Abstract：
INTRODUCTION:Patients with hip fractures are usually frail and elderly with a 30-day mortality in excess of 10% in European series. Perioperative morbidity is often multifactorial in nature, and unimodal interventions will not necessarily decrease mortality. The purpose of this prospective study was to analyse causes of mortality, and thereby the potential and limitations to decrease mortality after hip fracture surgery. METHODS:300 consecutive, unselected hip fracture patients were treated in a multimodal rehabilitation programme with continuous perioperative epidural analgesia and anaesthesia, early surgery, standardized fluid and transfusion therapy, enforced oral nutrition and early mobilization and physiotherapy. All deaths within 30 days of surgery or during primary hospitalization were analysed and classified according to whether death was unavoidable, probably unavoidable, or potentially avoidable. RESULTS:Thirty-day mortality was 13.3% (40 patients) and the total perioperative mortality was 15.6% (47 patients). Death was definitely unavoidable in 28%, probably unavoidable in 15%, and in theory potentially avoidable in 57%. In the patients where death was potentially avoidable, active care was curtailed in 16 of 27 (59%) patients. CONCLUSION:About a quarter of the total mortality in hip fracture patients is definitely unavoidable, and death is probably only avoidable in about half of the unselected patients. These results have important implications for the design of future outcome studies, which should focus on other relevant outcomes than mortality per se.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Foss NB,Kehlet Hdoi
10.1093/bja/aei010subject
Has Abstractpub_date
2005-01-01 00:00:00pages
24-9issue
1eissn
0007-0912issn
1471-6771pii
S0007-0912(17)35755-0journal_volume
94pub_type
杂志文章abstract：:We investigated the effect of incision and sternotomy on the auditory evoked potential (AEP) and EEG, to try to predict a haemodynamic response to incision or sternotomy using the AEP and EEG in 41 patients undergoing cardiac surgery during propofol and alfentanil anaesthesia. The AEP and EEG were recorded before inci...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/76.5.685
更新日期：1996-05-01 00:00:00
abstract：BACKGROUND:We defined the nature of the pharmacological interaction after intrathecal co-administration of ginsenosides with clonidine, and clarified the contribution of the α-2 adrenoceptors on the effect of ginsenosides. METHODS:Pain was evoked by injection of a formalin solution (5%, 50 μl) into the hindpaw of male...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aeq367
更新日期：2011-03-01 00:00:00
abstract：:Skills related to driving, the ability to discriminate the fusion of flickering light, and hand and foot proprioception, were measured double-blind in 34 healthy volunteers before and after three doses of i.v. diazepam. The effects of diazepam were most harmful to co-ordination. With 0.15 mg/kg, 0.30 mg/kg and 0.45 mg...
journal_title：British journal of anaesthesia
pub_type： 临床试验,杂志文章
doi：10.1093/bja/47.4.457
更新日期：1975-04-01 00:00:00
abstract：BACKGROUND:Early clot amplitudes measured on thromboelastometry (ROTEM®) predict maximum clot firmness (MCF) in adults. In this multicentre, retrospective study, we aimed to confirm the suspected relationship between early ROTEM® variables and MCF, in children undergoing cardiac or non-cardiac surgery. METHODS:4762 RO...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,多中心研究
doi：10.1093/bja/aev369
更新日期：2015-12-01 00:00:00
abstract：:We studied 325 patients undergoing elective noncardiac surgery who had preoperative ambulatory ECG monitoring performed for a duration of 5130 h (range 8-24 h; mean 15.8 h). Sixty-four subjects (20%) had one or more episodes of ST segment depression consistent with myocardial ischaemia. Of all preoperative cardiovascu...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/73.5.574
更新日期：1994-11-01 00:00:00
abstract：:We studied psychomotor performance in 10 healthy volunteers during recovery after a target-controlled infusion of propofol. Choice reaction time, dual task tracking with secondary reaction time and a within-list recognition task were assessed at target blood propofol concentrations of 0.8, 0.4 and 0.2 microgram ml-1. ...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/85.3.396
更新日期：2000-09-01 00:00:00
abstract：:We have studied the effects of flow and dobutamine on systemic haemodynamic variables, oxygen delivery (DO2) and oxygen consumption (VO2) in 20 patients during cardiopulmonary bypass (CPB) with mild hypothermia (34 degrees C). In a subgroup of seven patients, we also studied the effects on gastric microcirculatory blo...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/76.1.5
更新日期：1996-01-01 00:00:00
abstract：BACKGROUND:Data on contributors to between-individual variability in overall tramadol clearance and O-demethyl tramadol (M1) formation in preterm neonates and young infants are limited. METHODS:A population pharmacokinetic analysis of tramadol and M1 was undertaken using non-linear mixed effects model. Covariate analy...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aen019
更新日期：2008-04-01 00:00:00
abstract：:Patients receiving opioids report feeling sleepy, but opioids actually inhibit the rapid eye movement phase of sleep (REM). Inhibition of REM sleep is followed by a rebound increase in REM sleep associated with cardiopulmonary complications. The medial pontine reticular formation (mPRF) is a brain region from which mo...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/74.2.188
更新日期：1995-02-01 00:00:00
abstract：:We have compared the efficacy of patient-controlled interscalene analgesia (PCIA) using ropivacaine with patient-controlled analgesia (PCA) using nicomorphine in 60 patients (n = 30 in each group), in a prospective, randomized study. In both groups, all patients received interscalene block with 0.75% ropivacaine befor...
journal_title：British journal of anaesthesia
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1093/bja/81.4.603
更新日期：1998-10-01 00:00:00
abstract：BACKGROUND:The perioperative period may be associated with a marked neurohumoral stress response, significant fluid losses, and varied fluid replacement regimes. Acute changes in serum sodium concentration are therefore common, but predictors and outcomes of these changes have not been investigated in a large surgical ...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aeu409
更新日期：2015-04-01 00:00:00
abstract：:Experiments were performed on rats using two analgesimetric tests (tail-flick; hot-plate) before and after injection i.v. of graded doses of aprotinin (12.5, 25.0 and 50 KIU g-1). A dose-related analgesic effect was noted with both tests. Prior administration of naloxone 0.001 mg g-1 i.p. inhibited the analgesic actio...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/52.11.1107
更新日期：1980-11-01 00:00:00
abstract：:We investigated whether low-dose erythromycin (200 mg) given as an oral premedicant altered the residual gastric volume and its acidity in fasted patients at induction of anaesthesia in a single-blinded study. Sixty patients were allocated randomly to receive either an erythromycin tablet (200 mg) or nothing with 10 m...
journal_title：British journal of anaesthesia
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1093/bja/85.6.861
更新日期：2000-12-01 00:00:00
abstract：BACKGROUND:The aim of this study was to explore difficulties at work from anaesthetists' own perspective and to examine how anaesthetists handle and cope with situations that are perceived as difficult and potentially stressful. METHODS:Two sets of interviews were conducted with 19 specialist anaesthetists in Sweden. ...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,多中心研究
doi：10.1093/bja/aem233
更新日期：2007-10-01 00:00:00
abstract：:The effect of alfentanil on sympathetic reflexes evoked by supramaximal electrical stimulation of the radial nerve has been observed in five dogs anaesthetized with alpha-chloralose, paralysed with suxamethonium and artificially ventilated. In five dogs during the infusion of alfentanil at a rate of 20 micrograms kg-1...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/61.4.441
更新日期：1988-10-01 00:00:00
abstract：:We have examined the effects of two types of insulin therapy (continuous i.v. infusion (group A: 1.25 u. h-1) and direct i.v. bolus administration of 10 u. every 2 h (group B: 10 u./2 h)) on the metabolic and endocrine responses to surgery in 60 adult diabetic patients undergoing general anaesthesia for elective proce...
journal_title：British journal of anaesthesia
pub_type： 临床试验,杂志文章
doi：10.1093/bja/72.1.5
更新日期：1994-01-01 00:00:00
abstract：:Plasma concentrations of pancuronium were measured in nine patients undergoing surgery because of total biliary obstruction. When compared with the averaged model-independent pharmacokinetic parameters obtained for normal patients, the terminal half-life of 270 min was more than twice normal (132 min, P less than 0.00...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/49.11.1103
更新日期：1977-11-01 00:00:00
abstract：:A simple mathematical model of the chest wall was constructed so that during tidal breathing the relative volume contributions of the rib cage and abdomen/diaphragm could be measured in man, using four mercury-in-rubber strain gauges around the trunk. From the dimensions of the trunk and the change in circumference de...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/51.5.391
更新日期：1979-05-01 00:00:00
abstract：:The calculation of pharmacokinetic parameters after a bolus injection of fentanyl allowed an i.v. infusion scheme which guarantees analgesia for the entire duration of surgery, with the advantage of steady plasma concentration and body content. In the initial phase after bolus injection, the serum concentration decrea...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/52.10.1021
更新日期：1980-10-01 00:00:00
abstract：:Cancer treatment is associated with significant morbidity and mortality. Surgery is a mainstay of treatment for many tumours, and anaesthetists care for cancer patients on a daily basis. Surgery itself induces a stress response and inhibits the immune system, and cancer surgery is associated with the release of tumour...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,评审
doi：10.1093/bja/aev375
更新日期：2015-12-01 00:00:00
abstract：BACKGROUND:Propofol is used during living-related donor liver transplantation because its metabolism is not greatly affected by liver failure. However, the pharmacokinetics of propofol during liver transplantation have not been fully defined. The purpose of this study was to evaluate the apparent systemic clearance of ...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aei243
更新日期：2005-11-01 00:00:00
abstract：:The possibility of an interaction between diazepam and pancuronium bromide was investigated in six patients undergoing general anaesthesia maintained with fentanyl, droperidol and nitrous oxide. Neuromuscular blockade was controlled using a feedback mechanism which automatically adjusted the rate of injection of pancu...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/53.8.859
更新日期：1981-08-01 00:00:00
abstract：:Plasma concentrations of amethocaine were measured after topical application of amethocaine cream 2 g (5% w/w) to the dorsum of the right hand of 10 adult volunteers. The cream was applied for 240 min and plasma was assayed for amethocaine and its metabolite p-n-butylaminobenzoic acid at 0, 30, 60, 90, 120 and 240 min...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/67.4.432
更新日期：1991-10-01 00:00:00
abstract：:This is the report of a 55-yr-old female who developed severe myotonia and dystonia after general anaesthesia. Before starting on gabapentin therapy for a neuropathic pain condition, she had undergone numerous uneventful general anaesthetics. Since receiving treatment with gabapentin, she has experienced severe moveme...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aem130
更新日期：2007-08-01 00:00:00
abstract：:We describe an obstetric patient who presented for removal of a retained placenta. After insertion of the spinal anaesthetic, she developed a severe headache, and a subarachnoid haemorrhage was diagnosed. We discuss the differential diagnosis of the headache, the occurrence of intracranial haemorrhages after dural pun...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/86.3.442
更新日期：2001-03-01 00:00:00
abstract：:Alveolar type II (ATII) cells perform many important functions within the lung, including surfactant metabolism. We have investigated the effects of isoflurane and different i.v. anaesthetics on cell metabolism in primary cultures of rat ATII cells. Biosynthesis of phosphatidylcholine, the main phospholipid component ...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/82.5.767
更新日期：1999-05-01 00:00:00
abstract：BACKGROUND:Transitions into and out of the anaesthetised state exhibit resistance to state transitions known as neural inertia. As a consequence, emergence from anaesthesia occurs at a consistently lower anaesthetic concentration than induction. Motivated by stochastic switching between discrete activity patterns obser...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1016/j.bja.2018.02.035
更新日期：2018-07-01 00:00:00
abstract：BACKGROUND:The pathophysiology of the serotoninergic system in malignant hyperthermia (MH) is not completely understood. The serotonin-2 (5HT(2A)) receptor agonist 1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane hydrochloride (DOI) induces typical MH symptoms, including skeletal muscle rigidity, an increase in body tempe...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aeg172
更新日期：2003-08-01 00:00:00
abstract：:The evidence for an association between hypertensive disease, elevated admission arterial pressure, and perioperative cardiac outcome is reviewed. A systematic review and meta-analysis of 30 observational studies demonstrated an odds ratio for the association between hypertensive disease and perioperative cardiac outc...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,meta分析,评审
doi：10.1093/bja/aeh091
更新日期：2004-04-01 00:00:00
abstract：:We studied 100 healthy women undergoing outpatient gynaecological laparoscopy in a randomized, double-blind and placebo-controlled study to evaluate the effect of neostigmine on postoperative nausea and vomiting (PONV). After induction of anaesthesia with propofol, anaesthesia was maintained with sevoflurane and 66% n...
journal_title：British journal of anaesthesia
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1093/bja/81.5.757
更新日期：1998-11-01 00:00:00
