A locally adapted functional outcome measurement score for total hip replacement in west Africa: introduction of the Ouaga score

Background: Functional outcome scores are often used to measure results of Total Hip Replacement (THR). Most current scoring systems were designed for use in Europe or North America and seem not optimally suited for a general West African setting. We introduce a cross-cultural adaptation of the Lequesne index as a new score.Method: A new functional hip score, adapted to the West African setting and based on the Lequesne Index was introduced. To evaluate this score, the score questionnaire was completed by a group of patients in the Paul VI Hospital in Ouagadougou, Burkina Faso, who were possible candidates for hip replacement. Patients with hip fractures were excluded. Double scores acquired with a minimal interval of four weeks were analysed and test-retest reliability was assessed using intra-class correlation coefficient.Results: Mean patient age was 43,3 years. All patients were able to answer all questions. Double scores were available in 21 patients. Intra-class correlation coefficient was 0.896 indicating very good correlation.Conclusion: The current study has shown that the cross-cultural adaptation of the Lequesne Index, used as Ouaga Score. It can be obtained easily and is reliable in a general West African patient population. We recommend the use of the Ouaga Score for functional evaluation and follow-up of THR in West Africa.Keywords: THR, Hip, Africa, Functional score, Hip replacement, Arthroscop

Isolated radial head dislocation, a rare and easily missed injury in the presence of major distracting injuries: a case report

High velocity accidents can lead to major injuries – long bone fractures, abdominal trauma, pelvic fractures and chest injuries. These injuries can act as distracting factors during the initial assessment of a polytrauma patient and innocuous but significant smaller injuries can be missed. We present a rare case of isolated anterolateral radial head dislocation in a polytrauma patient

Risk Factors For Recurrent Stroke After Coronary Artery Bypass Grafting

<p>Abstract</p> <p>Objectives</p> <p>Preventing stroke after coronary artery bypass grafting (CABG) remains a therapeutic goal, due in part to the lack of identifiable risk factors. The aim of this study, accordingly, was to identify risk factors in CABG patients with a previous history of stroke.</p> <p>Methods</p> <p>Patients with a history of stroke who underwent CABG at Beijing An Zhen hospital from January 2007 to July 2010 were selected (n = 430), and divided into two groups according to the occurrence of postoperative stroke. Pre-operative and post-operative data were retrospectively collected and analyzed by univariate and multivariate logistic regression analyses.</p> <p>Results</p> <p>Thirty-two patients (7.4%) suffered post-operative stroke. Univariate analysis identified several statistically significant risk factors in the post-operative stroke group, including pre-surgical left ventricular ejection fractions (LVEF) ≤50%, on-pump surgery, post-operative atrial fibrillation (AF), and hypotension. Multivariable analysis identified 4 independent risk factors for recurrent stroke: unstable angina (odds ratio (OR) = 2.95, 95% CI: 1.05-8.28), LVEF ≤50% (OR = 2.77, 95% CI: 1.23-6.27), AF (OR = 4.69, 95% CI: 1.89-11.63), and hypotension (OR = 2.55, 95% CI: 1.07-6.04).</p> <p>Conclusion</p> <p>Unstable angina, LVEF ≤50%, post-operative AF, and post-operative hypotension are independent risk factors of recurrent stroke in CABG patients with a previous history of stroke.</p

Is quality of life post cardiac surgery overestimated?

Contains fulltext : 134078.pdf (publisher's version ) (Open Access)BACKGROUND: Quality of Life (QoL) studies concerns the difference in QoL between the baseline and the post-surgical assessment. Many such studies, however, suffer from incomplete QoL-data with regard to patients with a proven survival--the drop-outs. Our hypothesis is that patients with a low preoperative QoL, high operative risk and older age are at higher risk for drop-out, which may result in a biased conclusion. METHODS: This study includes 1675 patients, all of whom were operated between July 1, 2009 and July 1,2012 and have a proven one-year survival, as well as a complete preoperative EuroQoL registration (EQ-5D and EQ-VAS). Based on the calculated 30 and 70 percentiles of age, EuroSCORE risk, and EQ-5D and EQ-VAS values, the group was split into three different subgroups. We studied whether (1) there was a correlation between age, risk, preoperative QoL and postoperative QoL and (2) if the drop-outs were correlated to age, risk and preoperative QoL. RESULTS: There is a statistically significant correlation between postoperative QoL and both age (p = 0.029) and risk (p = 0.002). Both relations have a negative Pearson's r. There is also a statistically significant (p = 0.0001) correlation between pre- and postoperative QoL, now with a positive Pearson's r. The percentage of drop-outs increases in a statistically significant manner with an increased risk (p = 0.001), older age (p = 0.001) and a low preoperative QoL (EQ-5D, p = 0.001 and EQ-VAS, p = 0.003). CONCLUSION: We conclude that QoL post cardiac surgery is overestimated, certainly for older, high risk patients and patients with a low preoperative QoL