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Journal and News Scan
March 7, 2016
Submitted by: CTSNet Staff
607 consecutive patients with non-small-cell lung cancer who had undergone pulmonary resection were analyzed according to the distance from their home to the hospital: 0 < 10, 10–30 and >30 km. The mean postoperative hospital stay differed between the groups, but there were no significant differences in the median length of follow-up, disease-free survival.
March 7, 2016
Submitted by: CTSNet Staff
The analysis compares 1478 patients who underwent CABG and received no red blood cell (RBC) transfusion to 1528 CABG patients with 1–2 units of RBCs. The 30-day mortality rate was 0.3% and 0.2%, respectively. The propensity score-adjusted odds ratio (OR) in the RBC+ group was 0.29 [95% confidence interval (CI): 0.06–1.50; P = 0.14]. Major clinical complications did not differ significantly between groups.
March 7, 2016
Submitted by: CTSNet Staff
Approximately 3800 patients who underwent elective cardiac surgery were analyzed for post-surgical acute kidney injury (AKI). AKI occurred in 21% of patients who initiated a statin within 100 days prior to surgery compared with 29% of patients without prior statin use. The adjusted relative risk for the effect of statin initiation on AKI was RR = 0.86 (95% CI: 0.74, 0.98). Thus, presurgical statin initiation is associated with a reduction in AKI risk after cardiac surgery.
March 7, 2016
Submitted by: Mark Ferguson
Using data from the National Cancer Data Base, the surgical and oncologic efficacy of minimally invasive (VATS, robotic) lobectomy were compared to open lobectomy. Groups were created for comparison using propensity score matching techniques. VATS compared to open was associated with shorter LOS, higher readmission rates, and slightly better 2-year survival. Nodal upstaging and 30-day mortality were similar. No differences were identified comparing VATS to robotic resections for nodal upstaging, 30-day mortality, or 2-year survival.
March 7, 2016
Submitted by: Mark Ferguson
This retrospective study of 434 infants and children undergoing TOF repair focused on how methods of handling hypoplastic pulmonary arteries affects long-term outcomes. The most agressive patching technique resulted in the highest incidence of reintervention, whereas patients who had no intervention for hypoplastic pulmonary arterties had the lowest incidence of reintervention. This suggests that patching restricts the growth potential of the native vessels, and indicates that patients generally do better without intervention.
March 7, 2016
Submitted by: Mark Ferguson
This literature review evaluated 21 studies that included nearly 4000 patients having undergone transcatheter aortic valve implantation (TAVI), specifically focusing on prosthesis-patient mismatch (PPM). Overall prevalence of PPM was 35%, with 8% of patients having severe PPM. PPM occurred less often after TAVI than after surgical AVR. PPM was not associated with increased long-term mortality.
March 7, 2016
Submitted by: Mark Ferguson
Outcomes of tricuspid valve replacement at a single institution over a 4 decade period were reviewed. A bioprosthesis was used in 82%, and the surgical mortality was nearly 28%. Freedom from structural deterioration was better in the mechanical valve group. Mechanical valves were, however, associated with earlier and more severe morbidity, including a significantly higher incidence of thromboembolic complications.
March 4, 2016
Submitted by: Rakesh Arora
Surgical intervention in older people is increasing in prevalance but is associated with higher rates of adverse postoperative outcomes as compared to younger people. Current models of preoperative risk assessment and optimisation may be indequate for this complex surgical population. In this article, the Authors discuss the challenges and potential solutions in the establishment of quality surgical care for older people.
March 4, 2016
Submitted by: Rakesh Arora
Lactic acidosis is a very common biological issue for the postoperative patient with shock. This very nice review addresses thehemodynamic consequences of shock-associated lactic acidosis and highlights the various therapeutic options that can be considered by the bedside clinician.
March 4, 2016
Submitted by: Rakesh Arora
The optimal timing of tracheotomy in critically ill patients remains a topic of debate. The Authors performed a systematic review to clarify the potential benefits of early versus late tracheotomy. Three categories of timing of tracheotomy (within 4 versus after 10 days, within 4 versus after 5 days, within 10 versus after 10 days) were analyzed. Twelve studies with a total of 2,689 patients were included in this analysis. The Authors have identified that early tracheotomy is associated with more ventilator-free days, shorter ICU stays, less sedation, and reduced long-term mortality, compared to late tracheotomy