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[Coronary surgery from the aspect of ambulatory care follow-up]

https://arctichealth.org/en/permalink/ahliterature55296
Source
Klin Khir. 1991;(10):1-4
Publication Type
Article
Date
1991
Author
G V Knyshov
I V Vykhovaniuk
N V Tkhor
V I Ursulenko
S N Furkalo
Source
Klin Khir. 1991;(10):1-4
Date
1991
Language
Russian
Publication Type
Article
Keywords
Ambulatory Care
Coronary Artery Bypass
Coronary Disease - epidemiology - surgery
English Abstract
Follow-Up Studies
Humans
Postoperative Complications - epidemiology - therapy
Ukraine - epidemiology
Abstract
The authors observed for a long-period 453 patients with the ischemic heart disease after the operation of aorto-coronary shunting (ACS). At discharge from the hospital, in 96.9% of the patients operated on, the clinical improvement of the state was noted, in 78.4% of them, the attacks of angina disappeared. Five years later, in 46.1% of the patients examined, there were no stenocardia, in 53.9%, retrosternal pain was noted. According to the findings of repeated coronarography, development of the stenocardiac syndrome is caused by insufficient function of the venous shunts and aggravation of stenosing atherosclerosis. By means of twin pharmacodynamic tests, it was established that monotherapy and combined therapy with calcium antagonists were the optimal ones.
PubMed ID
1774856 View in PubMed
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Endoscopic transpapillary stenting for pancreatic fistulas after necrosectomy with necrotizing pancreatitis.

https://arctichealth.org/en/permalink/ahliterature264301
Source
Surg Endosc. 2015 Jan;29(1):108-12
Publication Type
Article
Date
Jan-2015
Author
Heikki Karjula
Arto Saarela
Anne Vaarala
Jarmo Niemelä
Jyrki Mäkelä
Source
Surg Endosc. 2015 Jan;29(1):108-12
Date
Jan-2015
Language
English
Publication Type
Article
Keywords
Adult
Aged
Cholangiopancreatography, Endoscopic Retrograde
Feasibility Studies
Female
Follow-Up Studies
Humans
Incidence
Male
Middle Aged
Pancreas - surgery
Pancreatic Fistula - epidemiology - etiology - therapy
Pancreatitis, Acute Necrotizing - surgery
Postoperative Complications - epidemiology - therapy
Prospective Studies
Stents
Treatment Outcome
Abstract
Data concerning the incidence and treatment of pancreatic fistula after necrosectomy in severe acute necrotizing pancreatitis (SAP) are scarce. Our aim was to assess the incidence of pancreatic fistula, and the feasibility and results of endoscopic transpapillary stenting (ETS) in patients with SAP after necrosectomy.
From January 2009 to December 2012 twenty-nine consecutive patients with SAP and necrosectomy in Oulu University Hospital were enrolled into this study. Five patients died before ETS because of the rapid progress of the disease and were, therefore, excluded.
ERP was performed for the remaining 24 patients demonstrating fistula in 22/24 patients (92 %). ETS was successful in 23 patients and the fistula closed in all of them after a median of 82 (2-210) days with acceptable morbidity and no procedure-related mortality.
All patients after necrosectomy for SAP seem to have internal or external pancreatic fistula. EST aimed at internal drainage of the necrosectomy cavity is a feasible and effective therapy in these patients.
PubMed ID
24942784 View in PubMed
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The epidemiology and treatment patterns of postoperative adhesion induced intestinal obstruction in Varsinais-Suomi Hospital District.

https://arctichealth.org/en/permalink/ahliterature180325
Source
Scand J Surg. 2004;93(1):68-72
Publication Type
Article
Date
2004
Author
J. Kössi
P. Salminen
M. Laato
Author Affiliation
Department of Surgery, Päijät-Häme Central Hospital, Lahti, Finland. jyrki.kossi@phks.fi
Source
Scand J Surg. 2004;93(1):68-72
Date
2004
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Analysis of Variance
Chi-Square Distribution
Female
Finland - epidemiology
Humans
Incidence
Intestinal Obstruction - etiology - surgery
Intestine, Small
Male
Middle Aged
Postoperative Complications - epidemiology - therapy
Retrospective Studies
Tissue Adhesions - complications - epidemiology
Abstract
The epidemiology and treatment patterns of postoperative adhesion induced intestinal obstruction have been poorly investigated in Finland. This study evaluated the epidemiology and treatment patterns of postoperative adhesion induced intestinal obstruction in a well defined geographical area (Hospital District).
All inpatient episodes between 1.1.1999 and 31.12.1999 due to postoperative adhesion induced intestinal obstruction in Varsinais-Suomi Hospital District were evaluated retrospectively using individual patient records.
123 hospitalizations due to postoperative adhesion-related intestinal obstruction were observed during the study period. The total number of preceding operations was 176 considering altogether 101 patients. The most prevalent single initial operations causing adhesion induced intestinal obstruction were colorectal, upper abdominal, and female reproductive system procedures. Of all treatment episodes 32% were operative and mortality was 2%. The median days of hospital stay (range) of all inpatient episodes, operative episodes, and conservative episodes were 6 (1-58), 11 (2-34) and 4 (1-58), respectively. Patient dependent factors associated with increased likelihood to operative treatment of obstruction were: female gender (40% in females vs 23% in males, P = 0.042) and previous gynaecological surgery (70% of the patients, P = 0.032). Intraoperative findings were obstruction in 70%, strangulation in 20%, necrosis in 8%, and perforation in 2% of operations. Bowel resection was needed in 38% of operations. Preceding gynaecological surgery increased the likelihood of bowel strangulation as an intraoperative finding.
The epidemiology, treatment patterns and results of postoperative adhesion induced intestinal obstruction are of the average international level in the Varsinais-Suomi Hospital District. The treatment patterns among the different hospitals in the Hospital District are similar. Female gender is associated with increased risk for operative treatment of adhesive obstruction. Previous gynaecological surgery increases the likelihood of operative treatment and complicated obstruction.
PubMed ID
15116825 View in PubMed
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Hysterectomy in Denmark. An analysis of postoperative hospitalisation, morbidity and readmission.

https://arctichealth.org/en/permalink/ahliterature18653
Source
Dan Med Bull. 2002 Nov;49(4):353-7
Publication Type
Article
Date
Nov-2002
Author
Charlotte Møller
Henrik Kehlet
Jan Utzon
Bent Ottesen
Author Affiliation
National Board of Health, Danish Centre for Evaluation and Health Technology Assessment, Islands Brygge 67, P.O. Box 1881, DK-2300 Copenhagen S.
Source
Dan Med Bull. 2002 Nov;49(4):353-7
Date
Nov-2002
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Carcinoma in Situ - mortality - surgery
Comparative Study
Denmark - epidemiology
Endometrial Neoplasms - mortality - surgery
Female
Humans
Hysterectomy
Incidence
Laparotomy
Length of Stay
Middle Aged
Morbidity
Patient Readmission
Postoperative Complications - epidemiology - therapy
Registries
Survival Analysis
Treatment Outcome
Uterine Cervical Neoplasms - mortality - surgery
Uterine Neoplasms - mortality - surgery
Women's health
Abstract
INTRODUCTION: The aim of this study was to describe the incidence of "standard" hysterectomy in Denmark, including surgical procedure, postoperative hospitalisation, morbidity, mortality and readmission rate within 30 days. MATERIAL AND METHODS: Analysis of data from the Danish National Patient Register for a two-year period (1998-2000) concerning hysterectomies for benign indications, carcinoma in situ cervicis uteri and endometrial carcinoma stage I. A stratified sample of 821 discharge resumés was reviewed for detection of complications. RESULTS: During the two years 10,171 women underwent "standard" hysterectomy followed by a median postoperative hospitalisation of 4 days. In departments performing more than 100 operations per year, the median hospital stay varied from 3 to 5.5 days. Eighty per cent were performed by laparotomy, 6% laparoscopically assisted and 14% by the vaginal route with marked regional variation in the choice of surgical approach. The number of vaginal hysterectomies varied from 0-67% in departments with a surgical activity of more than 100 per year. The mortality rate was 0.06% and 8% were readmitted within 30 days after the operation. If allowing extrapolation from the random sample to the entire population the complication rate was estimated to a minimum of 18%. CONCLUSION: "Standard" hysterectomy in Denmark is associated with considerable morbidity and marked regional variation in choice of surgical approach. The present study emphasizes the need for a national hysterectomy database with the possibility of evaluating surgical activity, reducing morbidity rates and developing homogeneous guidelines.
PubMed ID
12553170 View in PubMed
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Manipulation under anesthesia after primary knee arthroplasty in Sweden: incidence, patient characteristics and risk of revision.

https://arctichealth.org/en/permalink/ahliterature310337
Source
Acta Orthop. 2019 10; 90(5):484-488
Publication Type
Journal Article
Date
10-2019
Author
Hunbogi Thorsteinsson
Margareta Hedström
Otto Robertsson
Natalie Lundin
Annette W-Dahl
Author Affiliation
Department of Orthopedics, Skane University Hospital , Lund.
Source
Acta Orthop. 2019 10; 90(5):484-488
Date
10-2019
Language
English
Publication Type
Journal Article
Keywords
Aged
Anesthesia
Ankylosis - epidemiology - therapy
Arthroplasty, Replacement, Knee - adverse effects - methods
Female
Humans
Knee Joint - physiopathology
Length of Stay - statistics & numerical data
Male
Manipulation, Orthopedic - methods - statistics & numerical data
Middle Aged
Osteoarthritis, Knee - epidemiology - surgery
Postoperative Care - methods
Postoperative Complications - epidemiology - therapy
Range of Motion, Articular
Registries
Reoperation - statistics & numerical data
Risk factors
Sweden - epidemiology
Abstract
Background and purpose - The incidence of manipulation under anesthesia (MUA) after knee arthroplasty surgery has been reported to vary between 0.5% and 10%. We evaluated the incidence of MUA after primary knee arthroplasty in Sweden, the demographics of the patients and the risk of revision. Patients and methods - Between 2009 and 2013, 64,840 primary total and unicompartmental knee arthroplasties (TKA and UKA) were registered in the Swedish Knee Arthroplasty Register (SKAR). MUAs performed between 2009 and 2014 were identified through the in- and outpatient registers of the Swedish National Board of Health and Welfare. Pertinent data were verified through medical records and patient demographics and revisions were obtained from the SKAR. Results - 1,258 MUAs were identified. Of these, 1,078 were 1st-time MUAs, performed within 1 year after the primary knee arthroplasty. The incidence of MUA was 1.7% and the incidence varied between hospitals from 0% to 5%. The majority were performed after TKA (98%), in younger patients (65%
PubMed ID
31269851 View in PubMed
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Probability, predictors, and prognosis of posttransplantation glomerulonephritis.

https://arctichealth.org/en/permalink/ahliterature152779
Source
J Am Soc Nephrol. 2009 Apr;20(4):843-51
Publication Type
Article
Date
Apr-2009
Author
Worawon Chailimpamontree
Svetlana Dmitrienko
Guiyun Li
Robert Balshaw
Alexander Magil
R Jean Shapiro
David Landsberg
John Gill
Paul A Keown
Author Affiliation
Division of Nephrology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Source
J Am Soc Nephrol. 2009 Apr;20(4):843-51
Date
Apr-2009
Language
English
Publication Type
Article
Keywords
Canada - epidemiology
Ethnic Groups - statistics & numerical data
Female
Glomerulonephritis - epidemiology - mortality - surgery - therapy
Humans
Immunosuppressive Agents - therapeutic use
Kidney Diseases - classification - surgery
Kidney Transplantation - adverse effects - immunology
Male
Postoperative Complications - epidemiology - therapy
Predictive value of tests
Probability
Prognosis
Retrospective Studies
Risk factors
Sex Characteristics
Survival Analysis
Survivors
Time Factors
Abstract
Glomerulonephritis (GN) is the leading cause of chronic kidney disease among recipients of renal transplants. Because modern immunosuppressive regimens have reduced the incidence of rejection-related graft loss, the probability and clinical significance of posttransplantation GN (PTGN) requires reevaluation. In this Canadian epidemiologic study, we monitored 2026 sequential renal transplant recipients whose original renal disease resulted from biopsy-proven GN (36%), from presumed GN (7.8%), or from disorders other than GN (56%) for 15 yr without loss to follow-up. Kaplan-Meier estimates of PTGN in the whole population were 5.5% at 5 yr, 10.1% at 10 yr, and 15.7% at 15 yr. PTGN was diagnosed in 24.3% of patients whose original renal disease resulted from biopsy-proven GN, compared with 11.8% of those with presumed GN and 10.5% of those with disorders other than GN. Biopsy-proven GN in the native kidney, male gender, younger age, and nonwhite ethnicity predicted PTGN. Current immunosuppressive regimens did not associate with a reduced frequency of PTGN. Patients who developed PTGN had significantly reduced graft survival (10.2 versus 69.7%; P
Notes
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PubMed ID
19193778 View in PubMed
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Readmissions after fast-track hip and knee arthroplasty.

https://arctichealth.org/en/permalink/ahliterature142981
Source
Arch Orthop Trauma Surg. 2010 Sep;130(9):1185-91
Publication Type
Article
Date
Sep-2010
Author
Henrik Husted
Kristian Stahl Otte
Billy B Kristensen
Thue Orsnes
Henrik Kehlet
Author Affiliation
Department of Orthopedic Surgery, Hvidovre University Hospital, Copenhagen, Denmark. henrikhusted@dadlnet.dk
Source
Arch Orthop Trauma Surg. 2010 Sep;130(9):1185-91
Date
Sep-2010
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Ambulatory Surgical Procedures - statistics & numerical data
Arthroplasty, Replacement, Hip - adverse effects - methods
Arthroplasty, Replacement, Knee - adverse effects - methods
Confidence Intervals
Denmark - epidemiology
Female
Follow-Up Studies
Humans
Incidence
Length of Stay
Male
Middle Aged
Patient Readmission - statistics & numerical data
Postoperative Complications - epidemiology - therapy
Prosthesis Failure
Prosthesis-Related Infections - diagnosis - epidemiology - therapy
Reoperation
Retrospective Studies
Risk assessment
Surgical Wound Infection - diagnosis - epidemiology - therapy
Abstract
With the implementation of fast-track surgery with optimization of both logistical and clinical features, the postoperative convalescence has been reduced as functional milestones have been achieved earlier and consequently length of stay (LOS) in hospital has been reduced. However, it has been speculated that a decrease in LOS may be associated with an increase in readmissions in general, including risk of dislocation after total hip arthroplasty (THA) or manipulation after total knee arthroplasty (TKA).
1,731 consecutive, unselected patients were operated with primary THA or TKA in a well-described standardized fast-track setup from 2004 to 2008. All readmissions and deaths within 90 days were analyzed using the national health register.
Mean LOS decreased from 6.3 to 3.1 days. Within 90 days, 15.6% of patients following TKA were readmitted as opposed to 10.9% after THA (p = 0.005). Three deaths (0.17%) were associated with clotting episodes. Suspicion of DVT (not found) and suspicion of infection made up half of the readmissions. Readmissions in general and for thromboembolic events, dislocations and manipulations in specific did not increase with decreasing LOS. There was no difference between readmission rates per year for either TKA or THA but there was a significantly reduced risk of dislocation found with decreasing LOS comparing each year from 2005 to 2007 with the index year of 2004 (with the longest LOS and the highest incidence of dislocation).
Fast-track TKA and THA do not increase the readmission rate. Readmissions are more frequent after TKA than THA, but dislocation after THA and manipulation after TKA do not increase as LOS is decreasing.
PubMed ID
20535614 View in PubMed
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7 records – page 1 of 1.