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The Canadian Journal of Urology Dec 2020
Topics: Anti-Bacterial Agents; Humans; Male; Postoperative Period; Urethra; Urinary Incontinence; Urinary Sphincter, Artificial
PubMed: 33325345
DOI: No ID Found -
Anesthesia and Analgesia Sep 2019
Topics: Brain; Humans; Neurotoxicity Syndromes; Postoperative Period
PubMed: 31425253
DOI: 10.1213/ANE.0000000000004300 -
Anesthesiology Feb 2023
Topics: Humans; Acetylcysteine; Atrial Fibrillation; Postoperative Complications; Postoperative Period; Risk Factors
PubMed: 36512708
DOI: 10.1097/ALN.0000000000004406 -
Anesthesiology Feb 2023
Topics: Humans; Acetylcysteine; Atrial Fibrillation; Postoperative Complications; Postoperative Period; Risk Factors
PubMed: 36512706
DOI: 10.1097/ALN.0000000000004407 -
Anesthesiology Feb 2023
Topics: Humans; Acetylcysteine; Atrial Fibrillation; Postoperative Complications; Postoperative Period; Risk Factors
PubMed: 36512701
DOI: 10.1097/ALN.0000000000004405 -
Korean Journal of Anesthesiology Feb 2022Myocardial injury is defined as an elevation of cardiac troponin (cTn) levels with or without associated ischemic symptoms. Robust evidence suggests that myocardial... (Randomized Controlled Trial)
Randomized Controlled Trial
Myocardial injury is defined as an elevation of cardiac troponin (cTn) levels with or without associated ischemic symptoms. Robust evidence suggests that myocardial injury increases postoperative mortality after noncardiac surgery. The diagnostic criteria for myocardial injury after noncardiac surgery (MINS) include an elevation of cTn levels within 30 d of surgery without evidence of non-ischemic etiology. The majority of cases of MINS do not present with ischemic symptoms and are caused by a mismatch in oxygen supply and demand. Predictive models for general cardiac risk stratification can be considered for MINS. Risk factors include comorbidities, anemia, glucose levels, and intraoperative blood pressure. Modifiable factors may help prevent MINS; however, further studies are needed. Recent guidelines recommend routine monitoring of cTn levels during the first 48 h post-operation in high-risk patients since MINS most often occurs in the first 3 days after surgery without symptoms. The use of cardiovascular drugs, such as aspirin, antihypertensives, and statins, has had beneficial effects in patients with MINS, and direct oral anticoagulants have been shown to reduce the mortality associated with MINS in a randomized controlled trial. Myocardial injury detected before noncardiac surgery was also found to be associated with postoperative mortality, though further studies are needed.
Topics: Blood Pressure; Humans; Myocardial Ischemia; Postoperative Complications; Postoperative Period; Risk Factors
PubMed: 34657407
DOI: 10.4097/kja.21372 -
BMC Geriatrics Apr 2022Most people having major surgery are over the age of 65. The transition out of hospital is a vulnerable time for older adults, particularly after major surgery. Research... (Review)
Review
BACKGROUND
Most people having major surgery are over the age of 65. The transition out of hospital is a vulnerable time for older adults, particularly after major surgery. Research on postoperative transitions in care is growing, but it is not clear how postoperative transitions are being evaluated. The objective of this scoping review was to synthesize processes and outcomes used to evaluate postoperative transitions in care for older adults.
METHODS
We conducted a scoping review that included articles evaluating a postoperative transition in care among adults aged > 65 having major elective surgery. We searched Medline (Ovid), EMBASE (Ovid), CINHAL, and Cochrane Central Register of Controlled Trials (CENTRAL) from their respective inception dates to April 6, 2021. We also searched The World Health Organization International Clinical Trials Registry Platform and ClinicalTrials.gov from their respective inception dates to April 6, 2021. Screening and data extraction was completed by reviewers in duplicate. Data relevant to study design and objective, intervention description, and process or outcome evaluations were extracted. Process evaluations were categorized using the Ideal Transitions in Care Framework, and outcome evaluations were categorized using the Institute for Healthcare Improvement Triple Aim Framework.
RESULTS
After screening titles and abstracts and full-text article review, we included 20 articles in our final synthesis. There was variability in the processes and outcomes used to evaluate postoperative transitions in care. The most common outcomes evaluated were health service utilization (n = 9), including readmission and Emergency Department visits, experiential outcomes (n = 9) and quality of life (n = 7). Process evaluations included evaluating the education provided to patients to promote self-management (n = 6), coordination of care among team members (n = 3) and outpatient follow-up (n = 3). Only two articles measured frailty, one article used theory to guide their evaluations and no articles engaged knowledge users.
CONCLUSIONS
There is inconsistency in how postoperative transitions in care were evaluated. There is a need to use theories and to engage key stakeholders involved in postoperative transitions in care, including older adults and their caregivers, to identify the most appropriate approaches for developing and evaluating interventions to meaningfully improve care.
Topics: Aged; Elective Surgical Procedures; Emergency Service, Hospital; Humans; Postoperative Period; Quality of Life; Self-Management
PubMed: 35428193
DOI: 10.1186/s12877-022-02989-6 -
Anaesthesia Apr 2020
Topics: Blood Transfusion; Blood Transfusion, Autologous; Hematopoietic Stem Cell Transplantation; Humans; Liver Neoplasms; Postoperative Period
PubMed: 31872437
DOI: 10.1111/anae.14965 -
BMC Anesthesiology Aug 2022The 15-item Quality of Recovery-15 (QoR-15) scale is strongly recommended as a standard patient-reported outcome measure assessing the quality of recovery after surgery... (Observational Study)
Observational Study
BACKGROUND
The 15-item Quality of Recovery-15 (QoR-15) scale is strongly recommended as a standard patient-reported outcome measure assessing the quality of recovery after surgery and anesthesia in the postoperative period. This study aimed to validate the Dutch translation of the questionnaire (QoR-15NL).
MATERIALS AND METHODS
An observational, prospective, single-centre cohort study was conducted. Patients who underwent surgery under general anesthesia completed the QoR-15NL (preoperatively (t1) and twice postoperatively (t2 and t3)) and a visual analogue scale (VAS) for general recovery at t2. A psychometric evaluation was performed to assess the QoR-15NL's validity, reliability, responsiveness, reproducibility and feasibility.
RESULTS
Two hundred and eleven patients agreed to participate (recruitment rate 94%), and 165 patients were included (completion rate 78%). The QoR-15NL score correlated with the VAS for general recovery (rs = 0.59). Construct validity was further demonstrated by confirmation of expected negative associations between the QoR-15NL and duration of surgery (rs = -0.25), duration of Post Anesthesia Care Unit stay (rs = -0.31), and duration of hospital stay (rs = -0.27). The QoR-15NL score decreased significantly according to the extent of surgery. Cronbach's alpha was 0.87, split-half reliability was 0.8, and the test-retest intra-class coefficient was 0.93. No significant floor- or ceiling effect was observed.
CONCLUSION
The QoR-15NL scale is a valid, easy-to-use, and reliable outcome assessment tool with high responsiveness for patient-reported quality of recovery after surgery and general anesthesia in the Dutch-speaking population. The QoR-15NL's measurement properties are comparable to the original questionnaire and other translated versions.
TRIAL REGISTRATION
not applicable.
Topics: Anesthesia Recovery Period; Anesthesia, General; Cohort Studies; Humans; Prospective Studies; Reproducibility of Results; Surveys and Questionnaires
PubMed: 35915438
DOI: 10.1186/s12871-022-01784-5 -
Indian Journal of Ophthalmology Apr 2023Cataract surgery is one of the most commonly performed ophthalmic surgeries in the world. Dry eye disease (DED) is found to coexist in most patients with cataracts due... (Review)
Review
Cataract surgery is one of the most commonly performed ophthalmic surgeries in the world. Dry eye disease (DED) is found to coexist in most patients with cataracts due to the overlapping age groups of both these conditions. Preoperative evaluation for DED is important to improve outcomes. A pre-existing DED affecting the tear film is likely to affect biometry. Moreover, special intraoperative considerations are needed in eyes with DED to reduce complications and improve postoperative outcomes. Dry eye disease (DED) is known to occur following an uneventful cataract surgery or a pre-existing DED is likely to worsen following cataract surgery as well. In these situations, despite a good visual outcome, patient dissatisfaction is common owing to the distressing DED symptoms. This review aims to summarize the preoperative, intraoperative, and postoperative considerations when performing cataract surgery in the presence of a coexisting DED.
Topics: Humans; Cataract; Cataract Extraction; Dry Eye Syndromes; Postoperative Period; Tears
PubMed: 37026268
DOI: 10.4103/IJO.IJO_2807_22