the participants, the majority represented by men (p = 0.000). Excessive weight was more often observed in women (p = 0.013), the mean body mass index in women was 29.5 kg/m2 . The mean values of the analyzed laboratory parameters (cholesterol, low- and highdensity lipoprotein cholesterol, triglycerides, glucose) were within the range of normal values. Previously diagnosed hypertension was noted in 64.6% of the participants, diabetes in 12%, coronary heart disease in about 7%, stroke in 1.6% of the participants. Assessment of cardiovascular risk according to SCORE scale showed that 17% of participants were at low risk, 50% – moderate risk in, and 29.2% – high-very high risk. Upon visiting healthcare provider, only 38.1% of subjects received recommendations for lifestyle changes. Respondents were frequently given recommendations to adjust their diet, followed by recommendations regarding weight loss, increased physical activity; smoking cessation and lower alcohol consumption were recommended less often. Respondents changed their lifestyle significantly more often in accordance with the recommendations received at the time of visit (p = 0.000); out of them, 56.7% had moderate cardiovascular risk, 26.7% had high and very high risk, and low risk according to SCORE – 16.7%. However, study participants were more likely to not follow received recommendations (p = 0.000).Conclusion. Due to high uptake of healthcare services in the population, high prevalence of risk factors and low adherence of the population to prevention, it can be concluded that the current model of prevention does not work. Innovative tools are needed to manage risk factors for cardiovascular diseases and positively change a person`s lifestyle.
15
Verderber, A., AM Castelfranco, D. Nishioka, and KG Johnson. "Cardiovascular risk factors and cardiac surgery outcomes in a multiethnic sample of men and women." American Journal of Critical Care 8, no. 3 (May 1, 1999): 140–48. http://dx.doi.org/10.4037/ajcc1999.8.3.140.
Full textAbstract:
BACKGROUND: Cardiovascular disease is more prevalent in some ethnic groups than in others, as are risk factors stemming from cultural practices and values. Data on the health status of Asians and Pacific Islanders are scarce and sporadic, and data on the 2 groups are usually combined for analysis. OBJECTIVE: To determine ethnic and sex-related differences among white, Japanese, and Pacific Island subjects in cardiovascular risk factors and outcomes after coronary artery bypass graft surgery. METHODS: Data were collected from a random sample of 41 men and 19 women scheduled for nonemergent coronary artery bypass graft surgery: 19 white, 18 Japanese, and 23 Pacific Island/Hawaiian subjects. Subjects were interviewed about risk factors before surgery and were followed up for the first 20 hours after surgery. Problems that occurred during the remainder of the hospital stay were assessed by chart review. Instruments used included the Charlson Comorbidity Index, Acute Physiology and Chronic Health Evaluation II, and the Therapeutic Intervention Scoring System. RESULTS: Pacific Island and Japanese subjects differed significantly in their demographic and clinical characteristics. Pacific Islanders tended to have a more difficult postoperative course than did white subjects, whereas Japanese patients tended to have fewer problems and an easier postoperative course than other subjects. CONCLUSIONS: Further study of ethnic variations in risk factors and surgical outcomes, especially variations in comorbidities, age at the onset of signs and symptoms, and postoperative complications, is needed. Combining data obtained from Japanese and Pacific Island subjects for data analysis most likely will result in a loss of important information.
16
Miyamoto, Susumu, Takanori Ikeda, Satoshi Ogawa, Takanari Kitazono, Jyoji Nakagawara, Kazuo Minematsu, Yuji Murakawa, et al. "Clinical Risk Factors of Thromboembolic and Major Bleeding Events for Patients with Atrial Fibrillation Treated with Rivaroxaban in Japan." Journal of Stroke and Cerebrovascular Diseases 29, no. 4 (April 2020): 104584. http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2019.104584.
Full text
17
Kohli, Michele, Lilian Yuan, Michael Escobar, Tyrone David, Grant Gillis, Marta Garcia, and John Conly. "A Risk Index for Sternal Surgical Wound Infection After Cardiovascular Surgery." Infection Control & Hospital Epidemiology 24, no. 1 (January 2003): 17–25. http://dx.doi.org/10.1086/502110.
Full textAbstract:
AbstractObjectives:To identify factors that increase the risk of sternal surgical wound infection after cardiovascular surgery and to develop a bedside clinical risk index using these factors.Design:A risk index was developed using clinical data collected from a cohort of 11,508 cardiac surgery patients and validated using three independent subsets of the data. With two of these subsets, we derived a logistic regression equation and then modified the scoring algorithm to simplify the calculation of patient risk scores by clinicians. The final subset was used to validate the index. The area under the receiver operating characteristic (aROC) curve was the primary measure of goodness of fit.Setting:Toronto General Hospital, a teaching hospital and the largest center for cardiac surgery in Ontario, Canada.Patients:Cardiac surgery patients receiving cardiopulmonary bypass between April 1, 1990, and December 31, 1995, who survived at least 6 days after surgery.Results:Variables that were used to construct the risk index included reoperation due to complication (odds ratio, 4.3; range, 1.9 to 8.5), diabetes (odds ratio, 2.4; range, 1.5 to 3.7), more than 3 days in the intensive care unit (odds ratio, 5.4; range, 3.2 to 8.7), and use of the internal mammary artery for revascularization (odds ratio, 3.2; range, 1.7 to 5.8). Validation showed that the index had an aROC curve of 0.64.Conclusions:The risk index described in this article allows clinicians to quickly stratify patients into four risk groups associated with an increasing risk of sternal surgical wound infection. It may be used perioperatively or as part of a wound infection surveillance system.
18
Gamidov, S. I., R. I. Ovchinnikov, A. Yu Popova, and T. V. Shatylko. "Risk factors for erectile dysfunction: known and unexpected facts (review)." Andrology and Genital Surgery 22, no. 4 (December 16, 2021): 13–21. http://dx.doi.org/10.17650/1726-9784-2021-22-4-13-21.
Full textAbstract:
The prevalence of erectile dysfunction (ED) among men over 50 years is 31-51 %. By 2025, the prevalence of ED is expected to increase to 322 million men worldwide. In Russia, according to academician D.Yu. Pushkar', ED suffers up to 89.9 %.In this regard, it seems very important to establish the causes of this condition. The purpose of this review is to assess the current state of the literature on the issue of risk factors leading to or associated with the development of ED.The presented works show that well-known factors play a role in the occurrence of ED: unfavorable environmental conditions, harmful lifestyle factors, chronic intoxication, obesity, genetic predisposition, deficiency of sex hormones and vitamins, diseases of the cardiovascular system, prostate and urethra, as well as drugs for their treatment. Also, new indicators in laboratory and instrumental studies that change with ED are considered.Among the well-known data, there are also some very original works devoted to this topic. The relationship between ED and reproductive disorders, psoriasis, periodontitis, human immunodeficiency virus infection and some drugs use is now being investigated, which is presented in this review.
19
Wouters, Stijn C. W., Luc Noyez, Freek W. A. Verheugt, and Rene M. H. J. Brouwer. "Preoperative Prediction of Early Mortality and Morbidity in Coronary Bypass Surgery." Cardiovascular Surgery 10, no. 5 (October 2002): 500–505. http://dx.doi.org/10.1177/096721090201000510.
Full textAbstract:
Objective. A scoring system to predict early mortality and morbidity in CABG, distinguishing low and high risk patients. Methods. 563 patients (1998) served as development dataset, 969 patients as validation set. Univariate and logistic regression analysis was used to identify risk factors. Results. Gender, hypertension, pulmonary disease, reoperation, age. operative status and left-ventricular function were predictive variables for early mortality. The area under the ROC curve was 0.81. We identified a low risk, mortality of 1.8% and a high-risk group, mortality of 13.4%. Diabetes, hypertension, kidney and lung disease, reoperation, operative status and left ventricular function were predictive variables for morbidity. The area under the ROC curve was 0.73. We identified a low risk, morbidity of 17%, and a high-risk group, morbidity of 41%. Conclusion. This scoring system is a simple system identifying a low and high-risk group for morbidity and early mortality.
20
Cromhout, Pernille Fevejle, Lau Caspar Thygesen, Philip Moons, Samer Nashef, Sune Damgaard, and Selina Kikkenborg Berg. "Social and emotional factors as predictors of poor outcomes following cardiac surgery." Interactive CardioVascular and Thoracic Surgery 34, no. 2 (October 4, 2021): 193–200. http://dx.doi.org/10.1093/icvts/ivab261.
Full textAbstract:
Abstract OBJECTIVES Existing risk prediction models in cardiac surgery stratify individuals based on their predicted risk, including only medical and physiological factors. However, the complex nature of risk assessment and the lack of parameters representing non-medical aspects of patients’ lives point towards the need for a broader paradigm in cardiac surgery. Objectives were to evaluate the predictive value of emotional and social factors on 4 outcomes; death within 90 days, prolonged stay in intensive care (≥72 h), prolonged hospital admission (≥10 days) and readmission within 90 days following cardiac surgery, as a supplement to traditional risk assessment by European System for Cardiac Operative Risk Evaluation (EuroSCORE). METHODS The study included adults undergoing cardiac surgery in Denmark 2014–2017 including information on register-based socio-economic factors, and, in a nested subsample, self-reported symptoms of anxiety and depression. Logistic regression analyses were conducted, adjusted for EuroSCORE, of variables reflecting social and emotional factors. RESULTS Amongst 7874 included patients, lower educational level (odds ratio 1.33; 95% confidence interval 1.17–1.51) and living alone (1.25; 1.14–1.38) were associated with prolonged hospital admission after adjustment for EuroSCORE. Lower educational level was also associated with prolonged intensive care unit stay (1.27; 1.00–1.63). Having a high income was associated with decreased odds of prolonged hospital admission (0.78; 0.70–0.87). No associations or predictive value for symptoms of anxiety or depression were found on any outcomes. CONCLUSIONS Social disparity is predictive of poor outcomes following cardiac surgery. Symptoms of anxiety and depression are frequent especially amongst patients with a high-risk profile according to EuroSCORE. Subj collection 105, 123
21
van Riemsdijk, I. C., C. C. Baan, A. H. M. M. Balk, P. M. A. J. Vantrimpont, L. P. W. M. Maat, and W. Weimar. "Improvement of cardiovascular risk factors in heart transplant recipients after conversion from cyclosporine to tacrolimus: a role of the TGF-β system." Transplantation Proceedings 34, no. 5 (August 2002): 1864–65. http://dx.doi.org/10.1016/s0041-1345(02)03074-9.
Full text
22
Mendoza-Herrera, Kenny, Andrea Pedroza-Tobías, César Hernández-Alcaraz, Leticia Ávila-Burgos, Carlos A. Aguilar-Salinas, and Simón Barquera. "Attributable Burden and Expenditure of Cardiovascular Diseases and Associated Risk Factors in Mexico and other Selected Mega-Countries." International Journal of Environmental Research and Public Health 16, no. 20 (October 22, 2019): 4041. http://dx.doi.org/10.3390/ijerph16204041.
Full textAbstract:
Background: This paper describes the health and economic burden of cardiovascular diseases (CVD) in Mexico and other mega-countries through a review of literature and datasets. Methods: Mega-countries with a low (Nigeria), middle (India), high (China/Brazil/Mexico), and very high (the U.S.A./Japan) human development index were included. The review was focused on prevalence of dyslipidemias and CVD economic impact and conducted according to the PRISMA statement. Public datasets of CVD indicators were explored. Results: Heterogeneity in economic data and limited information on dyslipidemias were found. Hypertriglyceridemia and hypercholesterolemia were higher in Mexico compared with other countries. Higher contribution of dietary risk factors for cardiovascular mortality and greater probability of dying prematurely from CVD were observed in developing countries. From 1990–2016, a greater decrease in cardiovascular mortality in developed countries was registered. In 2015, a CVD expense equivalent to 4% of total health expenditure was reported in Mexico. CVD ranked first in health expenditures in almost all these nations and the economic burden will remain significant for decades to come. Conclusions: Resources should be assured to optimize CVD risk monitoring. Educational and medical models must be improved to enhance CVD diagnosis and the prescription and adherence to treatments. Long-term benefits could be attained by modifying the food system.
23
Mccormack, David, Damian Balmforth, Adam El-Gamel, Sammra Ibrahim, Philipp Lohrmann, Rakesh Uppal, and Alex Shipolini. "Risk Factors for Respiratory Tract Infection Following Cardiac Surgery: Insights from the Recovery from Operation Quality Assessment System Investigators." Heart, Lung and Circulation 27 (2018): S568—S569. http://dx.doi.org/10.1016/j.hlc.2018.04.189.
Full text
24
Vasile, Vlad C., Jeffrey W. Meeusen, Jose R. Medina Inojosa, Leslie J. Donato, Christopher G. Scott, Meredith S. Hyun, Manlio Vinciguerra, Richard R. Rodeheffer, Francisco Lopez-Jimenez, and Allan S. Jaffe. "Ceramide Scores Predict Cardiovascular Risk in the Community." Arteriosclerosis, Thrombosis, and Vascular Biology 41, no. 4 (April 2021): 1558–69. http://dx.doi.org/10.1161/atvbaha.120.315530.
Full textAbstract:
Objective: Cardiovascular disease remains a leading cause of mortality worldwide. Ceramide scores have been associated with adverse outcomes in patients with established coronary artery disease. The prognostic value of ceramide score has not been assessed in the general population. We tested the hypothesis that ceramide scores are associated with major adverse cardiac events (MACE) in a community-based cohort with average coronary artery disease burden at enrollment. Approach and results: In a prospective community-based cohort, we performed passive follow-up using a record linkage system to ascertain the composite outcome of MACE, defined as acute myocardial infarction, coronary revascularization (bypass grafting or percutaneous intervention), stroke, or death. Ceramides were analyzed as log-transformed continuous variables, ratios or scores, and quartiles with adjustment for confounders. We analyzed 1131 subjects, 52% females, mean age±(SD) 64±9 years. After a median follow-up of 13.3 years (Q1, 12.7; Q3, 14.4), 486 patients experienced a MACE: myocardial infarction (80), coronary artery bypass surgery (34), percutaneous coronary intervention (62), stroke (94), and all-cause death (362). Ceramide ratios were significantly associated with MACE independently of LDL-c (low-density lipoprotein cholesterol) and conventional coronary artery disease risk factors. Those in the highest quartile of ceramide score had nearly 1.5-fold risk of MACE, hazard ratio, 1.47 (95% CI, 1.12–1.92). There was a dose-response association across quartiles of ceramide ratios and MACE. Conclusions: Elevated ceramide score is a robust predictor of cardiovascular disease and MACE in the community. The risk conferred by the ceramide score has a dose-response behavior and is independent of conventional risk factors.
25
Wills, Vinitha, Jacob Abraham, and N. S. Sreedevi. "Congenital anomalies: the spectrum of distribution and associated maternal risk factors in a tertiary teaching hospital." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 6, no. 4 (March 30, 2017): 1555. http://dx.doi.org/10.18203/2320-1770.ijrcog20171427.
Full textAbstract:
Background: To study the system-wise occurrence of congenital anomalies in newborns admitted in a tertiary hospital and to study the associated maternal factors.Methods: This is a retrospective study of all the mothers and their newborn babies with congenital anomalies who were delivered or referred to the Obstetrical Department / Neonatology unit during a two-year study period. The maternal risk factors and associated Obstetric complications were studied.Results: Among the babies born with congenital anomalies, the systems most involved were Genito-urinary System (28.5%) and Cardiovascular System (20.5%). Among the maternal risk factors, Diabetes (14.01%), previous abortions (12.7%) and hypothyroidism (8.7%) were the most significant associated factors. Intrauterine growth restriction (17.4%) was noted to be more common in these babies.Conclusions: The incidence of anomalies was most involving the Genito-urinary System and Cardiovascular System. The major risk factor identified was maternal Diabetes. Prevention by public awareness during adolescence, pre-conceptional counseling and antenatal screening is stressed. Availability of Pediatric surgery and Rehabilitative facilities to improve the quality of life would be warranted.
26
Newman, Mark F., Timothy O. Stanley, and Hilary P. Grocott. "Strategies to Protect the Brain During Cardiac Surgery." Seminars in Cardiothoracic and Vascular Anesthesia 4, no. 2 (July 2000): 53–64. http://dx.doi.org/10.1053/vc.2000.6499.
Full textAbstract:
Despite significant advances in cardiopulmonary by pass (CPB) technology, surgical techniques, and anes thetic management, central nervous system (CNS) com plications remain a common and costly problem after CPB. Stroke is often considered a rare and unprevent able complication of cardiac surgery. Recent studies have shown that through the use of echocardiography and historical risk stratification strategies, we can de fine which patients are at substantially greater risk for CNS injury. Through enhanced understanding of the etiology of stroke and perioperative factors, which are associated with potential for neuroprotection or injury extension, there now exists a greater potential than ever to substantially reduce neurological injury associ ated with cardiac surgery. Strategies and theories of stratifying patients at risk and secondarily reducing that risk are described, as well as consideration for early postoperative assessment to allow treatment when events occur.
27
Artyukh, V. A., S. A. Bozhkova, R. M. Tikhilov, A. V. Yarmilko, and Yu V. Muravyova. "Risk factors for lethal outcomes after surgical treatment of patients with chronic periprosthetic hip joint infection." Genij Ortopedii 27, no. 5 (October 2021): 555–61. http://dx.doi.org/10.18019/1028-4427-2021-27-5-555-561.
Full textAbstract:
Abstract. Introduction Periprosthetic joint infections (PJI) are serious complications of total hip arthroplasty (THA) and affect the patient's life expectancy. The aim of the study was to identify independent factors influencing the risk of death in patients with PJI after revision THA. Materials and methods The study included 51 lethal outcomes in patients with chronic PJI of the hip. Results and discussion In our cohort of 434 patients, 13 (2.99 %) patients died within the first year after surgery (p > 0.05), which is 2.2 times less than similar published data. The result of gender analysis showed no statistically significant differences in the risk of death between men and women (OR1.05 CI 0.59–1.89, p = 0.87). It was found that in patients over 70 years old, the risk of death was significantly higher (OR 2.05 CI 1.09–3.87, p = 0.031). Additional independent risk factors of death are diseases of the cardiovascular system. It was not possible to find a statistically significant effect of the nature of infection on the risk of death: no growth (OR 2.23, CI 0.52–9.61), monomicrobial infection (OR 1.98, CI 0.45–8, 73), polymicrobial infection (OR 3.2, CI 0.71–14.45, p > 0.05). Conclusion The mortality rate during the first year after revision THA in patients with PJI was 2.99 %, which is lower than the results of other researchers. In the next 2–3 years, the rate of death increases 3.9 times. The main independent risk factors are the age of patients and concomitant diseases of the cardiovascular system.
28
Yi, Qian, Ke Li, Zhao Jian, Ying-Bin Xiao, Lin Chen, Yao Zhang, and Rui-Yan Ma. "Risk Factors for Acute Kidney Injury after Cardiovascular Surgery: Evidence from 2,157 Cases and 49,777 Controls - A Meta-Analysis." Cardiorenal Medicine 6, no. 3 (2016): 237–50. http://dx.doi.org/10.1159/000444094.
Full textAbstract:
Purpose: Cardiovascular surgery-associated acute kidney injury (AKI-CS) contributes to mortality and morbidity. However, risk factors accelerating its development are unclear. We identified risk factors for AKI-CS in patients with cardiopulmonary bypass in the hospital surgical intensive care unit to predict and minimize renal complication in future cardiac surgery. Methods: We analyzed data from 14 case-control studies published prior to June 2014 and indexed in Science Citation Index, PubMed, and other databases to determine the major risk factors for AKI-CS. Results: Analyzed risk factors were divided into three groups: preoperative, intraoperative and postoperative. Preoperative factors included: age (OR, 4.87; 95% CI, 3.50-6.24), NYHA class III/IV (OR, 2.53; 95% CI, 1.32-4.86), hypertension (OR, 1.68; 95% CI, 1.44-1.97), preoperative creatinine (OR, 0.66; 95% CI, 0.18-1.14), peripheral vascular disease (OR, 1.31 95% CI, 1.09-1.57), respiratory system disease (OR, 1.29; 95% CI, 1.10-1.50), diabetes mellitus (OR, 1.52; 95% CI, 1.07-2.16), and cerebrovascular disease (OR, 2.13; 95% CI, 1.11-4.09). Intraoperative factors were: cardiopulmonary bypass time (OR, 33.78; 95% CI, 23.15-44.41), aortic clamping time (OR, 13.24; 95% CI, 7.78-18.69), use of intra-aortic balloon pump (OR, 4.44; 95% CI, 2.37-8.30), and type of surgery (OR, 1.01; 95% CI, 0.43-2.39). Postoperative factors were: infection (OR, 3.58; 95% CI, 1.43-8.97), redo operation (OR, 2.57; 95% CI, 1.75-3.78), emergency surgery (OR, 4.76; 95% CI, 3.05-7.43), and low cardiac output (OR, 2.30; 95% CI, 1.05-5.04). Conclusions: Our results support that preoperative, intraoperative, and postoperative factors are associated with AKI-CS. Ejection fraction, BMI, acute myocardial infarction, type of surgery, and congestive heart failure were not absolutely associated with AKI.
29
Dzhioeva, O. N., and O. M. Drapkina. "Postoperative atrial fibrillation as a risk factor for cardiovascular complications in non-cardiac surgery." Cardiovascular Therapy and Prevention 19, no. 4 (September 5, 2020): 2540. http://dx.doi.org/10.15829/1728-8800-2020-2540.
Full textAbstract:
Reducing mortality due to cardiovascular complications (CVC) after non-cardiac surgery is one of the priority tasks of modern healthcare. According to the literature data, it is the CVC that are leading cause of perioperative mortality in non-cardiac surgery. Atrial fibrillation (AF) is a common complication after surgery. It is believed that in most cases the AF is potentiated by a combination of factors. It is intraoperative triggers, such as deliberate hypotension, anemia, injury, and pain, that can directly contribute to development of arrhythmia. However, heart rate monitoring after non-cardiac surgery is performed in only a small number of patients, so in most cases, arrhythmias remain unreported. The Revised Cardiac Risk Index (RCRI) and theAmericanCollegeof Surgeons National Surgical Quality Improvement Program (ACS NSQIP) Surgical Risk Calculator are the current tools for assessing perioperative cardiovascular risk. Postoperative AF is not included in any CVC risk stratification system. The presented review systematizes the data that postoperative AF is closely associated with perioperative complications and in some cases it may be the only marker of these complications. It has been shown that AF detection is of great clinical importance in both high-risk patients and, especially, in patients with a low risk of potential complications in non-cardiac surgery.
30
Nagao, Kazuhiro, Masahide Ebi, Takaya Shimura, Tomonori Yamada, Yoshikazu Hirata, Tomohiro Iwai, Takanori Ozeki, et al. "The Modified eCura System for Identifying High-Risk Lymph Node Metastasis in Patients with Early Gastric Cancer Resected by Endoscopic Submucosal Dissection." Gastroenterology Insights 13, no. 1 (February 14, 2022): 60–67. http://dx.doi.org/10.3390/gastroent13010007.
Full textAbstract:
Background: Endoscopic submucosal dissection (ESD) is widely used for early gastric cancer (EGC) in patients without lymph node metastasis (LNM). Prediction of LNM after ESD is important to determine prognosis in patients with EGC. In this regard, the eCura system was applied to predict LNM after noncurative ESD for EGC. This study aimed to identify risk factors for LNM and improve the accuracy of the eCura system for predicting the risk of LNM after ESD. Methods: A total of 150 patients who underwent noncurative resection of EGC by ESD were retrospectively enrolled at five institutions in Japan. All patients underwent additional surgery with lymph node resection after ESD. The risk factors for LNM among clinicopathological parameters were examined and receiver operating characteristic curve (ROC) analysis was used to determine the optimal cutoff point for predicting high LNM risk using the modified eCura system. Results: Of 150 patients, 19 (13%) had LNM. In the multivariate analysis, lymphatic invasion, and tumor size >30 mm were independent risk factors for LNM. Using a cutoff score of ≥4 for predicting high risk based on the eCura system, the rate of LNM was significantly higher in the high-risk group (4–7 points) than in the low-risk group (0–3 points) (odds ratio 12.0, 95% confidence interval 3.7–54.2, p < 0.0001). Conclusions: An eCura score ≥4 may improve the prediction of LNM risk after ESD in patients with EGC in the intermediate-risk group (2–4 points) of the eCura system, suggesting better treatment strategies for patients. Further prospective and long-term follow-up studies are needed to validate the efficacy of the modified system.
31
Aurelia, Hangan, Dumitru Eugen, Rugina Sorin, and Dumitru Irina Magdalena. "Clostridium Difficile Infection - Analysis of Risk Factors in Constanta." ARS Medica Tomitana 26, no. 4 (November 1, 2020): 159–62. http://dx.doi.org/10.2478/arsm-2020-0032.
Full textAbstract:
Abstract It has been estimated that the human gut contains about 1,000 species of bacteria and 100 times more genes than are found in the human genome. Over 2 Kg - as weight. It is the human microbiom that form a true “forgotten organ” of our body. Due to the abuse of antibiotics, the Clostridium difficile infection became one of the top nosocomial infections due to complications and financial pressure on the medical system. We conducted a prospective study of the characteristics of risk factors and epidemiological aspects in patients with Clostridium difficile infection admitted to the Clinical Hospital for Infectious Diseases from Constanta for a period of 3 years. Demographics (age), risk factors (surgery, history of antibiotics or proton pump inhibitors, comorbidities) were noted. The classes of antibiotics used, other than the basic treatment of the condition were analyzed. Also the source of the infection including the ward were the patient was previously hospitalized. 47% (104) of the patients were in the 60-80 interval of age. Nearly half of the patients had a history of surgery. Only 52 patients out of a total of 221 had no history of antibiotic therapy. More than half had PPI therapy prior to the onset of CD infection. In terms of comorbidities, they are multiple, at different systems, the most common being cardiovascular, nutritional and renal diseases. The source of infection was found as nosocomial in 65% of patients. Regarding the origin of the hospital wards, the surgical departments were the main ones in which CD infections appeared: General Surgery (46), Orthopedics (33) and Urology (13). Our study results confirm that reported risk factors are advanced age, antibiotics use, proton pump inhibitors administration, comorbidities and exposure to health care sistem.
32
Karakhalis, N. B., and M. N. Karakhalis. "Risk Factors of Thrombotic Complications and Antithrombotic Therapy in Paediatric Cardiosurgical Patients." Acta Biomedica Scientifica 6, no. 2 (June 24, 2021): 81–91. http://dx.doi.org/10.29413/abs.2021-6.2.9.
Full textAbstract:
The development of cardiosurgical care for paediatric and neonatal patients is undergoing the rapid growth. Complex, multi-stage reconstructive operations and the use of invasive monitoring are associated with high risk of venous and arterial thrombosis.The cardiac surgery patient is inherently unique, since it requires controlled anticoagulation during cardiopulmonary bypass. Moreover, the most cardiovascular pediatric patients require antithrombotic measures over the perioperative period. In addition to medication support with the use of various groups of antithrombotic agents, vascular access management is justified in order to minimize the risk of thromboembolic complications, which can affect both the functional status, and common and inter-stage mortality.The purpose of this review was to systematize the available data on risk factors contributing to the development of thrombotic complications in patients with congenital heart disease.An information search was carried out using Internet resources (PubMed, Web of Science, eLibrary.ru); literature sources for period 2015–2020 were analysed. As a result of the analysis of the literature data age-dependent features of the haemostatic system, and associated with the defect pathophysiology, and undergone reconstructive interventions were described. The issues of pathophysiology of univentricular heart defects and risk factors associated with thrombosis were also covered.Moreover, aspects of intraoperative anti-thrombotic support are discussed, as well as measures to prevent thromboembolic complications in this population.Coordinated actions of haematologists, cardiologists, anaesthesiologists, intensivists, and cardiac surgeons will allow achieving a fine balance between risks of bleeding and thrombosis in the population of paediatric patients undergoing cardiovascular surgery.
33
Karabulut, H., F. Toraman, C. Alhan, G. Çamur, S. Evrenkaya, S. Daǧdelen, and S. Tarcan. "EuroSCORE Overestimates the Cardiac Operative Risk." Cardiovascular Surgery 11, no. 4 (August 2003): 295–98. http://dx.doi.org/10.1177/096721090301100408.
Full textAbstract:
Introduction: It was the purpose of our study to assess the validity of EuroSCORE (European system for cardiac operative risk evaluation) in our patient population. Materials and Methods: Between March 1999 and August 2001, information on risk factors and mortality was collected for 1123 consecutive adult patients undergoing heart surgery with cardiopulmonary bypass. EuroSCORE was used for risk stratification. Mean age ± standard deviation was 58.6 ± 10.9 and 29.1% of the patients were female. The area under the receiver operating characteristic (ROC) curve was calculated as an index for the predictive value of the scoring system. Results: The area under the ROC curve was 0.824 for all patients and 0.828 for the isolated CABG subgroup which shows an excellent predictive ability. When the scoring system was applied in low, medium, and high risk groups, there was no overlap between 95% confidence intervals of observed and expected mortality in all three groups both for the isolated CABG cases and for all patients. Decreased left ventricular ejection fraction, emergent operation, and preoperative unstable angina requiring i.v. nitrate treatment were significant predictive variables for early mortality. Conclusion: EuroSCORE is a simple and objective system for predicting the risk of heart surgery. The predictive power of the EuroSCORE is excellent, however it seems that mortally is considerably overestimated by this score.
34
Chen, Xiaoying, Xian Liu, Jinglun Liu, and Dan Zhang. "Pulmonary embolism secondary to deep venous thrombosis: A retrospective and observational study for clinical characteristics and risk stratification." Phlebology: The Journal of Venous Disease 36, no. 8 (March 24, 2021): 627–35. http://dx.doi.org/10.1177/0268355521990964.
Full textAbstract:
Objective To investigate the risk factors, predilection sites in pulmonary embolism (PE) patients caused by deep venous thrombosis (DVT) and explore the value of scoring systems in assessing the risk of PE in DVT patients. Methods A total of 692 DVT patients were enrolled, and divided into no pulmonary embolism (NPE, 226, 32.66%), silent pulmonary embolism (SPE, 330, 47.67%) and featuring pulmonary embolism (FPE, 136, 19.65%) groups. For each group, the differences of clinical data and PE locations were compared, and the risk factors of PE secondary to DVT were analyzed. The predictive value of the scoring system for the diagnosis of PE and FPE was evaluated. Results PE presented more in the bilateral pulmonary arteries (PAs) (249, 53.43%) and has no significant difference in PESI scores in different locations. Gender, DVT locations, and previous surgery were the independent risk factors of PE. DVT locations, previous history of COPD, and previous surgical interventions were the independent risk factors of FPE. The results for areas under the ROC curves were: AUC(Wells) = 0.675, AUC (Revised Geneva) = 0.601, AUC(D-dimer) = 0.595 in the PE group; AUC(Wells) = 0.722, AUC (Revised Geneva) = 0.643, AUC(D-dimer) = 0.557 in the FPE group. Conclusions PE secondary to DVT mostly occurs in the bilateral PAs. Male gender, DVT locations, and previous surgery increased the risk of PE. The Wells scoring system was more advantageous for evaluating the diagnosis of PE in patients with DVT.
35
Cohn, S. L., W. B. London, T. Monclair, K. K. Matthay, P. F. Ambros, and A. D. Pearson. "Update on the development of the international neuroblastoma risk group (INRG) classification schema." Journal of Clinical Oncology 25, no. 18_suppl (June 20, 2007): 9503. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.9503.
Full textAbstract:
9503 Background: Modern treatment strategies for neuroblastoma (NB) are tailored according to patient risk. However, it is not currently possible to compare the results of clinical studies conducted around the globe because the criteria used to define risk are not uniform. A committee of international investigators with expertise in NB have worked during the past 2 years to develop a uniform International NB Risk Group (INRG) Classification System for pre-treatment stratification. Methods: Investigators from North America and Australia (COG); Europe (SIOPEN and Germany), and Japan collated data on 8,800 children with NB diagnosed between 1990 and 2002. Survival tree regression analyses tested 13 potential prognostic factors. Tumor differentiation, MKI, and diagnostic category were evaluated individually in lieu of the International NB Pathology Classification (INPC) system to determine if these histologic features had prognostic value independent from age. To stage patients at the time of diagnosis prior to surgery, a new staging system was developed (INRGSS) based on the presence or absence of image-defined risk factors (IDRFs) and metastases. Results: Since statistical analyses demonstrated support for an optimal age cut- off between 14–19 months, 18 months was selected. In addition to age, stage, MYCN amplification, tumor differentiation, ploidy, and genetic aberrations of 11q were found to be the most highly prognostically significant factors. These clinical and biological factors were combined to define 15 INRG pre-treatment groups. Patients with low- (3 groups), intermediate- (4 groups), high- (4 groups), or ultra-high-risk NB (4 groups) had EFS of ≥85%, >70–85%, >50–70%, or <50%, respectively. Conclusion: International collaborative studies in NB will be greatly facilitated by the INRG classification system which will allow comparisons of different risk-based therapeutic approaches in homogeneous patient cohorts. No significant financial relationships to disclose.
36
Harashima, Saki, Maiko Fujimori, Tatsuo Akechi, Tomohiro Matsuda, Kumiko Saika, Takaaki Hasegawa, Keisuke Inoue, et al. "Suicide, other externally caused injuries and cardiovascular death following a cancer diagnosis: study protocol for a nationwide population-based study in Japan (J-SUPPORT 1902)." BMJ Open 9, no. 7 (July 2019): e030681. http://dx.doi.org/10.1136/bmjopen-2019-030681.
Full textAbstract:
IntroductionA growing body of literature has demonstrated that cancer patients have a higher risk of suicide and cardiovascular mortality compared with the general population, especially immediately after a cancer diagnosis. Using data from the National Cancer Registry in Japan launched in January 2016, we will conduct the first nationwide population-based study in Japan to compare incidence of death by suicide, other externally caused injuries (ECIs) and cardiovascular disease following a cancer diagnosis with that of the general population in Japan. We will also aim to identify the patient subgroups and time periods associated with particularly high risk.Methods and analysisOur study subjects will consist of cancer cases diagnosed between 1 January 2016 and 31 December 2016 in Japan and they will be observed until 31 December 2018. We will calculate standardised mortality ratios (SMRs) and excess absolute risks (EARs) for suicide, other ECIs and cardiovascular death compared with the general population in Japan, after adjustment for sex, age and prefecture. SMRs and EARs will be calculated separately in relation to a number of factors: sex; age at diagnosis; time since cancer diagnosis; prefecture of residence at diagnosis; primary tumour site; behaviour code of tumour; extension of tumour; whether definitive surgery of the primary site was performed; and presence/absence of multiple primary tumours.Ethics and disseminationThe study protocol was approved by the institutional review board and ethics committee of the National Cancer Center Japan and Nagoya City University Graduate School of Medical Sciences. The findings will be disseminated through peer-reviewed publications and conference presentations.Trial registration numberUMIN000035118; Pre-results.
37
Aoyama, Norio. "Effect of periodontal disease on circulatory system via vascular endothelial function." Impact 2021, no. 5 (June 7, 2021): 22–24. http://dx.doi.org/10.21820/23987073.2021.5.22.
Full textAbstract:
In establishing better interconnectedness between different branches of medicine, new advancements can be made. Instead of focusing on the affected region of a body, it can be helpful to look at a bigger picture and explore the links to other body parts. For example, there are links between dentistry and general medicine but yet there remains a separation between the two. There is a growing awareness of how oral health can impact on the rest of the body, such as links between periodontal disease and cardiovascular diseases, and this is the context of Associate Professor Norio Aoyama's work. He is based at Kanagawa Dental University, Japan, where he is exploring the links between the cardiovascular system and the oral environment. He hopes that his work can enhance awareness of the relationship between medical care and dentistry. Periodontal disease can lead to chronic infection and eventual loss of teeth. One hallmark of this chronic infection is the related chronic immune response with inflammation and Aoyama believes the link between periodontal and cardiovascular disease is due to this chronic element. Aoyama and his team try demonstrating a causal link between the two diseases by recruiting patients to create control and test groups. The patients in the main test group, with periodontal disease but no cardiovascular risk factors, might have their vascular endothelial dysfunction examined using reactive hyperaemia peripheral arterial tonometry.
38
Kanayama, Masatoshi, Toshihiro Osaki, Natsumasa Nishizawa, Makoto Nakagawa, Tomoko So, and Mantaro Kodate. "Modified risk scoring system for acute exacerbation of interstitial lung disease." Asian Cardiovascular and Thoracic Annals 27, no. 1 (November 26, 2018): 18–22. http://dx.doi.org/10.1177/0218492318816229.
Full textAbstract:
Background Lung cancer patients with interstitial lung disease often develop acute exacerbation of their interstitial lung disease after lung resection. Special care is needed in selection of the surgical procedure to reduce acute exacerbation and provide long-term survival. Methods The Japanese Association for Chest Surgery devised a risk scoring system based on 7 risk factors to predict the probability of postoperative acute exacerbation. We excluded surgical procedures and used a modified system categorizing 4 groups: group A (risk score 0–6), group B (risk score 7–10), group C (risk score 11–14), and group D (risk score 15–18). We retrospectively examined 60 lung cancer patients with interstitial lung disease to determine whether the modified risk scoring system is useful for selecting the optimal surgical procedure in anticipation of curability and risk of postoperative acute exacerbation. Results Eight (13.3%) patients experienced postoperative acute exacerbation. In group A ( n = 20), there was no difference in the incidence of acute exacerbation between wedge (0%) and anatomic resection (6.3%, p = 0.800). In group B ( n = 40), the incidence was significantly higher after anatomic resection (5.0% vs. 30.0%, p = 0.046). Thus group A had high-quality outcomes with anatomic resection, and in group B, the incidence of postoperative acute exacerbation can be reduced if wedge resection is performed. Conclusions Our modified risk scoring can be useful for selecting the optimal surgical procedure in anticipation of curability and the risk of acute exacerbation of interstitial lung disease after lung cancer surgery.
39
Nonaka, Tadashi, Shinichi Oka, Kei Miyata, Takeshi Mikami, Izumi Koyanagi, Kiyohiro Houkin, Kazuhisa Yoshifuji, and Toshio Imaizumi. "Prediction of Prolonged Postprocedural Hypotension after Carotid Artery Stenting." Neurosurgery 57, no. 3 (September 1, 2005): 472–77. http://dx.doi.org/10.1227/01.neu.0000170541.23101.81.
Full textAbstract:
ABSTRACT OBJECTIVE: Stent placement for the treatment of carotid artery stenosis may cause hemodynamic instability that induces ischemic complications for patients with bilateral carotid lesions. We carried out this study to define predictors of persistent hypotension after carotid stenting. METHODS: Thirty-three lesions in 31 consecutive patients (mean age, 69.2 ± 8.6 yr) who underwent stent deployment for carotid stenosis were studied. Fourteen lesions were treated with Easy Wall stents (Boston Scientific, Tokyo, Japan) and 19 lesions were treated with Smart stents (Johnson & Johnson, Warren, NJ). We reviewed preoperative angiograms and ultrasonograms of the carotid artery and analyzed the predictive factors of postprocedural prolonged hypotension (systolic blood pressure <90 mm Hg and periods >3 h). RESULTS: Postprocedural hypotension was observed in 14 lesions (42.4%), of which medical treatment was necessary in seven (21.2%). A distance between carotid bifurcation and maximum stenotic lesion (≤10 mm; P = 0.0028) and type of stenosis (eccentric; P = 0.0287) on angiogram and fibrous plaque morphological features (P = 0.0008) and calcifications at carotid bifurcation (P = 0.0004) on ultrasonograms were determined to be independent risk factors of postprocedural hypotension. We introduced a scoring system for predicting prolonged hypotension that included factors such as the distance from carotid bifurcation to maximum stenotic lesion (≤10 mm), type of stenosis (eccentric), plaque morphological features (echogenic), and calcification at carotid bifurcation. The score was determined by adding one point for each of these factors. Three points or more on this score strongly suggested a high risk of prolonged hypotension. CONCLUSION: Our scoring system, which includes angiographic and ultrasonographic findings, may be a good index for the prediction of prolonged hypotension after carotid stenting and may contribute to the reduction of periprocedural ischemic events.
40
Alassar, Aiman, David Roy, Nada Abdulkareem, Oswaldo Valencia, Stephen Brecker, and Marjan Jahangiri. "Acute Kidney Injury after Transcatheter Aortic Valve Implantation: Incidence, Risk Factors, and Prognostic Effects." Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 7, no. 6 (November 2012): 389–93. http://dx.doi.org/10.1177/155698451200700603.
Full textAbstract:
Objective Acute kidney injury (AKI) is a common complication after surgical aortic valve replacement and is associated with increased mortality. Transcatheter aortic valve implantation (TAVI) is now considered the criterion standard treatment of patients with severe symptomatic aortic stenosis ineligible for surgery. The aim of this study was to establish the incidence, risk factors, and prognostic consequences of AKI after TAVI and at 1-year follow-up in a single center. Methods Between December 2007 and March 2011, a total of 79 patients with severe aortic stenosis who underwent 81 TAVI procedures with the Medtronic CoreValve System or the Edwards SAPIEN heart valve were included. Baseline characteristics and procedural complications were recorded. Acute kidney injury was defined according to the Valve Academic Research Consortium criteria (modified risk, injury, failure, loss, and end-stage kidney disease criteria). Results The mean age was 84 (78–87) years; 49 were men. After TAVI, 10 patients (12.3%) developed AKI, which had completely resolved in 9 patients before hospital discharge. Nine patients (10%) had mild AKI (stage 1) and only one patient (10%) experienced moderate AKI (stage 2) according to Valve Academic Research Consortium definitions. The predictive factors of AKI were diabetes (odds ratio, 6.722; P = 0.004) and preoperative creatinine level greater than 104 μmol/L (odds ratio, 1.024; P = 0.02). Thirteen patients (16.4%) died within 1 year after TAVI. Three of the nonsurvivors (3.7%) developed AKI postoperatively. Acute kidney injury was, however, not a predictive factor of 1-year mortality after TAVI. Conclusions Acute kidney injury occurred in 12.3% of the patients after TAVI and persisted in only one patient before hospital discharge. Diabetes and preoperative creatinine level were found to be the main predictive factors of AKI after TAVI. Acute kidney injury was not associated with increased 1-year mortality.
41
Evseveva, M. E., M. V. Eremin, M. V. Rostovtseva, O. V. Sergeeva, E. N. Fursova, V. A. Rusidi, I. Yu Galkova, and V. D. Kudryavtseva. "Phenotypes of early and favorable vascular aging in young people depending on the risk factors and presence of connective tissue dysplasia." Cardiovascular Therapy and Prevention 19, no. 6 (December 31, 2020): 2524. http://dx.doi.org/10.15829/1728-8800-2020-2524.
Full textAbstract:
Aim. To study the main risk factors and signs of connective tissue dysplasia (CTD) in young people according to quartile analysis of cardioankle vascular index (CAVI).Material and methods. The study involved 243 young people (men, 81; women, 162) aged 18-25 years. All subjects were divided into quartile groups depending on CAVI on both sides, or CAVI-R and CAVI-L, determined using the VaSera-1500 system (Fucuda Denshia,Japan). According to the latest guidelines, the 4th quartile of this distribution among persons of the same sex and age corresponds to early vascular aging (EVA) syndrome. The 1st quartile corresponds to favorable vascular aging. We analyzed the main RFs and CTD signs in each of the 4 CAVI quartiles. Data processing was carried out using the Statistica 10.0 software package (StatSoft Inc,USA).Results. The minimum and maximum CAVI in the sample were 3,2 and 7,9. The overwhelming majority of studied risk factors in both sexes were not associated with the stiffness. Only body mass and body mass index increasedwith a decrease in vascular stiffness and vice versa. The average number of external stigmas of dysembryogenesis in young people increased from the 1st to the 4th CAVI quartile, with significant differences in the extreme groups. Such CTD signs as a carpal tunnel syndrome and thumb sign also significantly differed between the 1st and 4th quartiles.Conclusion. The presented results can be used for prevention among young people to form more individualized programs taking into account a comprehensive assessment of vascular aging phenotype and the level of external stigmatization of each young person.
42
Kostyamin, Yuri D., and Ilya S. Grekov. "Cardiac surgery-associated acute kidney injury." Perm Medical Journal 38, no. 5 (September 15, 2021): 93–105. http://dx.doi.org/10.17816/pmj38593-105.
Full textAbstract:
This literature review is devoted to one of the topical multidisciplinary problems of modern clinical practice the development of acute kidney injury after cardiac surgery. The prevalence of this pathology varies on average from 5 to 43 %, while the frequency of early hospital mortality increases significantly in the population of such patients compared with patients without cardiac surgery-associated renal damage. It is assumed that the work of the artificial circulatory system contributes to the development of such complications, but as shown by many studies, the etiology of such kidney damage is multifactorial and cannot be explained by only one pathogenetic mechanism. The article highlights the current understanding of the etiology, pathogenesis and risk factors of acute kidney injury after cardiovascular interventions, describes new markers of early detection of renal dysfunction, and describes some prognostic aspects of the disease. Early identification and stratification of risk groups will allow for a timely preventive strategy, which will significantly improve early and long-term postoperative outcomes in such patients.
43
Chun, Kevin C., Kai Y. Teng, LeAnn A. Chavez, Elyse N. Van Spyk, Kiana M. Samadzadeh, John G. Carson, and Eugene S. Lee. "Risk Factors Associated with the Diagnosis of Abdominal Aortic Aneurysm in Patients Screened at a Regional Veterans Affairs Health Care System." Annals of Vascular Surgery 28, no. 1 (January 2014): 87–92. http://dx.doi.org/10.1016/j.avsg.2013.06.016.
Full text
44
Ide, Yujiro, Hisateru Tachimori, Yasutaka Hirata, Norimichi Hirahara, Noritaka Ota, Kisaburo Sakamoto, Tadashi Ikeda, and Kenji Minatoya. "Risk analysis for patients with a functionally univentricular heart after systemic-to-pulmonary shunt placement." European Journal of Cardio-Thoracic Surgery 60, no. 2 (March 13, 2021): 377–83. http://dx.doi.org/10.1093/ejcts/ezab077.
Full textAbstract:
Abstract OBJECTIVES To investigate risk factors for mortality after systemic-to-pulmonary (SP) shunt procedures in patients with a functionally univentricular heart using the Japan Cardiovascular Surgery Database registry. METHODS Clinical data from 75 domestic institutions were collected. Overall, 812 patients with a functionally univentricular heart who underwent initial SP shunt palliation were eligible for analysis. Patients with pulmonary atresia with an intact ventricular septum and patients with a SP shunt as part of the Norwood procedure were excluded. Risk factors for 30- and 90-day mortalities were analysed using a logistic regression model. RESULTS Median age and body weight at SP shunt placement were 41 days and 3.6 kg, respectively. Modified Blalock–Taussig shunt, central shunt and other types of SP shunts were applied in 689 (84.9%), 94 (11.8%) and 30 (3.7%) patients, respectively. Cardiopulmonary bypass was utilized in 410 patients (51%) for 128 min (median, 19–561). There were 411 isolated SP shunt procedures. Median hospital stay was 27 days, and 742 (91.4%) patients were discharged. The 30- and 90-day mortality rates were 3.4% and 6.0%, respectively. Placement of a central shunt was identified as a risk factor for 30-day mortality, while lower body weight, preoperative ventilator support, right atrial isomerism and coexistence of major aortopulmonary collateral arteries and an unbalanced atrioventricular septal defect were identified as risk factors for 90-day mortality. CONCLUSIONS SP shunt carries a high mortality rate in patients with a functionally univentricular heart when it is performed in smaller patients with complex cardiac anomalies.
45
Luo, Wenqi, Wang Huaibin, Zhen Wenjun, Tan Jie, Ouyang Xiaokang, Wang Zi, and Ma Yujian. "Predictors of Postoperative Atrial Fibrillation after Isolated On-Pump Coronary Artery Bypass Grafting in Patients ≥60 Years Old." Heart Surgery Forum 20, no. 1 (February 28, 2017): E038—E042. http://dx.doi.org/10.1532/hsf.1583.
Full textAbstract:
Background: Postoperative atrial fibrillation (POAF) after coronary artery bypass grafting (CABG) is one of the most common complications that can contribute to an increased risk of mortality, particularly in older patients. The identification of predictors of POAF after CABG could impact patient care. This study aims to determine the risk factors of POAF in patients ≥60 years old who underwent isolated on-pump coronary artery bypass grafting (ONCAB) in order to provide a basis for the prevention and treatment of POAF after ONCAB.
Methods: Between October 2011 and November 2015, a total of 304 patients ≥60 years old underwent isolated ONCAB in our department. The patients were divided into 2 groups, the AF group and the non-AF group, according to the occurrence of POAF. A retrospective analysis was performed on the general characteristics and perioperative data of the patients. Logistic regression analysis was used to identify the predictors of POAF after ONCAB in patients ≥60 years old.
Results: The incidence of POAF after ONCAB in patients ≥60 years old was 23.36% (71/304). Statistically significant differences were observed in patients’ age, history of hypertension, left atrium diameter, European System for Cardiac Operative Risk Evaluation (EuroSCORE) I and II, and the highest level of serum creatinine after operation (all P < .05). Logistic regression analyses showed that a history of hypertension (OR = 2.575, CI 1.208-5.488, P = .014), left atrium diameter (OR = 1.105, CI 1.047-1.167, P = .000) and EuroSCORE I score (OR = 1.132, CI 1.001-1.279, P = .048) were independent risk factors for POAF after ONCAB in patients ≥60 years old.
Conclusion: The occurrence of POAF after isolated ONCAB in patients ≥60 years old was affected by many risk factors; a history of hypertension, the left atrium diameter and the EuroSCORE I score were all predictors of POAF.
46
Wong, Y., J. Maddicks-Law, P. Raymond, M. Davidson, B. Thomson, V. Sharma, G. Javorsky, and A. Prabhu. "Real World Experience with Transmedics Organ Care System in Cardiac Transplantation with Donor Organs Associated with Marginal Risk Factors." Journal of Heart and Lung Transplantation 40, no. 4 (April 2021): S195—S196. http://dx.doi.org/10.1016/j.healun.2021.01.569.
Full text
47
Stoliński, Jarosław, Robert Musiał, Dariusz Plicner, and Janusz Andres. "Respiratory System Function in Patients after Minimally Invasive Aortic Valve Replacement Surgery." Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 12, no. 2 (March 2017): 127–36. http://dx.doi.org/10.1097/imi.0000000000000349.
Full textAbstract:
Objective The aim of the study was to comparatively analyze respiratory system function after minimally invasive, through right minithoracotomy aortic valve replacement (RT-AVR) to conventional AVR. Methods Analysis of 201 patients scheduled for RT-AVR and 316 for AVR between January 2010 and November 2013. Complications of the respiratory system and pulmonary functional status are presented. Results Complications of the respiratory system occurred in 16.8% of AVR and 11.0% of RT-AVR patients ( P = 0.067). The rate of pleural effusions, thoracenteses, pneumonias, or phrenic nerve dysfunctions was not significantly different between groups. Perioperative mortality was 1.9% in AVR and 1.0% in RT-AVR ( P = 0.417). Mechanical ventilation time after surgery was 9.7 ± 5.9 hours for AVR and 7.2 ±3.2 hours for RT-AVR patients ( P < 0.001). Stroke (odds ratio [OR] = 13.4, P = 0.008), increased postoperative blood loss (OR = 9.6, P <0.001), and chronic obstructive pulmonary disease (OR = 7.7, P < 0.001) were risk factors of prolonged mechanical lung ventilation. A week after surgery, the results of most pulmonary function tests were lower in the AVR than in the RT-AVR group ( P < 0.001 was seen for forced expiratory volume in the first second, vital capacity, total lung capacity, maximum inspiratory pressure and maximum expiratory pressure, P = 0.377 was seen for residual volume). Conclusions Right anterior aortic valve replacement minithoracotomy surgery with single-lung ventilation did not result in increased rate of respiratory system complications. Spirometry examinations revealed that pulmonary functional status was more impaired after AVR in comparison with RT-AVR surgery.
48
AI-Ghalayini, Kamal W., Mohammed A. Salama, Hadia Bassam Al Mahdi, Sameer Al-Harthi, Wesam A. Alhejily, Mirvat A. Alasnag, Noura O. Tasbhji, Diana A. H. Al-Quwaie, Panos Deloukas, and Sherif Edris. "Identification of Genetic Variants Associated With Myocardial Infarction in Saudi Arabia." Heart Surgery Forum 23, no. 4 (July 23, 2020): E517—E523. http://dx.doi.org/10.1532/hsf.2955.
Full textAbstract:
The genetic variants associated with various genetic disorders have not been identified decisively in Saudi Arabia. Among these variants, six known for their association with coronary artery disease or myocardial infarction (MI) were studied on Saudi patients. Reference single nucleotide polymorphisms (SNPs) of these variants are rs5174, rs11591147, rs2259816, rs111245230, rs3782886 and rs2259820, referring to genes LRP8, PCSK9, HNF1A, SVEP1, BRAP and HNF1A, respectively. The analysis employed polymerase chain reaction panel coupled with mini-sequencing (SNapShot multiplex system) in order to identify these variants. A total of 100 MI patients and 103 healthy control individuals participated in this study. The six variants (SNPs) were evaluated for the risk of developing MI in the Saudi patients. Analysis of allele frequencies indicated that A allele of rs11591147 variant can be a protective allele, thus, is associated with the decreased risk of MI in Saudi individuals. Rare allele of rs111245230 variant (e.g., C allele) was extremely reduced, while rare allele of rs3782886 variant (e.g., G allele) does not exist in the ethnic signature of the Saudi population. This study elucidates the possible prediction of risk factors associated with severe diseases in Saudi population utilizing SNapShot multiplex system.
49
Motoyama, Satoru, Hiroyuki Yamamoto, Hiroaki Miyata, Masahiko Yano, Takushi Yasuda, Masaichi Ohira, Yoshiaki Kajiyama, et al. "Impact of certification status of the institute and surgeon on short-term outcomes after surgery for thoracic esophageal cancer: evaluation using data on 16,752 patients from the National Clinical Database in Japan." Esophagus 17, no. 1 (October 3, 2019): 41–49. http://dx.doi.org/10.1007/s10388-019-00694-9.
Full textAbstract:
Abstract Background In 2009, the Japan Esophageal Society (JES) established a system for certification of qualified surgeons as “Board Certified Esophageal Surgeons” (BCESs) or institutes as “Authorized Institutes for Board Certified Esophageal Surgeons” (AIBCESs). We examined the short-term outcomes after esophagectomy, taking into consideration the certifications statuses of the institutes and surgeons. Methods This study investigated patients who underwent esophagectomy for thoracic esophageal cancer and who were registered in the Japanese National Clinical Database (NCD) between 2015 and 2017. Using hierarchical multivariable logistic regression analysis adjusted for patient-level risk factors, we determined whether the institute’s or surgeon’s certification status had greater influence on surgery-related mortality or postoperative complications. Results Enrolled were 16,752 patients operated on at 854 institutes by 1879 surgeons. There were significant differences in the backgrounds and incidences of postoperative complications and surgery-related mortality rates between the 11,162 patients treated at AIBCESs and the 5590 treated at Non–AIBCESs (surgery-related mortality rates: 1.6% vs 2.8%). There were also differences between the 6854 patients operated on by a BCES and the 9898 treated by a Non-BCES (1.7% vs 2.2%). Hierarchical logistic regression analysis revealed that surgery-related mortality was significantly lower among patients treated at AIBCESs. The institute’s certification had greater influence on short-term surgical outcomes than the operating surgeon’s certification. Conclusions The certification system for surgeons and institutes established by the JES appears to be appropriate, as indicated by the improved surgery-related mortality rate. It also appears that the JES certification system contributes to a more appropriate medical delivery system for thoracic esophageal cancer in Japan.
50
Lin, Hongyuan, Jianfeng Hou, Hanwei Tang, Kai Chen, Shaoxian Guo, Liqing Wang, Hansong Sun, Zhe Zheng, and Shengshou Hu. "A Novel Risk Stratification System for Predicting In-Hospital Mortality Following Coronary Artery Bypass Grafting Surgery with Impaired Left Ventricular Ejection Fraction." Heart Surgery Forum 23, no. 5 (August 28, 2020): E621—E626. http://dx.doi.org/10.1532/hsf.3089.
Full textAbstract:
Background: Coronary artery disease (CAD) is the most common cause of heart failure (HF), and impaired ejection fraction (EF<50%) is a crucial precursor to HF. Coronary artery bypass grafting (CABG) is an effective surgical solution to CAD-related HF. In light of the high risk of cardiac surgery, appropriate scores for groups of patients are of great importance. We aimed to establish a novel score to predict in-hospital mortality for impaired EF patients undergoing CABG. Methods: Clinical information of 1,976 consecutive CABG patients with EF<50% was collected from January 2012 to December 2017. A novel system was developed using the logistic regression model to predict in-hospital mortality among patients with EF<50% who were to undergo CABG. The scoring system was named PGLANCE, which is short for seven identified risk factors, including previous cardiac surgery, gender, load of surgery, aortic surgery, NYHA stage, creatinine, and EF. AUC statistic was used to test discrimination of the model, and the calibration of this model was assessed by the Hosmer-lemeshow (HL) statistic. We also evaluated the applicability of PGLANCE to predict in-hospital mortality by comparing the 95% CI of expected mortality to the observed one. Results were compared with the European Risk System in Cardiac Operations (EuroSCORE), EuroSCORE II, and Sino System for Coronary Operative Risk Evaluation (SinoSCORE). Results: By comparing with EuroSCORE, EuroSCORE II and SinoSCORE, PGLANCE was well calibrated (HL P = 0.311) and demonstrated powerful discrimination (AUC=0.846) in prediction of in-hospital mortality among impaired EF CABG patients. Furthermore, the 95% CI of mortality estimated by PGLANCE was closest to the observed value. Conclusion: PGLANCE is better with predicting in-hospital mortality than EuroSCORE, EuroSCORE II, and SinoSCORE for Chinese impaired EF CABG patients.