6 research outputs found
Critical care usage after major gastrointestinal and liver surgery: a prospective, multicentre observational study
- Author
- Abbas Z.
- Abburu S.
- Abdelhadi M.
- Abdikadir H.R.
- Abdulmajid A.
- Abid A.
- Abid H.
- Abuhussein N.
- Abul M.H.
- Acquaah F.
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- Agarwal V.
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- Aidoo-Micah G.E.
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- Al-Mousawi A.
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- Wynell-Mayow W.M.
- Xiao C.
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- Yoganathan S.
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- Yousif A.
- Yow L.
- Yuen R.
- Zegeye M.I.
- Zhao J.
- Ziff O.
- Ziprin P.
- Zuhair M.
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2019
- Field of study
No full textBackground
Patient selection for critical care admission must balance patient safety with optimal resource allocation. This study aimed to determine the relationship between critical care admission, and postoperative mortality after abdominal surgery.
Methods
This prespecified secondary analysis of a multicentre, prospective, observational study included consecutive patients enrolled in the DISCOVER study from UK and Republic of Ireland undergoing major gastrointestinal and liver surgery between October and December 2014. The primary outcome was 30-day mortality. Multivariate logistic regression was used to explore associations between critical care admission (planned and unplanned) and mortality, and inter-centre variation in critical care admission after emergency laparotomy.
Results
Of 4529 patients included, 37.8% (n=1713) underwent planned critical care admissions from theatre. Some 3.1% (n=86/2816) admitted to ward-level care subsequently underwent unplanned critical care admission. Overall 30-day mortality was 2.9% (n=133/4519), and the risk-adjusted association between 30-day mortality and critical care admission was higher in unplanned [odds ratio (OR): 8.65, 95% confidence interval (CI): 3.51–19.97) than planned admissions (OR: 2.32, 95% CI: 1.43–3.85). Some 26.7% of patients (n=1210/4529) underwent emergency laparotomies. After adjustment, 49.3% (95% CI: 46.8–51.9%, P<0.001) were predicted to have planned critical care admissions, with 7% (n=10/145) of centres outside the 95% CI.
Conclusions
After risk adjustment, no 30-day survival benefit was identified for either planned or unplanned postoperative admissions to critical care within this cohort. This likely represents appropriate admission of the highest-risk patients. Planned admissions in selected, intermediate-risk patients may present a strategy to mitigate the risk of unplanned admission. Substantial inter-centre variation exists in planned critical care admissions after emergency laparotomies
Safety of Nonsteroidal Anti-inflammatory Drugs in Major Gastrointestinal Surgery: A Prospective, Multicenter Cohort Study
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- Xiao C
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- Yang T
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- Yates JA
- Yener A
- Yim N
- Yoganathan S
- Yong CS
- Yong N
- Yousif A
- Yow L
- Yuen R
- Zegeye MI
- Zhao J
- Ziff O
- Ziprin P
- Zuhair M
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 01/01/2017
- Field of study
No full textBackground
Significant safety concerns remain surrounding the use of nonsteroidal anti-inflammatory drugs (NSAIDs) following gastrointestinal surgery, leading to wide variation in their use. This study aimed to determine the safety profile of NSAIDs after major gastrointestinal surgery.
Methods
Consecutive patients undergoing elective or emergency abdominal surgery with a minimum one-night stay during a 3-month study period were eligible for inclusion. The administration of any NSAID within 3 days following surgery was the main independent variable. The primary outcome measure was the 30-day postoperative major complication rate, as defined by the Clavien–Dindo classification (Clavien–Dindo III–V). Propensity matching with multivariable logistic regression was used to produce odds ratios (OR) and 95 % confidence intervals.
Results
From 9264 patients, 23.9 % (n = 2212) received postoperative NSAIDs. The overall major complication rate was 11.5 % (n = 1067). Following propensity matching and adjustment, use of NSAIDs were not significantly associated with any increase in major complications (OR 0.90, 0.60–1.34, p = 0.560).
Conclusions
Early use of postoperative NSAIDs was not associated with an increase in major complications following gastrointestinal surgery
Body mass index and complications following major gastrointestinal surgery: a prospective, international cohort study and meta-analysis.
- Author
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- Qamar Ma
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- Rafiq Nm
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- Raman Kp
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- Raut P
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- Shahidi S
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- Sun E
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- Suppa A
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- Tharakan Rg
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- Thirumal V
- Thomas D
- Thomas G
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- Topal U
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- Trimble A
- Trist Aj
- Troia A
- Trompetto M
- Truma A
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- Tulum H
- Tung L
- Turaga S
- Turati L
- Turkmen M
- Turley H
- Turnbull Ja
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- Uppal E
- Urquhart A
- Uzun B
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- Vable T
- Valderrama P\ue9rez A
- Valli A
- Vallve-Bernal M
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- van de Ven Awh
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- van der Hoeven Ac
- Van der Lubbe M
- van der Pool Aem
- van der Zee C
- Van Dijck Wpm
- van Elst Tr
- van Engelenburg T
- van Geloven A
- Van Grevenstein Wmu
- Van Heumen Tm
- van Leeuwen Bl
- van Rijckevorsel Vajim
- van Steensel L
- Van Tol Rr
- van Verschuer Vmt
- van Wijnbergen Jwm
- Vanmali P
- Varley R
- Varma D
- Varma N
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- Vasko P
- Vasquez G
- Vaughan R
- Vazquez-Gonzalez I
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- Vela Polanco Ff
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- Woodcock N
- Woodward H
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- Wright Ev
- Wye J
- Wylam D
- Wylie J
- Wynell-Mayow Wm
- Xiao C
- Xu Gx
- Xylas D
- Y\u131gman S
- Yalcin Y
- Yaman S
- Yan A
- Yang T
- Yasar C
- Yates Ja
- Yauw S
- Yavuz G
- Yazkan Z
- Yekenkurul E
- Yener A
- Yeoh Tsl
- Yetiskin E
- Yildirim N
- Yildirim R
- Yildiz S
- Yildiz Ss
- Yildiz T
- Yilmaz I
- Yilmaz M
- Yilmaz S
- Yilmaz T
- Yim N
- Yoganathan S
- Yong Cs
- Yong N
- Yoruk I
- Yousif A
- Yow L
- Yuen R
- Yuksek B
- Yuksek Ma
- Yuksel A
- Yurdaor Ss
- Yurekli Am
- Zaidi R
- Zegeye Mi
- Zengin T
- Zhang Aa
- Zhao J
- Ziff O
- Zigiotto D
- Zijlmans Jl
- Zimmerman D
- Ziprin P
- Zope S
- Zuhair M
- Publication venue
- 'Wiley'
- Publication date
- 01/01/2018
- Field of study
No full textAIM:
Previous studies reported conflicting evidence on the effects of obesity on outcomes after gastrointestinal surgery. The aims of this study were to explore the relationship of obesity with major postoperative complications in an international cohort and to present a meta-analysis of all available prospective data.
METHODS:
This prospective, multicentre study included adults undergoing both elective and emergency gastrointestinal resection, reversal of stoma or formation of stoma. The primary end-point was 30-day major complications (Clavien-Dindo Grades III-V). A systematic search was undertaken for studies assessing the relationship between obesity and major complications after gastrointestinal surgery. Individual patient meta-analysis was used to analyse pooled results.
RESULTS:
This study included 2519 patients across 127 centres, of whom 560 (22.2%) were obese. Unadjusted major complication rates were lower in obese vs normal weight patients (13.0% vs 16.2%, respectively), but this did not reach statistical significance (P = 0.863) on multivariate analysis for patients having surgery for either malignant or benign conditions. Individual patient meta-analysis demonstrated that obese patients undergoing surgery for malignancy were at increased risk of major complications (OR 2.10, 95% CI 1.49-2.96, P < 0.001), whereas obese patients undergoing surgery for benign indications were at decreased risk (OR 0.59, 95% CI 0.46-0.75, P < 0.001) compared to normal weight patients.
CONCLUSIONS:
In our international data, obesity was not found to be associated with major complications following gastrointestinal surgery. Meta-analysis of available prospective data made a novel finding of obesity being associated with different outcomes depending on whether patients were undergoing surgery for benign or malignant disease
Body mass index and complications following major gastrointestinal surgery: A prospective, international cohort study and meta-analysis
- Author
- Aarts E
- Abbas Z
- Abburu S
- Abd Ghaffar Mk
- Abdelgalil R
- Abdelhadi M
- Abdikadir Hr
- Abdulmajid A
- Abdulrahman N
- Abid A
- Abid H
- Abrisqueta Carrion J
- Abuhussein N
- Abul Mh
- Acar S
- Acherman Yiz
- Acquaah F
- Acres M
- Adams R
- Adams Rd
- Adebayo Aa
- Adeleja I
- Adiyaman C
- Adjei H
- Adlan A
- Afzal Z
- Agalar C
- Agarwal V
- Agrawal M
- Ahern N
- Ahmad A
- Ahmad K
- Ahmad S
- Ahmed F
- Ahmed H
- Ahmed M
- Ahmed N
- Ahmed S
- Ahn Js
- Aidoo-Micah Ge
- Aildasani L
- Aithie Jm
- Akbulut F
- Akcaoglu T
- Akdogan A
- Akhtar S
- Akkaya E
- Akkucuk S
- Akpunarli B
- Aksoy K
- Aktas Mk
- Aktekin H
- Al-Mousawi A
- Al-Nasser A
- Al-Nasser Z
- Al-Obaedi O
- Al-Robeye A
- Albayrak D
- Alberdi San Roman I
- Alberti Delgado P
- Alcazar Montero Ja
- Alcocer Bp
- Alconchel-Gago F
- Aldrey I
- Ali A
- Ali B
- Ali H
- Ali M
- Ali S
- Alim Ye
- Aliseda-Jover D
- Alizadeh M
- Aljbour A
- Aljbour I
- Allan C
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- Altintas O
- Altomare Df
- Alvarez Reyes I
- Amajuoyi A
- Amarelo Garcia M
- Ambrona-Zafra D
- Amelung Fj
- Amin H
- Amin O
- Amphlett Ah
- Anabitarte O
- Anakwenze V
- Anandarajah C
- Anania G
- Anconelli D
- Anderson L
- Anderson Lb
- Anderson Rgj
- Anderson Sm
- Ang A
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- Anilkumar A
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- Antoniou I
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- Aonzo P
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- Aquilino F
- Aray E
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- Arenal Jj
- Arezzo A
- Argenti F
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- Arrigo A
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- Arslan U
- Arthurs B
- Arukan C
- Arun C
- Asbjoernsen Ca
- Ashfaq U
- Ashken L
- Ashraf S
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- Ashton Aj
- Ashwood J
- Asik M
- Aslan L
- Aslanyan A
- Asma A
- Asmadi A
- Assadullah S
- Atalay H
- Atasoy H
- Atayi A
- Atesavci Sn
- Atif M
- Atraszkiewicz Ba
- Attalla M
- Austreng L
- Auyoung E
- Avery P
- Axelson T
- Ayaz B
- Aydar Seyi
- Aytekin A
- Aziz H
- Aziz N
- Babaoglu H
- Bach S
- Badia Jm
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- Badran A
- Baeten Cim
- Bagaglini G
- Bagley J
- Bahcecioglu B
- Baixauli J
- Baker An
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- Bakewell Zr
- Bakhsh A
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- Balagna P
- Balaji S
- Balci B
- Baldwin A
- Bali An
- Balian V
- Bamac E
- Bamgbose Fa
- Bandirmali O
- Barai I
- Barmayehvar B
- Barnes J
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- Barrera Gomez M
- Barrow Tr
- Barthorpe Ae
- Bartlett J
- Bartlett Rd
- Barton Ec
- Bartoš M
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- Baskoy L
- Bassam N
- Bassett J
- Bassiony S
- Bastiaansen Ajnm
- Bath Mf
- Batho A
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- Bayoumy Ab
- Bayram S
- Bazeer Hz
- Beaver D
- Becerra Nieves M
- Beckett J
- Beecroft S
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- Bektur G
- Belia F
- Belibagli Zo
- Bell A
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- Bell N
- Bellinato M
- Bellio G
- Beltrán de Heredia J
- Bemand Tp
- Bemelman Wa
- Benevento A
- Benli S
- Berends F
- Bergara T
- Bernstein I
- Bertelli Puche Jl
- Besısık Hm
- Bethell Gs
- Beyatli S
- Bhanderi S
- Bhangu A
- Bhaskaran G
- Bhatt N
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- Bhome R
- Bhudia R
- Bianchini S
- Bianco F
- Bilgin S
- Bilicen G
- Bilici O
- Binbuga M
- Bingham G
- Birgin Bz
- Blanco Antona F
- Blanco-Colino R
- Blege Hk
- Blessed R
- Blonk L
- Bloomer J
- Bloomfield T
- Blore Cd
- Bober Dn
- Bodur S
- Boersma Am
- Bokkerink G
- Bolat Ab
- Bolton L
- Bolton W
- Bonouvrie D
- Bonsu S
- Bookless Lr
- Boom Ms
- Borrellas A
- Bos K
- Boschetti Me
- Bose R
- Botchey S
- Botrugno Em
- Bottini C
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- Boxall N
- Boyle J
- Bozkurt Gk
- Bradley C
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- Brathwaite-Shirley C
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- Bremner Rh
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- Brent G
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- Brewster O
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- Britton F
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- Brown E
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- Brown Fs
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- Brzyska K
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- Bucko Am
- Bulley F
- Bullman Lm
- Bullock Np
- Burger Bhcm
- Burgess A
- Burke D
- Burke E
- Burke J
- Burney Lj
- Buyukkarabacak Y
- Buyukkasap C
- Caballero Rodriguez E
- Caballero L
- Cakaloglu Hc
- Cakir E
- Cakir Sg
- Calar Sn
- Calcagno P
- Calisgan B
- Caliskan T
- Callan R
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- Campbell J
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- Canbay Torun B
- Candilio G
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- Canning N
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- Cantimer E
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- Cardwell Ae
- Carlson S
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- Carter D
- Carthew L
- Cartwright E
- Casagranda B
- Castiglione F
- Catalano M
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- Ceylan C
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- Charalambous G
- Charania A
- Charavanamuttu V
- Chaudhary M
- Chaudhry Fi
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- Checcacci P
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- Chen Jh
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- Cheung F
- Chew L
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- Chhabra A
- Chhina C
- Chilima Cp
- Chillarge G
- Chilvers Nj
- Chin H
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- Chitnis Ar
- Chiu Sm
- Choi J
- Choi Pj
- Chong Bf
- Chong J
- Choo Kp
- Chrastek D
- Chua Ey
- Chung A
- Cianchi F
- Ciano P
- Ciccioli E
- Ciciliot M
- Ciftci E
- Cin S
- Cinar S
- Cise S
- Cisternino G
- Ciurleo C
- Claireaux Ha
- Claramonte Bellmunt O
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- Clesham K
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- Colombo Em
- Colombo F
- Consten Ecj
- Cooper D
- Cooper Ge
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- Cornish E
- Corte M
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- Cotton A
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- de Castro Smm
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- de Groof Ej
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- de la Portilla de Juan F
- de la Rosa-Estadella M
- De la Torre Conde C
- De Luca E
- De Manzini N
- de Mees T
- De Nardi P
- de Roy van Zuidewijn D
- De Serra Tejada I
- de Vos Tot Nederveen Cappel Rj
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- Del Mar López-Cuevas M
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- Deliktas Ts
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- Demirci Zs
- Demirtas B
- Dennis R
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- Detmers Blom Fpn
- Devabalan Y
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- Dorman C
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- Durmaz H
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- Dutt S
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- Escalona Canal Mg
- Espin-Basany E
- Esposto R
- Espí Macías A
- Esteban Sinovas O
- Esteve L
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- Facchiano A
- Falcon Cazas A
- Fares Da
- Farina V
- Farmer Jd
- Fasano A
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- Geerlings M
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- Gerardi S
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- Ghaffar A
- Ghignone F
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- Giardino Fr
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- Gonzalez-Argente Xf
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- Hirani S
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- Hogendoorn W
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- Holloway C
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- Howard James N
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- Hughes Ba
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- Hung G
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- Huseynova S
- Husnoo Sb
- Hussain N
- Hussain O
- Hutchings I
- Huzmeli E
- Ibrahim A
- Ibrahim I
- Ilbak A
- Inci Et
- Ingham R
- Ingram E
- Innocenti P
- Iorga R
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- Jimenez-Gomez Lm
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- Karabulut E
- Karahan B
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- Kazmi Z
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- Kerimova N
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- Keyif Mf
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- Khajuria A
- Khalid H
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- Khan I
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- Khanijau R
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- Kloppenberg Fwh
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- Latras-Cortés I
- Laurino A
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- Luk Cy
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- Lwin Kn
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- Lynne S
- Lyons A
- Lyons R
- López-Mármol R
- López-Vendrell L
- Löwensteyn Yn
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- Marchal St
- Marchese N
- Marcos Rodrigo A
- Mariani F
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- Martin Morales E
- Martin Al
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- Martinez Rios Ce
- Martorana M
- Martí Fernández Rm
- Martínez Chillarón E
- Maru D
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- Mcgarvie S
- Mcgenity C
- Mcgowan C
- Mcgrath A
- Mcgregor Rj
- Mcintyre Cj
- Mckean E
- Mckelvey Ll
- Mckerr Cn
- Mckevitt Kl
- Mclaughin C
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- Meek J
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- Meijerink Wjhj
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- Mermer S
- Messina F
- Mestres Petit N
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- Mitha N
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- Mitxelena Elosegi L
- Mizan Sr
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- Publication venue
- 'Wiley'
- Publication date
- 01/01/2018
- Field of study
Get PDFAim Previous studies reported conflicting evidence on the effects of obesity on outcomes after gastrointestinal surgery. The aims of this study were to explore the relationship of obesity with major postoperative complications in an international cohort and to present a metaanalysis of all available prospective data. Methods This prospective, multicentre study included adults undergoing both elective and emergency gastrointestinal resection, reversal of stoma or formation of stoma. The primary end-point was 30-day major complications (Clavien\u2013Dindo Grades III\u2013V). A systematic search was undertaken for studies assessing the relationship between obesity and major complications after gastrointestinal surgery. Individual patient meta-analysis was used to analyse pooled results. Results This study included 2519 patients across 127 centres, of whom 560 (22.2%) were obese. Unadjusted major complication rates were lower in obese vs normal weight patients (13.0% vs 16.2%, respectively), but this did not reach statistical significance (P = 0.863) on multivariate analysis for patients having surgery for either malignant or benign conditions. Individual patient meta-analysis demonstrated that obese patients undergoing surgery formalignancy were at increased risk of major complications (OR 2.10, 95% CI 1.49\u20132.96, P < 0.001), whereas obese patients undergoing surgery for benign indications were at decreased risk (OR 0.59, 95% CI 0.46\u20130.75, P < 0.001) compared to normal weight patients. Conclusions In our international data, obesity was not found to be associated with major complications following gastrointestinal surgery. Meta-analysis of available prospective data made a novel finding of obesity being associated with different outcomes depending on whether patients were undergoing surgery for benign or malignant disease
Body mass index and complications following major gastrointestinal surgery: A prospective, international cohort study and meta-analysis
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- Publication venue
- Publication date
- 01/08/2018
- Field of study
No full textAim Previous studies reported conflicting evidence on the effects of obesity on outcomes after gastrointestinal surgery. The aims of this study were to explore the relationship of obesity with major postoperative complications in an international cohort and to present a metaanalysis of all available prospective data. Methods This prospective, multicentre study included adults undergoing both elective and emergency gastrointestinal resection, reversal of stoma or formation of stoma. The primary end-point was 30-day major complications (Clavien–Dindo Grades III–V). A systematic search was undertaken for studies assessing the relationship between obesity and major complications after gastrointestinal surgery. Individual patient meta-analysis was used to analyse pooled results. Results This study included 2519 patients across 127 centres, of whom 560 (22.2%) were obese. Unadjusted major complication rates were lower in obese vs normal weight patients (13.0% vs 16.2%, respectively), but this did not reach statistical significance (P = 0.863) on multivariate analysis for patients having surgery for either malignant or benign conditions. Individual patient meta-analysis demonstrated that obese patients undergoing surgery formalignancy were at increased risk of major complications (OR 2.10, 95% CI 1.49–2.96, P < 0.001), whereas obese patients undergoing surgery for benign indications were at decreased risk (OR 0.59, 95% CI 0.46–0.75, P < 0.001) compared to normal weight patients. Conclusions In our international data, obesity was not found to be associated with major complications following gastrointestinal surgery. Meta-analysis of available prospective data made a novel finding of obesity being associated with different outcomes depending on whether patients were undergoing surgery for benign or malignant disease
Critical care usage after major gastrointestinal and liver surgery: a prospective, multicentre observational study
- Author
- A. Abdulmajid
- A. Abid
- A. Al-Mousawi
- A. Al-Robeye
- A. Ali
- A. Amajuoyi
- A. Ang
- A. Anilkumar
- A. Aslanyan
- A. Asmadi
- A. Atayi
- A. Bakhsh
- A. Batho
- A. Bell
- A. Bhangu
- A. Borakati
- A. Broyd
- A. Burgess
- A. Charania
- A. Chhabra
- A. Chung
- A. Coates
- A. Cody
- A. Collins
- A. Cotton
- A. Craig-McQuaide
- A. Croall
- A. Curran
- A. Daoub
- A. Delport
- A. Dhanji
- A. Duffy
- A. Durr
- A. Ghaffar
- A. Hague
- A. He
- A. Hibberd
- A. Higgins
- A. Hill
- A. Ibrahim
- A. Iqbal
- A. Isaac
- A. Jaitley
- A. Jindal
- A. Johnston
- A. Kahar
- A. Kaushal
- A. Kerai
- A. Khajuria
- A. Khan
- A. Kishore
- A. Kreibich
- A. Ledsam
- A. Linton
- A. Livesey
- A. Lotfallah
- A. Luhishi
- A. MacAskill
- A. Malik
- A. Marsh
- A. Mastan
- A. McBride
- A. McGrath
- A. Mehdi
- A. Menon
- A. Mian
- A. Mishra
- A. Mohite
- A. Mortimer
- A. Murtaza
- A. Narain
- A. O'Connor
- A. O'Kane
- A. Odeleye
- A. Omar
- A. Pandey
- A. Pericleous
- A. Piquet
- A. Pizzolato
- A. Ponweera
- A. Prabhudesai
- A. Qureshi
- A. Radotra
- A. Ramnarine
- A. Rangedara
- A. Reed
- A. Sahathevan
- A. Shah
- A. Sheldon
- A. Shukla
- A. Simpson
- A. Sreh
- A. Szczap
- A. Tahmina
- A. Tai
- A. Thacoor
- A. Trimble
- A. Valli
- A. Wali
- A. Wang
- A. White
- A. Winarski
- A. Wright
- A. Yan
- A. Yener
- A. Yousif
- A.A. Adebayo
- A.A. Khetarpal
- A.A. Thevathasan
- A.C.D. Smith
- A.D. Greenhalgh
- A.D. Henson
- A.D. Semana
- A.D. Wood
- A.E. Barthorpe
- A.E. Cardwell
- A.E. Lim
- A.E. Logan
- A.E. Salih
- A.E. Ward
- A.F. Carroll
- A.H. Amphlett
- A.H.Y. Lee
- A.J. Ashton
- A.J. Boulton
- A.J. Dhutia
- A.J. Trist
- A.K. Clarke
- A.K. Tear
- A.L. Frank
- A.L. Kerr
- A.L. Martin
- A.M. Buchan
- A.M. Bucko
- A.M. Demetri
- A.M. Gwozdz
- A.M.A. Shafi
- A.N. Baker
- A.N. Kumar
- A.N. Street
- A.R. Chitnis
- A.R. Craig
- A.R. Dyal
- A.S. Fawaz
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- Saunders
- Sawyer
- Student Audit and Research in Surgery (STARSurg) Collaborative
- Symons
- T. Arif
- T. Axelson
- T. Bergara
- T. Bloomfield
- T. Dogra
- T. Fautz
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- T. Goldsmith
- T. Kane
- T. Khan
- T. Lewis
- T. Lo
- T. Patel
- T. Pitts-Tucker
- T. Raghvani
- T. Ramtoola
- T. Rangan
- T. Reakes
- T. Reeves
- T. Ross
- T. Sale
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- T. Sorah
- T. Spencer
- T. Tharmachandirar
- T. Ward
- T. Yang
- T.C. Hoskins
- T.E. Glover
- T.M. Brooks
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- T.M. Schulz
- T.M.P. Fung
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- T.W. Tilston
- U. Ashfaq
- U. Datta
- U. Hayat
- U. Khan
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- U. Sajjad
- U. White
- V. Agarwal
- V. Balian
- V. Charavanamuttu
- V. Elangovan
- V. Gupta
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- Wong
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- Publication venue
- 'Elsevier BV'
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