11 research outputs found
Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.
- Author
- Aamir A
- Abbas J
- Abbas N
- Abbott TEF
- Abdalla M
- Abdikadir H
- Abuhussein N
- Acquaah F
- Adamson R
- Adeleye O
- Adeogun A
- Adlan A
- Aftab R
- Afzal Z
- Agarwal M
- Aglan H
- Agnew CJF
- Agrawal R
- Ahern D
- Ahluwalia J
- Ahluwalia V
- Ahmad A
- Ahmad K
- Ahmed H
- Ahmed I
- Ahmed L
- Ahmed N
- Ahmed P
- Ainger E
- Ainsworth P
- Aishwarya G
- Ajibola-Taylor O
- Akhbari M
- Akhtar A
- Akhtar R
- Akpenyi O
- Al-Ausi M
- Al-Huneidi R
- Al-Khudairi R
- Al-Masri S
- Al-Mousawi A
- Al-Saadi N
- Alagappan A
- Alberts J
- Alfa-Wali M
- Ali A
- Ali B
- Ali I
- Ali M
- Ali Q
- Ali S
- Alturki N
- Alwandi A
- Amani L
- Amarnath T
- Amer M
- Amin H
- Amin MN
- Amoah R
- Amoah-Arko A
- Anandarajah C
- Ananthavarathan P
- Andah EJE
- Andrew K
- Andrews H
- Ang A
- Ang HL
- Ang JJ
- Ani C
- Anilkumar A
- Anto N
- Anwar S
- Apperley H
- Appleton S
- Aquilina T
- Archer M
- Arif T
- Arneill M
- Arnell S
- Arnold TJ
- Arshad A
- Arthur J
- Arulkumaran N
- Arya J
- Asad M
- Asemota N
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- Ashdown T
- Ashour R
- Ashraf MR
- Ashwood J
- Asif U
- Atkin G
- Atkins B
- Attalla M
- Aubrey-Jones D
- Auckburally S
- Auld F
- Auluck I
- Azam S
- Aziz R
- Azizi A
- Azmi F
- Babatunde F
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- Bajwa DS
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- STARSurg Collaborative Writing Committee, Data analysis, Steering committee, Advisory group, Regional leads, Collaborators and validators
- STARSurg Collaborative Writing Committee, Data analysis, Steering committee, Advisory group, Regional leads, Collaborators and validators, Nepogodiev, D
- Stechman M
- Stewart D
- Stewart E
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- Stewart R
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- Stoddart MT
- Stokes E
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- Yalamarthi S
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- Yarham E
- Yasin IH
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- Yogeswara T
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- Yousaf A
- Youssef H
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- Zaat S
- Zanichelli D
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- Zheleniakova T
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- Zornoza A
- Zubikarai G
- Zulkifli A
- Zuzarte L
- Publication venue
- 'Wiley'
- Publication date
- 18/05/2018
- Field of study
Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability
Evaluation of appendicitis risk prediction models in adults with suspected appendicitis
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- Vila-Zarate C
- Villarejo-Campos P
- Vinnicombe Z
- Viscosi F
- Vitish-Sharma P
- Viviani E
- Viñas Nl
- Vohra R
- Vohra R
- Vulcano I
- Waite K
- Walji Hd
- Walsh E
- Walsh Tn
- Walters Kj
- Walters U
- Wardle Bg
- Wardle Bg
- Wardle Sd
- Warren O
- Warren Oj
- Warusavitarne J
- Watfah J
- Watson N
- Wauchope J
- Weatherburn Lw
- Weaver J
- Weegenaar Cr
- Weegenaar Cr
- Welsh S
- Wensley F
- West H
- West H
- Wheatstone S
- Wheeler C
- Whewell He
- White F
- Whitehorn Se
- Whitehorn Se
- Whitehouse P
- Whiteman E
- Whittaker L
- Wiggill S
- Wijesundera K
- Wilcox G
- Wilkin R
- Wilkin R
- Wilkin R
- Wilkin R
- Wilkin R. J. W.
- Williams Gl
- Williams M
- Williams R
- Williams S
- Wilson Ej
- Wilson M
- Winter Dc
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- Wolff J
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- Wong C
- Wong J
- Wong J
- Wong Ml
- Wong Sy
- Woo R
- Wood Cs
- Woodrow C
- Woodward A
- Woodward B
- Woodward B
- Worku D
- Worku D
- Wright E
- Wright Hl
- Wu F
- Xidas A
- Yalamarthi S
- Yang P
- Yanni F
- Yardimci E
- Yasin T
- Yen Sk
- Yeung K
- Yeung K
- Yoganathan S
- Yoong S
- Youssef H
- Yow L
- Yow L
- Zaborowski A
- Zadi Az
- Zalla T
- Zarka Za
- Zarka Za
- Zarog Ma
- Zelazek M
- Zerpa C
- Zhang Ay
- Zhou S
- Zorrilla L
- Zuin M
- Zurleni Tz
- Publication venue
- 'Wiley'
- Publication date
- 01/01/2019
- Field of study
Background
Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis.
Methods
A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis).
Results
Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent).
Conclusion
Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified
Primary care risk stratification in COPD using routinely collected data: a secondary data analysis
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- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- Field of study
Economic comparison of methods of wound closure: wound closure strips vs. sutures and wound adhesives
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- Publication venue
- 'Wiley'
- Publication date
- Field of study
Early Postoperative Oral Feeding After Colectomy: An Analysis of Factors That May Predict Failure
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- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- Field of study
Indirect acute effects of the COVID-19 pandemic on physical and mental health in the UK: a population-based study
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- Alqahtani
- Antonicelli
- Apicella
- Appleby
- Ball
- Benatti
- Berghaus
- Bloom
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- Bostock
- Bostock
- Carli
- Carrington
- Clarke
- Clerkin
- Cluver
- Daly
- Douglas
- Driggin
- Fernández-Aranda
- Fersia
- Foguet-Boreu
- Fonseca
- Gierisch
- Greenhalgh
- Griffin
- Hartmann-Boyce
- Iob
- Jia
- Joy
- Kanani
- Kenyon
- Kim
- Lim
- Mafham
- Marijon
- Maringe
- Matthews
- McAuley
- McConkey
- Morreel
- Mulholland
- Muruganandam
- Ng
- Nishiga
- Pal
- Qiu
- Quint
- Roberts
- Rothnie
- Schiavone
- Shrivastav
- Tam
- Trasberg
- Vannoni
- Varatharaj
- Vestesson
- Williams
- Williamson
- Wolf
- Yu
- Publication venue
- 'Elsevier BV'
- Publication date
- Field of study
Messenger RNA 3′ End Formation in Plants
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- A Bilger
- A Hunt
- AG Hunt
- AJ Herr
- AM Wallace
- AM Wallace
- B Addepalli
- B Dass
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- BC Meyers
- BC Meyers
- BD Mogen
- BJ Elliott
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- C Rouget
- C Touriol
- C Wu
- CC MacDonald
- CE Baynton
- CG Simpson
- CH Ko
- CL Bassett
- CM Hammell
- CR Mandel
- D Baillat
- D Evans
- DC Barnard
- DD Licatalosi
- DF Colgan
- DL Bentley
- E Beaudoing
- E Kavanagh
- E Nedea
- E Wahle
- FA Razem
- G Ji
- G Tang
- GG Simpson
- GG Simpson
- GL Bond
- H Dong
- H Nagasaki
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- H Xing
- HM Rothnie
- HM Rothnie
- I Hofmann
- I Kaufmann
- I Tzafrir
- IR Henderson
- J Hu
- J Yan
- J Zhao
- JC Loke
- JH Graber
- JJ Caballero
- JL Giranton
- JW Brown
- K Iida
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- KG Murthy
- KJ Delaney
- KP Forbes
- KP Forbes
- KS Dickson
- KS Dickson
- L Legendre
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- LR Meeks
- M Morlando
- M Morlando
- MH MacDonald
- MI Zarudnaya
- MM Kessler
- N Niwa
- N Ohtsubo
- N Proudfoot
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- NN Alexandrov
- O Calvo
- O Calvo
- P Stoilov
- PH Brown
- Q Li
- Q Li
- R Macknight
- R Mendez
- R Sorek
- R Xu
- R Xu
- RW Skadsen
- S Buratowski
- S Chen
- S Dettwiler
- S Gross
- S Kashiwabara
- S Kashiwabara
- S Kikuchi
- S Millevoi
- S Millevoi
- S Miyamoto
- SF Altschul
- SH Ahn
- SH Ok
- SI Gunderson
- SI Gunderson
- SM Barabino
- SR Valentini
- T Ishikawa
- T Tantikanjana
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- U Ruegsegger
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- WR Hansen
- X Qu
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- Y Jin
- Y Tacahashi
- Y Yao
- YJ Le
- YJ Lee
- YL Xiao
- Z Dominski
- Z Dominski
- ZJ Lorkovic´
- ZJ Lorkovic´
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 01/01/2008
- Field of study
Forschungsschwerpunkte in der Chirurgie — Gastrointestinale Motilität
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- A Berger
- A Csendes
- A Dubois
- A Ferrara
- A Pena
- A Stacchini
- A-O Escandell
- AG Parks
- AJP Smout
- BN Catchpole
- BT Massey
- C Herfarth
- C Herfarth
- C Pellegrini
- CF Code
- CS Holstein von
- CTM Speakman
- E Schippers
- E Schippers
- E Schippers
- E Schippers
- EMM Quigley
- EMM Quigley
- EMM Quigley
- EMM Quigley
- F Baldi
- F Lazorthes
- F Seow-Choen
- G Arlt
- G Batignani
- G Nylander
- G Vantrappen
- G Vantrappen
- G Vantrappen
- G Zaninotto
- GE Holle
- GS Sidhu
- H Troidl
- H-G Beger
- H-J Ehrlein
- H-J Stein
- H-J Stein
- H-J Stein
- H-J Stein
- H-J Stein
- HJ Silva da
- HM Richter
- IL Gregor mc
- J Braun
- J Braun
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- J Fass
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- JH Szurszewski
- JO Stadaas
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- JR Mathias
- JR Siewert
- JS Thompson
- K Nygaard
- K-A Kelly
- K-D Anderson
- K-H Lam
- K-H Lam
- KA Kelly
- L Bonavina
- L Bueno
- L Ennochson
- LE Perino
- M Cristallo
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- M Ruckebusch
- M-G Patti
- M-J Collen
- ME Neill
- MJ Carmichael
- MP Hocking
- MR Keighley
- NE Diamant
- NE Diamant
- NG Rothnie
- NJ Soper
- O Aanestad
- OO Rasmussen
- P Morrison
- P O’Connell
- PA Lloyd
- PR O’Connell
- PR O’Connell
- R Bumm
- RG Molloy
- RK Zeman
- RW Summers
- S Chaussade
- S Sarna
- S Shirazi
- S-P Goldenberg
- S-R Fisher
- SB Reiser
- SB Reiser
- SJ Snooks
- SJ Stryker
- St EA Attwood
- T Wittmann
- T Wittmann
- T Öresland
- T-R DeMeester
- T-T Zittel
- U Hildebrandt
- UT Strunz
- V Schumpelick
- V Schumpelick
- V-F Eckardt
- W Lawrence Jr
- WG Lewis
- WM Sun
- WM Sun
- WR Waddell
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 01/01/1997
- Field of study
Appendicitis risk prediction models in children presenting with right iliac fossa pain (RIFT study): a prospective, multicentre validation study.
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- A Chishti I
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- A Griffiths Ewen
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- Abdelwahed A
- Abou El Ella Y
- Abulafi M
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- Ahel J
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- Al-Sarireh B
- Al-Sheikh M
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- Alshafei A
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- Burnside D
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- Wijesundera K
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- Y Zhang A
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- Youssef H
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- Z Farrow E
- Z Zadi A
- Zaborowski A
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2020
- Field of study
Background
Acute appendicitis is the most common surgical emergency in children. Differentiation of acute appendicitis from conditions that do not require operative management can be challenging in children. This study aimed to identify the optimum risk prediction model to stratify acute appendicitis risk in children.
Methods
We did a rapid review to identify acute appendicitis risk prediction models. A prospective, multicentre cohort study was then done to evaluate performance of these models. Children (aged 5\u201315 years) presenting with acute right iliac fossa pain in the UK and Ireland were included. For each model, score cutoff thresholds were systematically varied to identify the best achievable specificity while maintaining a failure rate (ie, proportion of patients identified as low risk who had acute appendicitis) less than 5%. The normal appendicectomy rate was the proportion of resected appendixes found to be normal on histopathological examination.
Findings
15 risk prediction models were identified that could be assessed. The cohort study enrolled 1827 children from 139 centres, of whom 630 (34\ub75%) underwent appendicectomy. The normal appendicectomy rate was 15\ub79% (100 of 630 patients). The Shera score was the best performing model, with an area under the curve of 0\ub784 (95% CI 0\ub782\u20130\ub786). Applying score cutoffs of 3 points or lower for children aged 5\u201310 years and girls aged 11\u201315 years, and 2 points or lower for boys aged 11\u201315 years, the failure rate was 3\ub73% (95% CI 2\ub70\u20135\ub72; 18 of 539 patients), specificity was 44\ub73% (95% CI 41\ub74\u201347\ub72; 521 of 1176), and positive predictive value was 41\ub74% (38\ub75\u201344\ub74; 463 of 1118). Positive predictive value for the Shera score with a cutoff of 6 points or lower (72\ub76%, 67\ub74\u201377\ub74) was similar to that of ultrasound scan (75\ub70%, 65\ub73\u201383\ub71).
Interpretation
The Shera score has the potential to identify a large group of children at low risk of acute appendicitis who could be considered for early discharge. Risk scoring does not identify children who should proceed directly to surgery. Medium-risk and high-risk children should undergo routine preoperative ultrasound imaging by operators trained to assess for acute appendicitis, and MRI or low-dose CT if uncertainty remains.
Funding
None