Evaluation of O-POSSUM vs ASA and APACHE II scores in patients undergoing oesophageal surgery
|
|
- Richard Norton
- 5 years ago
- Views:
Transcription
1 ORIGINAL PAPERS Evaluation of O-POSSUM score in oesophageal surgery Romanian Journal of Anaesthesia and Intensive Care 2015 Vol 22 No 1, 7-12 Evaluation of O-POSSUM vs ASA and APACHE II scores in patients undergoing oesophageal surgery Raluca Fodor 1, Adrian Cioc 2, Bianca Grigorescu 2, Bogdan Lăzescu 2, Sanda Maria Copotoiu 1 1 Anaesthesiology and Intensive Care Department, University of Medicine and Pharmacy of Tîrgu Mureş, Romania 2 Anaesthesiology and Intensive Care Clinic, Clinical County Emergency Hospital Mureş, Romania Abstract Background and aims: Risk and prognostic scores quantify the patient s risk of death or complication according to the severity of his illness. The aim of this study was to evaluate the predictive accuracy of O POSSUM vs ASA and APACHE II models on patients undergoing oesophageal surgery. Material and method: In this observational retrospective study 55 patients were enrolled who had undergone surgical interventions of excision and reconstruction of the oesophagus for neoplastic oesophageal stenosis, in the Surgical Clinics (I and II) of the Clinical County Emergency Hospital Mures, between January 2011 and January By using patients file records after extracting the data we calculated the predictive mortality, according to the prognostic scores O-POSSUM, ASA and APACHE II and we analyzed its correlations with the postoperative evolution. We evaluated the discriminatory power of the three scores using the ROC (receiver-operating characteristic) curves. According to the cut-off value corresponding to each score, we compared the Kaplan Meier survival curves during the hospitalization period. Results: ROC curves analysis revealed that O-POSSUM had a better discriminatory power for mortality compared to the other two scores: AUC = 0.73 for O-POSSUM, AUC = 0.57 for APACHE II and AUC = 0.64 for ASA (p < 0.001). The cut-off value was statistically significant only in case of O-POSSUM, as it derives from the statistical analysis of the survival curves (p = 0.035). Conclusion: O-POSSUM predicts mortality more accurately compared to ASA or APACHE II in patients undergoing oesophageal surgery. Keywords: O-POSSUM, ASA, APACHE II, oesophageal surgery Rom J Anaesth Int Care 2015; 22: 7-12 Introduction Surgical interventions for the removal and reconstruction of the oesophagus represent the corner stone in the elective treatment of esophageal stenosis. Most patients with oesophageal cancer apply for surgery in an advanced stage of disease. Curative surgery requires considerable resources in the operating theatre Adress for correspondence: Raluca Fodor, MD, PhD Clinical County Emergency Hospital Str. Gh. Marinescu nr , Tîrgu Mureş, Romania ralucasolomon@yahoo.com and in the critical care unit and is associated with important postoperative morbidity and mortality. Respiratory complications occur the most frequently and are responsible for the majority of the postoperative deaths [1]. Therefore, preoperative surgical risk assessment is a crucial part of the modern surgical practice. Risk and prognostic scores quantify the patient s risk of death or complication according to the severity of his illness. This will allow a surgeon to anticipate the adverse events following the surgery and to facilitate the informed consent process and surgical decision making. Various surgical risk prediction models have been developed to objectively quantify the postoperative morbidity and mortality. Some of the common risk
2 8 Fodor et al. prediction models in surgery are APACHE II (Acute Physiology and Chronic Health Evaluation) [2], POSSUM (Physiological and Operative Severity Score for the enumeration of Mortality and Morbidity) [3] and ASA (The American Society of Anesthesiologist ) physical status classification [4]. The simplest and most used scoring system is the ASA score, based on the assessment of the patients physical status. The ASA score was initiated in the beginning of the 1940 s, and since then only minor changes have been added despite major progress in anesthesiology and surgery. The APACHE II score is a standard tool for the assessment of the degree of desease severity in ICU ranging between 0-71 points. Higher values are related to higher severity and mortality levels. This score is defined by 3 components: the acute physiological score involving 12 parameters, age score and chronic illnesses score. Each parameter has a coeficient ranging 0-4, according to the severity of abnormal findings. The APACHE II score cannot be directly converted to a percent risk of mortality. In order to calculate a mortality risk, the patient s indication for ICU admission must be accounted for. The POSSUM model for predicting post-operative mortality was developed in 1991 using cohorts of general surgical patients, but has been used in clinical practice only in the last decade. It is based on a combination of physiological parameters, operative variables and age of the patients. Each of these factors is given a weighted value and the predicted risk of morbidity or death is calculated by a logarithmic formula.the POSSUM scoring system was particularly developed as an audit tool to compare postoperative outcome in general surgery, but it would appear that the POSSUM model increasingly overestimates mortality particularly in those who were at low risk [5]. Possible reasons for this are the increasing use of minimally invasive operative techniques and the better peri-operative care. In 1996 a new variant of POSSUM was developed: P-POSSUM [5]. It used the same set of variables as POSSUM but has a different logistic regression equation. Both POSSUM and P-POSSUM scoring systems use a 12 factor physiological score and a 6 factor operative severity score [6]. Attempts have been made to modify the POSSUM scoring system for specific surgical procedures. For example: V-POSSUM [7] for vascular, RAAA- POSSUM [8] for ruptured abdominal aortic aneurysm, CR-POSSUM [9] for colorectal surgery and O- POSSUM [10] for oesophageal and upper gastrointestinal surgery. In O-POSSUM, the operative severity score is modified to exclude operative blood loss, number of procedures and peritoneal soiling. Age was regressed independently from POSSUM. Objective The aim of this study was to evaluate the predictive accuracy of O-POSSUM vs ASA and APACHE II scores in our case series of patients undergoing oesophageal surgery. In our setting, the O-POSSUM score is not utilized as a routine, but still holds a great potential for evaluating the risk severity associated with oesophageal surgery. Material and method The study was observational and retrospective. The Institutional Review Board approval was obtained before enrolling the patients (n = 55). Our including criteria were: adult patients who had undergone surgical interventions of removal and reconstruction of the oesophagus, in the Surgical Clinics No. I and II of the Clinical County Emergency Hospital Mures, between January 2011 and January 2014 and were admitted postoperatively in ICU. The following data were collected from the patients files: age, diagnostic, length of postoperative stay in ICU, the ASA score - as it appeared in the patient pre-anesthetic informed consent, the physiological and the disease-related variables necessary for calculating APACHE II score on the first day of ICU admittance, the preoperative physiological parameters and operative variables necessary for calculating O-POSSUM score and outcome of the patient at their ICU discharge. The data were collected from patients files and were proccessed using Microsoft Excel and SPSS statistics version 22 (IBM, New York, USA). We calculated the predictive mortality, according to the prognostic scores O-POSSUM, ASA and APACHE II and we correlated it with the postoperative evolution. We evaluated the discriminatory power of the three scores using the ROC (receiver-operating characteristic) curves. According to the cut-off value corresponding to each score, we compared the Kaplan Meier survival curves during hospitalization period. Results The present study enrolled a number of 55 patients (47 males and 8 females) diagnosed with neoplastic oesophageal stenosis. Patients age ranged years, and the average was ± 6.95 years. The median (range) lenght of hospitalization was 17 (2, 51) days. At the day of surgical intervention, values for O- POSSUM, APACHE II and ASA prognostic score systems were as they are presented in Table 1. Neoplastic stenosis was located most frequently at the lower third of the oesophagus (39.29%).
3 Evaluation of O-POSSUM score in oesophageal surgery 9 Table 1. The average values of the preoperative prognostic scores O-P OS S UM AP AC HE II AS A Mean Std. Deviation Minimum Maximum Using the Cox regression model, the site of tumor was not a predictor of mortality (p = 0.195, hazard ratio = 0.47) as presented in Table 2. Table 2. Tumor site as a predictor of mortality Cox regression model for tumor site as a predictor of mortality p value (higher Hazard 95.0% CI for Hazard Ratio than 0.05) Ratio Lower Upper Tumor Site CI confidence interval Fig. 2. Receiver-operating characteristic curve. O-POSSUM real mortality. SS Sensitivity, SP Specificity, AUC area under curve A number of 20 patients died after surgery (36.36%). We noticed that the highest mortality was in patients with neoplasic stenosis located in the intermediate and lower third of the esophagus (Figure 1). Surgical mortality is often seen as a surrogate of performance, to enable comparison between individual surgeons and hospitals. This method of comparison can be misleading due to differences in the case mix [11]. Fig. 3. Receiver-operating characteristic curve. APACHE II real mortality. SS Sensitivity, SP Specificity, AUC area under curve Fig. 1. Deaths according to tumor location We evaluated the discriminatory power for mortality of the three scores using the ROC (receiveroperating characteristic) curves (Figures 2, 3, 4). ROC curves analysis revealed that O-POSSUM had a better discriminatory power for mortality as compared to the other two scores: AUC = 0.73 for O- POSSUM, AUC = 0.57 for APACHE II and AUC = 0.64 for ASA (p < 0.001). Fig. 4. Receiver-operating characteristic curve. ASA real mortality. SS Sensitivity, SP Specificity, AUC area under curve
4 10 Fodor et al. According to the cut-off value corresponding to each score, we compared the Kaplan Meier survival curves during the hospitalization period. The cut-off value was establised in order to gain an optimal ratio between specificity and sensitivity, our target being the highest specificity (Figures 5, 6, 7). Fig. 7. Survival curve during hospitalization period for ASA. SS Sensitivity, SP Specificity Fig. 5. Survival curve during hospitalization period for O-POSSUM. SS Sensitivity, SP Specificity The cut-off value was statistically significant only in the case of O-POSSUM, as it derives from the statistical analysis of survival curves (p = 0.035). If we change the cut-off values of the APACHE II score, in order to increase specificity, the prognostic power of this score will be superior to O-POSSUM s (p = vs p = 0.035) (Figure 8). Fig. 6. Survival curve during hospitalization period for APACHE II (cut off value = 14.5). SS Sensitivity, SP Specificity Fig. 8. Survival curve during hospitalization period for APACHE II (cut off value= 19.5). SS Sensitivity, SP Specificity
5 Evaluation of O-POSSUM score in oesophageal surgery 11 Discussions O-POSSUM predicts mortality more accurately than ASA or APACHE II in patients undergoing oesophageal surgery. But, in the case of patients with multiple associated comorbidities, the APACHE II score has a superior statistical significance compared to the POSSUM score. The ASA score is easy to use but it is not very precise and it does not consider surgical insult in predicting postoperative outcome. Its main advantage consists of its simplicity, but it is also its major limitation.the ASA score does not make a difference either between the illnesses of different systems nor the different abnormalities in the same system and does not rank asymptomatic patients (eg. patients with severe coronary disease). Values of the ASA score cannot guide preoperative management of the patients, because it does not make a difference in the preoperative approach for an asthmatic patient to a patient with severe renal impairment or metastatic tumors [12]. The ASA score has no capacity to delimit or to add the risk imposed by multiple diseases. The evaluation of ASA score reflects only the patient s physical condition, with no respect to the magnitude of the surgical insult [13]. The APACHE scoring system is quite complex and time consuming. Moreover, all the parameters are not always easily obtainable, particularly outside the intensive care setting. Therefore, missing values in the data are a potential source of error in the APACHE scoring system [14].The APACHE II score is mainly useful for monitoring patients evolution in ICU but it is also accurate in predicting perioperative complications in the surgical patients [15, 16]. The POSSUM scoring system is an intermmediate score between ASA and APACHE regarding its objectivity and its simplicity. O-POSSUM was designed to provide a dedicated model for prediction of mortality after oesophago-gastric resections. According to our study, the O-POSSUM score system has the best discriminatory capacity in the assessment of postoperative mortality (AUC = 0.73 for O-POSSUM, AUC = 0.57 for APACHE II and AUC = 0.64 for ASA), but it could not identify patients with a higher risk for in-hospital mortality. For patients presenting multiple comorbidities, the APACHE II score is more accurate and it has a superior statistic significance than the O-POSSUM score. The high mortality is explained by the pressure to operate due to rejected patients or deferred from other hospitals, sometimes patients exceeding the indications for surgery. There were four studies of O-POSSUM on postoperative mortality in patients undergoing resection for gastro-oesophageal cancer [17-20]. Out of these four studies, three were oesophageal studies and one gastrooesophageal study. In all of them, O-POSSUM appeared to have poor predictive accuracy and showed significant lack of goodness of fit. However, a deficiency in the current POSSUM models is that they are not based on a good understanding of the patho-physiological process that results in morbidity and mortality following cancer surgery. Recently it has become clear that the systemic inflammatory response, as evidenced by an inflammation based prognostic score (Glasgow Prognostic Score), is strongly associated with long term survival of both inoperable [21] and operable [22] cancer patients. Given that the GPS is much simpler (two factors) compared with physiological POSSUM (12 factors) further work is required to compare its value in predicting morbidity and mortality following cancer surgery. These risk assessment tools have been used to allow for the comparative audit of surgical mortality although they fail to address the prediction of morbidity and mortality in individual patients. As a retrospective study this has several limitations. Of these the most important are the relative small number of subjects included (55 patients) and the existence of bias in collecting the necessary data from patients files that may adversely impact the reliability of the results. Conclusions Our results showed that O-POSSUM predicts mortality more accurately than the ASA or the APACHE II scores in patients undergoing oesophageal surgery. In patients with multiple comorbidities, the APACHE II score has increased statistical significance. Conflict of interest Nothing to declare References 1. Atkins BZ, D Amico TA. Respiratory complications after esophagectomy. Thorac Surg Clin 2006; 16: Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: a severity of disease classification system. Crit Care Med 1985; 13: Copeland GP, Jones D, Walters M. POSSUM: a scoring system for surgical audit. Br J Surg 1991; 78: Owens WD, Felts JA, Spitznagel EL Jr. ASA physical status classifications: a study of consistency of ratings. Anesthesiology 1978; 49: Whiteley MS, Prytherch DR, Higgins B, Weaver PC, Prout WG. An evaluation of the POSSUM surgical scoring system. Br J Surg 1996; 83:
6 12 Fodor et al. 6. Brooks MJ, Sutton R, Sarin S. Comparison of Surgical Risk Score, POSSUM and p-possum in higher-risk surgical patients. Br J Surg 2005; 92: Prytherch DR, Ridler BM, Beard JD, Earnshaw JJ; Audit and Research Committee, The Vascular Surgical Society of Great Britain and Ireland. A model for national outcome audit in vascular surgery. Eur J Vasc Endovasc Surg 2001; 21: Boyle JR, Prytherch DR, Payne SP, Pemberton RM, Sutton GL. P-POSSUM models for abdominal aortic aneurysm surgery. Br J Surg 2001; 88(4): Tekkis PP, Prytherch DR, Kocher HM, Senapati A, Poloniecki JD, Stamatakis JD, et al. Development of a dedicated riskadjustment scoring system for colorectal surgery (colorectal POSSUM). Br J Surg 2004; 91: Tekkis PP, McCulloch P, Poloniecki JD, Prytherch DR, Kessaris N, Steger AC. Risk-adjusted prediction of operative mortality in oesophagogastric surgery with O-POSSUM. Br J Surg 2004; 91: Markus PM, Martell J, Leister I, Horstmann O, Brinker J, Becker H. Predicting postoperative morbidity by clinical assessment. Br J Surg 2005; 92: Holt N, Silverman DG. Modeling perioperative risk: can numbers speak louder than words? Anesthesiol Clin 2006; 24: Slim K, Panis Y, Alves A, Kwiatkowski F, Mathieu P, Mantion G, et al. Predicting postoperative mortality in patients undergoing colorectal surgery. World J Surg 2006; 30: Chandra A, Mangam S, Marzouk D. A review of risk scoring systems utilised in patients undergoing gastrointestinal surgery. J Gastrointest Surg 2009; 13: Arvidsson S, Ouchterlony J, Nilsson S, Sjöstedt L, Svärdsudd K. The Gothenburg study of perioperative risk. Acta Anaesthesiol Scand 1994; 38: Shuhaiber JH. Quality measurement of outcome in general surgery revisited: commentary and proposal. Arch Surg 2002; 137: Lai F, Kwan TL, Yuen WC, Wai A, Siu YC, Shung E. Evaluation of various POSSUM models for predicting mortality in patients undergoing elective oesophagectomy for carcinoma. Br J Surg 2007; 94: Nagabhushan JS, Srinath S, Weir F, Angerson WJ, Sugden BA, Morran CG. Comparison of P-POSSUM and O-POSSUM in predicting mortality after oesophagogastric resections. Postgrad Med J 2007; 83: Lagarde SM, Maris AK, de Castro SM, Busch OR, Obertop H, van Lanschot JJ. Evaluation of O-POSSUM in predicting inhospital mortality after resection for oesophageal cancer. Br J Surg 2007; 94: Internullo E, Moons J, Nafteux P, Coosemans W, Decker G, De Leyn P, et al. Outcome after esophagectomy for cancer of the esophagus and GEJ in patients aged over 75 years. Eur J Cardiothorac Surg 2008; 33: McMillan DC. An inflammation-based prognostic score and its role in the nutrition-based management of patients with cancer. Proc Nutr Soc 2008; 67: McMillan DC. Systemic inflammation, nutritional status and survival in patients with cancer. Curr Opin Clin Nutr Metab Care 2009; 12: Evaluarea scorurilor O-POSSUM vs ASA şi APACHE II la pacienţii supuşi chirurgiei esofagiene Rezumat Obiectiv: Scorurile de risc şi prognostic cuantifică riscul de deces sau complicaţie a pacientului pe baza severităţii bolilor. Obiectivul acestui studiu a constat în evaluarea acurateţei predictive a scorurilor O- POSSUM vs ASA şi APACHE II la pacienţii supuşi chirurgiei esofagiene. Material şi metodă: În acest studiu observaţional, retrospectiv au fost înrolaţi 55 de pacienţi care au necesitat intervenţii chirurgicale de rezecţie şi reconstrucţie esofagiană pentru stenoze de etiologie neoplazică în Clinicile Chirurgie I şi II ale Spitalului Clinic Judeţean de Urgenţă Tîrgu Mureş în perioada 2011 ianuarie Am calculat mortalitatea predictivă potrivit scorurilor de prognostic O POSSUM, ASA şi APACHE II şi am corelat o cu evoluţia postoperatorie a pacienţilor. Evaluarea capacităţii discriminatorii a celor trei scoruri s-a realizat utilizând curbele ROC (receiveroperating characteristic). În funcţie de valoarea de cutoff aferentă fiecărui scor, am comparat curbele de supravieţuire Kaplan Meier pe perioada internării. Rezultate: Analiza curbelor ROC a arătat o mai bună capacitate discriminatorie în ceea ce priveşte mortalitatea pentru O-POSSUM (AUC = 0,73 pentru O-POSSUM, AUC = 0,57 pentru APACHE II şi AUC = 0,64 pentru ASA) (p < 0,001). Valoarea de cut-off a fost semnificativă statistic numai pentru O POSSUM, informaţie derivată din analiza curbelor de supravieţuire (p = 0.035). Concluzii: Scorul O-POSSUM a prezentat cea mai bună capacitate de discriminare în predicţia mortalităţii la pacienţii supuşi chirurgiei esofagiene. Cuvinte cheie: O-POSSUM, ASA, APACHE II, chirurgie esofagiană
Evaluation of POSSUM and P-POSSUM as predictors of mortality and morbidity in patients undergoing laparotomy at a referral hospital in Nairobi, Kenya
Evaluation of POSSUM and P-POSSUM as predictors of mortality and morbidity in patients undergoing laparotomy at a referral hospital in Nairobi, Kenya Kimani MM 1,2 *, Kiiru JN 3, Matu MM 3, Chokwe T 1,2,
More informationAssessment of Different Prognostic Scores for Early Postoperative Outcomes after Esophagectomy
Chirurgia (2014) 109: 480-485 No. 4, July - August Copyright Celsius Assessment of Different Prognostic Scores for Early Postoperative Outcomes after Esophagectomy B. Filip, I. Hutanu, I. Radu, M.G. Anitei,
More informationCardiopulmonary exercise testing provides a predictive tool for early and late outcomes in abdominal aortic aneurysm patients
Vascular surgery doi 10.1308/003588411X587235 Cardiopulmonary exercise testing provides a predictive tool for early and late outcomes in abdominal aortic AR Thompson, N Peters, RE Lovegrove, S Ledwidge,
More informationVolume 13 Issue 3 Version 1.0 Year 2013 Type: Double Blind Peer Reviewed International Research Journal Publisher: Global Journals Inc.
Volume 13 Issue 3 Version 1.0 Year 2013 Type: Double Blind Peer Reviewed International Research Journal Publisher: Global Journals Inc. (USA) Abstract - Background : Though POSSUM and P-POSSUM have been
More informationSurgical Apgar Score Predicts Post- Laparatomy Complications
ORIGINAL ARTICLE Surgical Apgar Score Predicts Post- Laparatomy Complications Dullo M 1, Ogendo SWO 2, Nyaim EO 2 1 Kitui District Hospital 2 School of Medicine, University of Nairobi Correspondence to:
More informationFTS Oesophagectomy: minimal research to date 3,4
Fast Track Programme in patients undergoing Oesophagectomy: A Single Centre 5 year experience Sullivan J, McHugh S, Myers E, Broe P Department of Upper Gastrointestinal Surgery Beaumont Hospital Dublin,
More informationAssociation of Age and Survival in Patients With Gastroesophageal Cancer Undergoing Surgery With or Without Preoperative Therapy
Association of Age and Survival in Patients With Gastroesophageal Cancer Undergoing Surgery With or Without Preoperative Therapy Fadi Braiteh, MD 1 ; Arlene M. Correa, PhD 2 ; Wayne L. Hofstetter, MD 2
More informationGeneral introduction and outline of thesis
General introduction and outline of thesis General introduction and outline of thesis 11 GENERAL INTRODUCTION AND OUTLINE OF THESIS The incidence of esophageal cancer is increasing in the western world.
More informationBelow is summarised some of the tools and papers that are worth looking at if you have an interest in the area.
What happens to the high risk patients who don t die? Perioperative SIG meeting PBLD Noosa 2015 Nicola Broadbent, Auckland, NZ In the process of writing this problem based learning discussion I have read
More informationTHE CLINICAL course of severe
ORIGINAL ARTICLE Improved Prediction of Outcome in Patients With Severe Acute Pancreatitis by the APACHE II Score at 48 Hours After Hospital Admission Compared With the at Admission Arif A. Khan, MD; Dilip
More informationRisk adjustment for audit of low risk general surgical patients by Jabalpur-POSSUM score
Original Article Risk adjustment for audit of low risk general surgical patients by Jabalpur-POSSUM score Vijay Parihar, Dhananjaya Sharma, Romesh Kohli, D. B. Sharma G. I. Surgery Unit, Department of
More informationDr. Stuart McCorkell BSc FRCA FFICM Anaesthetic Department, Guy s & St. Thomas s NHS Foundation Trust 2017 POPS
Dr. Stuart McCorkell BSc FRCA FFICM Anaesthetic Department, Guy s & St. Thomas s NHS Foundation Trust Why assess (estimate) risk? Patient information and informed consent (patient, surgeon) Stratify resource
More informationAssessment of surgical outcome in general surgery using Portsmouth possum scoring
Al Am een J Med Sci 2013; 6(1):65-69 US National Library of Medicine enlisted journal ISSN 0974-1143 ORIGI NAL ARTICLE C O D E N : A A J MB G Assessment of surgical outcome in general surgery using Portsmouth
More informationOvernight Intensive Recovery: Elective Open Aortic Surgery Without a Routine ICU Bed
Eur J Vasc Endovasc Surg 30, 252 258 (2005) doi:10.1016/j.ejvs.2005.03.004, available online at http://www.sciencedirect.com on Overnight Intensive Recovery: Elective Open Aortic Surgery Without a Routine
More informationPerioperative risk prediction scores
I N T E N S I V E C A R E Tutorial 343 Perioperative risk prediction scores Dr. Maria Chereshneva and Dr. Ximena Watson Anaesthetic Registrars, Croydon University Hospital, UK Dr. Mark Hamilton Anaesthetic
More informationDisclosure. I do not have any potential conflict of interest
Endovascular repair of ruptured abdominal aortic aneurysms is superior to open repair in risk stratified patients: a look at the United States experience through the SVS Vascular Quality Initiative 2003
More informationIs surgical Apgar score an effective assessment tool for the prediction of postoperative complications in patients undergoing oesophagectomy?
Interactive CardioVascular and Thoracic Surgery 27 (2018) 686 691 doi:10.1093/icvts/ivy148 Advance Access publication 9 May 2018 BEST EVIDENCE TOPIC Cite this article as: Li S, Zhou K, Li P, Che G. Is
More informationLong term survival study of de-novo metastatic breast cancers with or without primary tumor resection
Long term survival study of de-novo metastatic breast cancers with or without primary tumor resection Dr. Michael Co Division of Breast Surgery Queen Mary Hospital The University of Hong Kong Conflicts
More informationThe correlation between burn size and serum albumin level in the first 48 hours after burn injury
STUDII CLINICE The correlation between burn size and serum albumin level in the first 48 hours after burn injury Jurnalul Român de Anestezie Terapie Intensivă 2013 Vol.20 Nr.1, 5-9 The correlation between
More informationRuptured Abdominal Aortic Aneurysms: Factors Influencing Postoperative Mortality and Long-term Survival
Eur J Vasc Endovasc Surg 15, 62-66 (1998) Ruptured Abdominal Aortic Aneurysms: Factors Influencing Postoperative Mortality and Long-term Survival H. P. A. van Dongen 1, J. A. Leusink% F. L. Moll% F. M.
More informationBest Practices for Fast Track in Bariatric Surgery: Enhanced Recovery After Bariatric Surgery
Best Practices for Fast Track in Bariatric Surgery: Enhanced Recovery After Bariatric Surgery Abdelrahman Nimeri, MBBCh, FACS, FASMBS ACS NSQIP Surgeon Champion Chief of General, Thoracic & Vascular Surgery
More informationPredicting perioperative mortality after oesophagectomy: a systematic review of performance and methods of multivariate models
British Journal of Anaesthesia 114 (1): 32 43 (2015) Advance Access publication 17 September 2014. doi:10.1093/bja/aeu294 Predicting perioperative mortality after oesophagectomy: a systematic review of
More informationPostoperative hypothermia and patient outcomes after elective cardiac surgery
doi:10.1111/j.1365-2044.2011.06784.x ORIGINAL ARTICLE Postoperative hypothermia and patient outcomes after elective cardiac surgery D. Karalapillai, 1 D. Story, 2 G. K. Hart, 3,4 M. Bailey, 5 D. Pilcher,
More information6. Endovascular aneurysm repair
Introduction The standard treatment for aortic aneurysm, open repair, involves a large abdominal incision and cross-clamping of the aorta. In recent years, a minimally invasive technique, endovascular
More informationPREVENT COMPLICATIONS IN MAJOR SURGERY
PREVENT COMPLICATIONS IN MAJOR SURGERY Dept of Anesthesia and ICM (Prof. G. Della Rocca) Azienda Ospedaliero-Universitaria University of Udine. Udine, Italy CLINICAL TRIAL OF SURVIVORS CARDIORESPIRATORY
More informationORIGINAL ARTICLE. APACHE II, POSSUM, and ASA Scores and the Risk of Perioperative Complications in Patients With Oral or Oropharyngeal Cancer
ORIGINAL ARTICLE APACHE II, POSSUM, and ASA Scores and the Risk of Perioperative Complications in Patients With Oral or Oropharyngeal Cancer Karina de Cássia Braga Ribeiro, DDS, PhD; Luiz Paulo Kowalski,
More informationOriginal Article. Postoperative hypothermia and patient outcomes after major elective non-cardiac surgery. Abstract
Original Article doi:10.1111/anae.12129 Postoperative and patient outcomes after major elective non-cardiac surgery D. Karalapillai, 1 D. Story, 2 G. K. Hart, 3 M. Bailey, 4 D. Pilcher, 5 A. Schneider,
More informationPerioperative changes of serum albumin are a predictor of postoperative pulmonary complications in lung cancer patients: a retrospective cohort study
Original Article Perioperative changes of serum albumin are a predictor of postoperative pulmonary complications in lung cancer patients: a retrospective cohort study Pengfei Li 1,2#, Jue Li 1,2#, Yutian
More informationCancer and AAA: Causal role for chronic inflammation?
Cancer and AAA: Causal role for chronic inflammation? Sakalihasan Natzi MD,PhD Department of Cardiovascular and Thoracic Surgery University hospital of Liège, Experimental Research Center of the Cardiovascular
More informationOutcome following surgery for colorectal cancer
Outcome following surgery for colorectal cancer Colin S McArdle* and David J Hole *University Department of Surgery, Glasgow Royal Infirmary, Glasgow and Department of Public Health, University of Glasgow,
More informationORIGINAL PAPER. Marginal pulmonary function is associated with poor short- and long-term outcomes in lung cancer surgery
Nagoya J. Med. Sci. 79. 37 ~ 42, 2017 doi:10.18999/nagjms.79.1.37 ORIGINAL PAPER Marginal pulmonary function is associated with poor short- and long-term outcomes in lung cancer surgery Naoki Ozeki, Koji
More informationEarly-goal-directed therapy and protocolised treatment in septic shock
CAT reviews Early-goal-directed therapy and protocolised treatment in septic shock Journal of the Intensive Care Society 2015, Vol. 16(2) 164 168! The Intensive Care Society 2014 Reprints and permissions:
More informationThe Effect of Tidal Volume on Pulmonary Complications following Minimally Invasive Esophagectomy: A Randomized and Controlled Study
The Effect of Tidal Volume on Pulmonary Complications following Minimally Invasive Esophagectomy: A Randomized and Controlled Study Yaxing Shen, MD, Ming Zhong, MD, Lijie Tan, MD Zhongshan Hospital,Fudan
More informationCritical care resources are often provided to the too well and as well as. to the too sick. The former include the patients admitted to an ICU
Literature Review Critical care resources are often provided to the too well and as well as to the too sick. The former include the patients admitted to an ICU following major elective surgery for overnight
More informationAnaesthesia for the Over 75s. Chris Edge
Anaesthesia for the Over 75s Chris Edge Topics to be Covered Post-operative cognitive management Morbidity and mortality General anaesthesia a good idea or not? Multiple comorbidities and assessment of
More informationOutcomes of Intensive Care Unit admissions after elective cancer surgery
Available online at www.sciencedirect.com EJSO 39 (2013) 584e592 www.ejso.com Outcomes of Intensive Care Unit admissions after elective M.M.E.M. Bos a, F. Bakhshi-Raiez b, J.W.T. Dekker c, N.F. de Keizer
More informationMinimally Invasive Esophagectomy- Valuable. Jayer Chung, MD University of Colorado Health Sciences Center December 11, 2006
Minimally Invasive Esophagectomy- Valuable Jayer Chung, MD University of Colorado Health Sciences Center December 11, 2006 Overview Esophageal carcinoma What is minimally invasive esophagectomy (MIE)?
More informationAfter primary tumor treatment, 30% of patients with malignant
ESTS METASTASECTOMY SUPPLEMENT Alberto Oliaro, MD, Pier L. Filosso, MD, Maria C. Bruna, MD, Claudio Mossetti, MD, and Enrico Ruffini, MD Abstract: After primary tumor treatment, 30% of patients with malignant
More informationImpact of infectious complications on gastric cancer recurrence
Gastric Cancer (2015) 18:368 374 DOI 10.1007/s10120-014-0361-3 ORIGINAL ARTICLE Impact of infectious complications on gastric cancer recurrence Tsutomu Hayashi Takaki Yoshikawa Toru Aoyama Shinichi Hasegawa
More informationAnesthesiology and Intensive Care Department, University of Medicine and Pharmacology of Craiova, Romania 2
Current Health Sciences Journal Vol. 40, No. 4, 2014 October December Original Paper The Predictive Value of Scores Used in Intensive Care Unit for Burn Patients Prognostic M. NOVAC 1, ALICE DRAGOESCU
More informationPreoperative Biliary Drainage Among Patients With Resectable Hepatobiliary Malignancy: Does Technique Matter?
Preoperative Biliary Drainage Among Patients With Resectable Hepatobiliary Malignancy: Does Technique Matter? Q. Lina Hu, MD; Jason B. Liu, MD, MS; Ryan J. Ellis, MD, MS; Jessica Y. Liu, MD, MS; Anthony
More informationAccuracy of endoscopic ultrasound staging for T2N0 esophageal cancer: a national cancer database analysis
Review Article Accuracy of endoscopic ultrasound staging for T2N0 esophageal cancer: a national cancer database analysis Ravi Shridhar 1, Jamie Huston 2, Kenneth L. Meredith 2 1 Department of Radiation
More informationFluid Balance in an Enhanced Recovery Pathway. Edwin Itenberg, DO, FACS, FASCRS St. Joseph Mercy Oakland MSQC/ASPIRE Meeting April 28, 2017
Fluid Balance in an Enhanced Recovery Pathway Edwin Itenberg, DO, FACS, FASCRS St. Joseph Mercy Oakland MSQC/ASPIRE Meeting April 28, 2017 No Disclosures 2 Introduction The optimal intravenous fluid regimen
More informationMINIMALLY INVASIVE ESOPHAGECTOMY FOR CANCER: where do we stand?
MINIMALLY INVASIVE ESOPHAGECTOMY FOR CANCER: where do we stand? Ph Nafteux, MD Copenhagen, Nov 3rd 2011 Department of Thoracic Surgery, University Hospitals Leuven, Belgium W. Coosemans, H. Decaluwé, Ph.
More informationTechnical Guidance for Surgical Workload Audit and Research Database: Anti Reflux Surgery V1.0
Technical Guidance for Surgical Workload Audit and Research Database: Anti Reflux Surgery V1.0 Contents 1. The Indicators... 3 1.1. Activity Volume... 3 3.2. Average Length of Stay (Days)... 3 3.3. 2/7/30
More informationThe Impact of Body Mass Index on Esophageal Cancer
Obesity does not appear to affect the morbidity of treatments for esophageal cancer. Samuel Bak. BK1464 Added Perspective I. Oil on canvas, 12ʺ 16ʺ. The Impact of Body Mass Index on Esophageal Cancer Joyce
More informationMortality After Elective and Ruptured Abdominal Aortic Aneurysm Surgical Repair: 12-Year Single-Center Experience of Estonia
738923SJS0010.1177/1457496917738923J. Lieberg, L-L. Pruks, M. Kals, K. Paapstel, A. Aavik, J. KalsAbdominal Aortic Aneurysm Repair and Mortality research-article2017 Original Research Article SJS SCANDINAVIAN
More informationPERIOPERATIVE ANESTHETIC RISK IN THE GERIATRIC PATIENT
PERIOPERATIVE ANESTHETIC RISK IN THE GERIATRIC PATIENT Susan H. Noorily, M.D. Clinical Professor of Anesthesiology Medical Director University Preoperative Medicine Center IMPORTANCE Half of all currently
More informationA case-control study of readmission to the intensive care unit after cardiac surgery
DOI: 0.2659/MSM.88384 Received: 202.04.24 Accepted: 203.0.25 Published: 203.02.28 A case-control study of readmission to the intensive care unit after cardiac surgery Authors Contribution: Study Design
More informationHow the ANZGOSA audit can benefit your practice: a look at GIST surgery from an Australian and NZ perspective. Aravind Suppiah; Sarah K.
How the ANZGOSA audit can benefit your practice: a look at GIST surgery from an Australian and NZ perspective Aravind Suppiah; Sarah K. Thompson ANZGOSA database Commenced 2010; 1469 cases (2002 2014)
More informationEvaluation of Possum Scoring in Patients Undergoing Emergency Laparotomy for Hollow Viscus Perforation
IOSR Journal of Pharmacy and Biological Sciences (IOSR-JPBS) e-issn:2278-3008, p-issn:2319-7676. Volume 11, Issue 4 Ver. IV (Jul. - Aug.2016), PP 104-113 www.iosrjournals.org Evaluation of Possum Scoring
More informationCurrent evidence in acute pain management. Jeremy Cashman
Current evidence in acute pain management Jeremy Cashman Optimal analgesia Best possible pain relief Lowest incidence of side effects Optimal analgesia Best possible pain relief Lowest incidence of side
More informationThe Royal Marsden. Surgery for Gastric and GE Junction Cancer: primary palliative when and where? William Allum Consultant Surgeon
The Royal Marsden Surgery for Gastric and GE Junction Cancer: primary palliative when and where? William Allum Consultant Surgeon Any surgeon can cure Surgeon - dependent No surgeon can cure EMR D2 GASTRECTOMY
More informationLog odds of positive lymph nodes is a novel prognostic indicator for advanced ESCC after surgical resection
Original Article Log odds of positive lymph nodes is a novel prognostic indicator for advanced ESCC after surgical resection Mingjian Yang 1,2, Hongdian Zhang 1,2, Zhao Ma 1,2, Lei Gong 1,2, Chuangui Chen
More informationClinical experience amongst surgeons in the Asymptomatic Carotid Surgery Trial-1 (ACST-1)
Clinical experience amongst surgeons in the Asymptomatic Carotid Surgery Trial-1 (ACST-1) Short Title: Clinical experience in the Asymptomatic Carotid Surgery Trial-1 (ACST-1) Authors: Anne Huibers 1,2,
More informationA Perioperative Physician s Perspective. SAAPM 25 th October 2016
A Perioperative Physician s Perspective SAAPM 25 th October 2016 Avoid hypoxia, Avoid hypotension Consider a spinal! What is a Perioperative Physician A physician who addresses the medical care of the
More informationTHE EFFICIENCY OF LOW MOLECULAR WIGHT HEPARINS IN THE PROPHYLAXIS OF VENOUS THROMBOEMBOLIC COMPLICATIONS IN GENERAL SURGERY
FARMACIA, 2012, Vol. 60, 1 127 THE EFFICIENCY OF LOW MOLECULAR WIGHT HEPARINS IN THE PROPHYLAXIS OF VENOUS THROMBOEMBOLIC COMPLICATIONS IN GENERAL SURGERY ANDREEA NICOLETA SAFTA 1, VLAD DENIS CONSTANTIN
More informationEvaluation of P-Possum in Elective and Emergency Surgeries
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 14, Issue 10 Ver. X (Oct. 2015), PP 52-59 www.iosrjournals.org Evaluation of P-Possum in Elective and
More informationRisk Assessment of Mortality Following Intraoperative Cardiac Arrest Using POSSUM and P-POSSUM in Adults Undergoing Non-Cardiac Surgery
Original Article Yonsei Med J 2015 Sep;56(5):1401-1407 pissn: 0513-5796 eissn: 1976-2437 Risk Assessment of Mortality Following Intraoperative Cardiac Arrest Using POSSUM and P-POSSUM in Adults Undergoing
More informationPost Oesophagectomy Leakage at Kenyatta National Hospital Nairobi - Kenya
S.W.O. Ogendo 77 Original Paper Post Oesophagectomy Leakage at Kenyatta National Hospital Nairobi - Kenya S.W.O. Ogendo Cardiothoracic Surgery, University of Nairobi. Email: info@soogendo.com Background:
More informationENDPOINTS FOR AKI STUDIES
ENDPOINTS FOR AKI STUDIES Raymond Vanholder, University Hospital, Ghent, Belgium SUMMARY! AKI as an endpoint! Endpoints for studies in AKI 2 AKI AS AN ENDPOINT BEFORE RIFLE THE LIST OF DEFINITIONS WAS
More informationGlasgow Prognostic Score (GPS) Can Be a Useful Indicator to Determine Prognosis of Patients With Colorectal Carcinoma
Int Surg 2014;99:512 517 DOI: 10.9738/INTSURG-D-13-00118.1 Glasgow Prognostic Score (GPS) Can Be a Useful Indicator to Determine Prognosis of Patients With Colorectal Carcinoma Tadahiro Nozoe, Rumi Matono,
More informationACCURATE prediction of perioperative risk is an
Review Article David S. Warner, M.D., Editor Risk Stratification Tools for Predicting Morbidity and Mortality in Adult Patients Undergoing Major Surgery Qualitative Systematic Review Suneetha Ramani Moonesinghe,
More informationPatient Satisfaction for Carotid Endarterectomy Performed under Local Anaesthesia
Eur J Vasc Endovasc Surg 27, 654 659 (2004) doi: 10.1016/j.ejvs.2004.03.010, available online at http://www.sciencedirect.com on Patient Satisfaction for Carotid Endarterectomy Performed under Local Anaesthesia
More information17 th December 2008 Glasgow eprints Service
McMillan, D.C. and Hole, D.J. and McArdle, C.S. (2008) The impact of old age on cancer-specific and non-cancer-related survival following elective potentially curative surgery for Dukes A/B colorectal
More informationThe role of physical training in lowering the cardio-metabolic risk
The role of physical training in lowering the cardio-metabolic risk Timea Szasz 1, Eugen Bota 2, Lucian Hoble 3 Abstract The cardio-metabolic risk represents the overall risk of developing type 2 diabetes
More informationComplex Thoracic and Abdominal Aortic Repair Using Hybrid Techniques
Complex Thoracic and Abdominal Aortic Repair Using Hybrid Techniques Tariq Almerey MD, January Moore BA, Houssam Farres MD, Richard Agnew MD, W. Andrew Oldenburg MD, Albert Hakaim MD Department of Vascular
More informationLate survival in non-operated patients with infra-renal abdominal aortic aneurysm
*Manuscript (Please include all author details) Click here to download Manuscript (Please include all author details): Article clean copy.doc Click here to view linked References 1 2 Late survival in non-operated
More informationDATA REPORT. August 2014
AUDIT DATA REPORT August 2014 Prepared for the Australian and New Zealand Gastric and Oesophageal Surgical Association by the Royal Australasian College of Surgeons 199 Ward St, North Adelaide, SA 5006
More informationPre-operative detection of valvular heart disease by anaesthetists
Anaesthesia, 2006, 61, pages 127 132 doi:10.1111/j.1365-2044.2005.04505.x Pre-operative detection of valvular heart disease by anaesthetists W. A. van Klei, 1 C. J. Kalkman, 1 M. Tolsma, 1 C. L. G. Rutten
More informationACUTE ABDOMEN IN DIABETIC PATIENTS ANALYSIS OF COMPLICATIONS AND MORTALITY
2014 ILEX PUBLISHING HOUSE, Bucharest, Roumania http://www.jrdiabet.ro Rom J Diabetes Nutr Metab Dis. 21(4):277-284 doi: 10.2478/rjdnmd-2014-0034 ACUTE ABDOMEN IN DIABETIC PATIENTS ANALYSIS OF COMPLICATIONS
More informationOedema is associated with clinical outcome following emergency abdominal surgery
general surgery doi 10.1308/003588413X13629960046552 Oedema is associated with clinical outcome following PG Vaughan-Shaw, J Saunders, T Smith, AT King, MA Stroud University Hospital Southampton NHS Foundation
More informationPREDICTORS OF PROLONGED HOSPITAL STAY
PREDICTORS OF PROLONGED HOSPITAL STAY IN CARDIAC SURGERY Zuraida Khairudin Faculty of Science Computer and Mathematics, Universiti Teknologi MARA, Malaysia zurai405@salam.uitm.edu.my ABSTRACT quality of
More informationProspective Evaluation of Quality of Life After Conventional Abdominal Aortic Aneurysm Surgery
Eur J Vasc Endovasc Surg 16, 203-207 (1998) Prospective Evaluation of Quality of Life After Conventional Abdominal Aortic Aneurysm Surgery J. M. 1". Perkins ~, 1". R. Magee, L. J. Hands, J. Collin, R.
More informationDeposited on: 4 November 2009
Roxburgh, C.S.D. and Crozier, J.E.M. and Maxwell, F. and Foulis, A.K. and Brown, J. and McKee, R.F. and Anderson, J.H. and Horgan, P.G. and McMillan, D.C. (2009) Comparison of tumour-based (Petersen Index)
More informationBest Papers. F. Fusco
Best Papers UROLOGY F. Fusco Best papers - 2015 RP/RT Oncological outcomes RP/RT IN ct3 Utilization trends RP/RT Complications Evolving role of elnd /Salvage LND This cohort reflects the current clinical
More informationMinimally Invasive Esophagectomy
Minimally Invasive Esophagectomy M A R K B E R R Y, M D A S S O C I AT E P R O F E S S O R D E PA R T M E N T OF C A R D I O T H O R A C I C S U R G E R Y S TA N F O R D U N I V E R S I T Y S E P T E M
More informationOutcome after surgery for fracture of the hip in patients aged over 95 years
Outcome after surgery for fracture of the hip in patients aged over 95 years G. Holt, D. Macdonald, M. Fraser, A. T. Reece From Western Infirmary, Glasgow, Scotland Despite the increase in numbers of the
More informationAPACHE II: A Severity of Disease Classification System Standard Operating Procedure for Accurate Calculations
BACKGROUND APACHE II: A Severity of Disease Classification System Standard Operating Procedure for Accurate Calculations The APACHE prognostic scoring system was developed in 1981 at the George Washington
More informationAdvances in surgical techniques and medical support. Predictive value of E-PASS and POSSUM systems for postoperative risk assessment of spinal surgery
J Neurosurg Spine 20:75 82, 2014 AANS, 2014 Predictive value of E-PASS and POSSUM systems for postoperative risk assessment of spinal surgery Clinical article *Jun Hirose, M.D., Ph.D., 1,2 Takuya Taniwaki,
More informationMortality predicted by APACHE I1
Anaesthesia, 1996, Volume 5 1, pages 7 19-723 Mortality predicted by APACHE I1 The effect of changes in physiological values and post-icu hospital mortality D. R. GOLDHILL AND P. S. WITHINGTON Summary
More informationA new measure of acute physiological derangement for patients with exacerbations of obstructive airways disease: The COPD and Asthma Physiology Score
Respiratory Medicine (2007) 101, 1994 2002 A new measure of acute physiological derangement for patients with exacerbations of obstructive airways disease: The COPD and Asthma Physiology Score Martin J.
More informationExternal Validation of the Acute Physiology and Chronic Health Evaluation II in Korean Intensive Care Units
Original Article http://dx.doi.org/10.3349/ymj.2013.54.2.425 pissn: 0513-5796, eissn: 1976-2437 Yonsei Med J 54(2):425-431, 2013 External Validation of the Acute Physiology and Chronic Health Evaluation
More informationScreening for abdominal aortic aneurysm reduces overall mortality in men. A meta-analysis of the
Title page Manuscript type: Meta-analysis. Title: Screening for abdominal aortic aneurysm reduces overall mortality in men. A meta-analysis of the mid- and long- term effects of screening for abdominal
More informationDelay in Diagnostic Workup and Treatment of Esophageal Cancer
J Gastrointest Surg (2010) 14:476 483 DOI 10.1007/s11605-009-1109-y ORIGINAL ARTICLE Delay in Diagnostic Workup and Treatment of Esophageal Cancer Brechtje A. Grotenhuis & Pieter van Hagen & Bas P. L.
More informationStellenwert der prä- und postoperativen Sicht des Chirurgen
Interdisziplinäre Chirurgie Stellenwert der prä- und postoperativen Ernährung Sicht des Chirurgen Kantonsspital Luzern 24.11.2005 Prof. L. Krähenbühl Chirurgische Klinik Hôpital Cantonal Fribourg Problems
More informationOriginal Article Is there an association between ABO blood group and overall survival in patients with esophageal squamous cell carcinoma?
Int J Clin Exp Med 2014;7(8):2214-2218 www.ijcem.com /ISSN:1940-5901/IJCEM0001278 Original Article Is there an association between ABO blood group and overall survival in patients with esophageal squamous
More informationRisk factors for fatal outcome in surgical patients with postoperative. aspiration pneumonia
Original article Risk factors for fatal outcome in surgical patients with postoperative aspiration pneumonia Peter Studer 1, Genevieve Räber 1, Daniel Ott 2, Daniel Candinas 1, Beat Schnüriger 1 1 Department
More informationExtent of visceral pleural invasion and the prognosis of surgically resected node-negative non-small cell lung cancer
Thoracic Cancer ISSN 1759-7706 ORIGINAL ARTICLE Extent of visceral pleural invasion and the prognosis of surgically resected node-negative non-small cell lung cancer Yangki Seok 1, Ji Yun Jeong 2 & Eungbae
More informationPHYSICAL EXERCISES FOR DIABETIC POLYNEUROPATHY
STUDIA UBB EDUCATIO ARTIS GYMN., LIX, 4, 2014, pp. 101-106 (RECOMMENDED CITATION) PHYSICAL EXERCISES FOR DIABETIC POLYNEUROPATHY DOCU AXELERAD ANY 1*, DOCU AXELERAD DANIEL 2 ABSTRACT. Introduction: Chronic
More informationThe role of cytoreductive. nephrectomy in elderly patients. with metastatic renal cell. carcinoma in an era of targeted. therapy
The role of cytoreductive nephrectomy in elderly patients with metastatic renal cell carcinoma in an era of targeted therapy Dipesh Uprety, MD Amir Bista, MD Yazhini Vallatharasu, MD Angela Smith, MA David
More informationPatients Preferences for Surgical Management of Esophageal Cancer: A Discrete Choice Experiment
World J Surg (2015) 39:2492 2499 DOI 10.1007/s00268-015-3148-8 ORIGINAL SCIENTIFIC REPORT Patients Preferences for Surgical Management of Esophageal Cancer: A Discrete Choice Experiment Esther W. de Bekker-Grob
More informationFast track surgery: the role of the surgeon Enrico Ferrari, MD University of Lausanne, Switzerland
June 11 th 2015 Fast track surgery: the role of the surgeon Enrico Ferrari, MD University of Lausanne, Switzerland Fast track Is a process involving rapid progress from preoperative preparation through
More informationTransfusion & Mortality. Philippe Van der Linden MD, PhD
Transfusion & Mortality Philippe Van der Linden MD, PhD Conflict of Interest Disclosure In the past 5 years, I have received honoraria or travel support for consulting or lecturing from the following companies:
More informationIDENTIFYING RISK FACTORS FOR POSTOPERATIVE CARDIOVASCULAR AND RESPIRATORY COMPLICATIONS AFTER MAJOR ORAL CANCER SURGERY
ORIGINAL ARTICLE IDENTIFYING RISK FACTORS FOR POSTOPERATIVE CARDIOVASCULAR AND RESPIRATORY COMPLICATIONS AFTER MAJOR ORAL CANCER SURGERY Jasjit K. Dillon, BDS, MBBS, DDS, Stanley Y. Liu, DDS, Chirag M.
More informationSurgery in Frail Elders. Emily Finlayson, MD, MS Department of Surgery University of California, San Francisco September, 2011
Surgery in Frail Elders Emily Finlayson, MD, MS Department of Surgery University of California, San Francisco September, 2011 What we re going to cover Mortality after surgery in the elderly Fact v Fantasy
More informationCite this article as: BMJ, doi: /bmj (published 23 April 2007)
Cite this article as: BMJ, doi:10.1136/bmj.39168.496366.55 (published 23 April 2007) RESEARCH Use of administrative data orclinicaldatabases as predictors of risk of death in hospital: comparison of models
More informationComplex Thoracoscopic Resections for Locally Advanced Lung Cancer
Complex Thoracoscopic Resections for Locally Advanced Lung Cancer Duke Thoracoscopic Lobectomy Workshop March 21, 2018 Thomas A. D Amico MD Gary Hock Professor of Surgery Section Chief, Thoracic Surgery,
More informationLONG-TERM SURGICAL OUTCOMES OF 1018 PATIENTS WITH EARLY STAGE NSCLC IN ACOSOG Z0030 (ALLIANCE) TRIAL
LONG-TERM SURGICAL OUTCOMES OF 1018 PATIENTS WITH EARLY STAGE NSCLC IN ACOSOG Z0030 (ALLIANCE) TRIAL Stacey Su, MD; Walter J. Scott, MD; Mark S. Allen, MD; Gail E. Darling, MD; Paul A. Decker, MS; Robert
More informationNQF-ENDORSED VOLUNTARY CONSENSUS STANDARDS FOR HOSPITAL CARE. Measure Information Form
Last Updated: Version 3.2 NQF-ENDORSED VOLUNTARY CONSENSUS STANDARDS FOR HOSPITAL CARE Measure Information Form Measure Set: Surgical Care Improvement Project (SCIP) Set Measure ID#: SCIP- Performance
More information