Abstract:
:Among hypertensive and diabetic patients undergoing elective noncardiac surgery, preoperative status and intraoperative changes in mean arterial pressure (MAP) were evaluated as predictors of postoperative ischemic complications. Of 254 patients evaluated before operation and monitored during operation, 30 (12%) had postoperative cardiac death, ischemia, or infarction. Twenty-four per cent of patients with a previous myocardial infarction or cardiomegaly had an ischemic postoperative cardiac complication. Only 7% of those without either of these conditions sustained an ischemic complication. No other preoperative characteristics, including the presence of angina, predicted ischemic cardiac risk. Nineteen per cent of patients who had 20 mm Hg or more intraoperative decreases in MAP lasting 60 minutes or more had ischemic cardiac complications. Patients who had more than 20 mm Hg decreases in MAP lasting 5 to 59 minutes and more than 20 mm Hg increases lasting 15 minutes or more also had increased complications (p less than 0.03). Changes in pulse were not independent predictors of complications and the use of the rate-pressure product did not improve prediction based on MAP alone. In conclusion patients with a previous infarction or radiographic cardiomegaly are at high risk for postoperative ischemic complications. Prolonged intraoperative increases or decreases of 20 mm or more in MAP also resulted in a significant increase in these potentially life-threatening surgical complications.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Charlson ME,MacKenzie CR,Gold JP,Ales KL,Topkins M,Fairclough GP Jr,Shires GTdoi
10.1097/00000658-198911000-00012subject
Has Abstractpub_date
1989-11-01 00:00:00pages
637-48issue
5eissn
0003-4932issn
1528-1140journal_volume
210pub_type
杂志文章abstract:INTRODUCTION:Complexity of combined heart-liver transplantation has resulted in low adoption rates. We report a case series of adult patients receiving en-bloc heart-liver transplantation (HLTx), describe technical aspects, and discuss benefits of the technique. METHODS:Retrospective review of patients receiving en-bl...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003721
更新日期:2020-01-14 00:00:00
abstract:OBJECTIVE:Comparative effectiveness research has mostly been focused on comparison of treatment techniques. The goal of the present study was to extend the research to physician specialty. BACKGROUND:Both surgeons and interventionalists (cardiologists and radiologists) are involved in endovascular repairs (EVAR) of ao...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3182a196b5
更新日期:2013-09-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to examine the effects of radiofrequency ablation (RFA) on tumor growth and growth factor expression in a murine model. BACKGROUND:Surgical excision remains the only potentially curative therapy for hepatic malignancies. Tumor growth in the remaining liver may be accelerated aft...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000261319.51744.59
更新日期:2007-05-01 00:00:00
abstract:OBJECTIVE:To review retrospectively a 4-year experience with pediatric surgical networking at a major academic medical center in the Midwest. BACKGROUND:The growth of managed care in the United States during the past decade has had a major impact on the practice of medicine in general, but especially on academic medic...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199909000-00006
更新日期:1999-09-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Factors that control pancreatic regenerating (reg I) gene expression are unknown, but it is believed that its expression may correspond with cellular differentiation. The authors recently demonstrated that reg I is expressed in AR42J, a rat acinar cell line whose state of differentiation can be...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199703000-00013
更新日期:1997-03-01 00:00:00
abstract:OBJECTIVES:The American Joint Committee on Cancer (AJCC) staging system for gastric cancer bases N status on absolute number of metastatic nodes, regardless of the number of examined nodes. We examined a modified staging system utilizing node ratio (Nr), the ratio of metastatic to examined nodes. METHODS:A total of 18...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31824857e2
更新日期:2012-03-01 00:00:00
abstract:OBJECTIVE:Create and validate diverticulitis surgical site infection prediction scale. BACKGROUND:Surgical site infections cause significant morbidity after colorectal surgery. An infection prediction scale could target infection prevention bundles to high-risk patients. METHODS:Prospectively collected National Surgi...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002859
更新日期:2019-12-01 00:00:00
abstract::We reviewed 37 consecutive, hemodynamically stable patients (16 adults, 21 children) who had splenic injuries diagnosed by computed tomography (CT) scan to compare the CT evaluation with operative assessment of injury and eventual treatment. Computed tomographic scans and operative findings were graded by a splenic in...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199005000-00009
更新日期:1990-05-01 00:00:00
abstract::Although survival from primary breast cancer has improved with earlier diagnosis and treatment, the management of the opposite breast is still in question. The risk factors for bilaterality are known, and preoperative mammography is occasionally helpful, but identification of early second breast cancer is very limited...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198506000-00001
更新日期:1985-06-01 00:00:00
abstract::The present work was performed to clarify the effects of epidermal growth factor (EGF) on the growth of human breast cancer and carcinoma of the esophagus. Human breast cancer MX-1, UM-1, and esophageal cancer ES-4 were transplanted to the subcutaneous tissue of nude mice. Human EGF (2 micrograms) was injected locally...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:
更新日期:1990-03-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to determine the minimum amount of weight loss required to see a reduction in major adverse cardiovascular events (MACE). BACKGROUND:Although obesity is an established risk factor for morbidity and mortality, the minimum amount of weight loss to have a meaningful impact on cardiovas...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004369
更新日期:2020-10-01 00:00:00
abstract:OBJECTIVE:To compare outcomes of fenestrated (FEVAR) and open repairs of complex abdominal aortic aneurysms (cAAA). BACKGROUND:FEVAR has emerged as an alternative to open surgery for treating cAAA, but direct comparisons are limited. METHODS:We studied all repairs of intact or symptomatic cAAA in the Vascular Quality...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000003094
更新日期:2020-05-01 00:00:00
abstract::Nineteen patients with primary duodenal carcinoid were analysed retrospectively, and eight of the tumors were immunocytochemically examined. One tumor contained somatostatin, two tumors gastrin, two tumors both these peptides, and one tumor contained serotonin. In two tumors no peptide or amine could be demonstrated. ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198304000-00003
更新日期:1983-04-01 00:00:00
abstract:OBJECTIVE:The authors addressed whether a repeat hepatic operation is warranted in patients with recurrent isolated hepatic metastases. Are the results as good after second operation as after first hepatic operation? SUMMARY BACKGROUND DATA:Five-year survival after initial hepatic operation for colorectal metastases i...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199606000-00015
更新日期:1996-06-01 00:00:00
abstract:OBJECTIVE:To determine the optimal management of symptomatic non-parasitic liver cysts. SUMMARY BACKGROUND DATA:Management options for symptomatic nonparasitic liver cysts lack substantiation through comparative studies with respect to safety and long-term effectiveness. METHODS:A retrospective review of the surgical...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199808000-00004
更新日期:1998-08-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to perform the first statewide, population-based, time-series analysis of the frequency of ruptured abdominal aortic aneurysm (RAAA), to determine the outcomes of RAAA, and to assess the association of patient, physician, and hospital factors with survival after RAAA. The hypoth...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199605000-00005
更新日期:1996-05-01 00:00:00
abstract::The enterococcus has been relegated to a position of unimportance in the pathogenesis of surgical infections. However the increasing prevalence and virulence of these bacteria prompt reconsideration of this view, particularly because the surgical patient has become increasingly vulnerable to infectious morbidity due t...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/00000658-199008000-00007
更新日期:1990-08-01 00:00:00
abstract::Previous studies have demonstrated that Na(+)-dependent brush border glutamine transport is diminished in septic patients. To examine the potential regulation of this decreased transport by endotoxin, cytokines, or glucocorticoids, the human intestinal Caco-2 cell line was studied in vitro. Na(+)-dependent glutamine t...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199205000-00017
更新日期:1992-05-01 00:00:00
abstract::Of 531 patients admitted to the Duke Coronary Care Unit with unstable angina (UA) from June 1981 to September 1982, 100 had persistent angina despite optimal medical therapy of nitrates, propranolol, and nifedipine. At catheterization, 70% of the refractory patients had left main (LM) or three-vessel disease (TVD), 68...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198410000-00007
更新日期:1984-10-01 00:00:00
abstract:OBJECTIVES:The aim of the study was to evaluate and study the full spectrum of swallowing dysfunction and long-term disease-specific outcomes in adults with surgically corrected esophageal atresia/tracheaesophageal fistula (EA/TEF). BACKGROUND:Long-term outcomes for adults who underwent EA/TEF repair because infants a...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001978
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:To evaluate the effect of Medicare Shared Savings Program accountable care organizations (ACOs) on hospital readmission after common surgical procedures. SUMMARY BACKGROUND DATA:Hospital readmissions following surgery lead to worse patient outcomes and wasteful spending. ACOs, and their associated hospitals,...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002737
更新日期:2019-05-01 00:00:00
abstract:OBJECTIVE:The authors assess the long-term results of repeat hepatectomies for recurrent metastases of colorectal cancer and determine the factors that can predict survival. SUMMARY BACKGROUND DATA:Safer techniques of hepatic resection have allowed surgeons to consider repeat hepatectomy for colorectal metastases in a...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199701000-00006
更新日期:1997-01-01 00:00:00
abstract:OBJECTIVE:To describe hospital-level variation in roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) in Michigan. BACKGROUND:Bariatric surgery is an increasingly prevalent elective surgical procedure that will likely be considered for future bundled payment programs, both public and private. Past research in ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002462
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE:To review a single center's experience and outcome with living donor transplants. SUMMARY BACKGROUND DATA:Outcome after living donor transplants is better than after cadaver donor transplants. Since the inception of the authors' program, they have performed 2,540 living donor transplants. For the most recent...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200108000-00004
更新日期:2001-08-01 00:00:00
abstract:OBJECTIVE:To determine whether the acute anti-inflammatory influence of epinephrine (EPI) extends to changes in heart rate variability (HRV) induced by the prototypical inflammatory stimulus, endotoxin (lipopolysaccharide [LPS]). SUMMARY BACKGROUND DATA:HRV reflects fluctuating cardiac autonomic inputs and is acutely ...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0b013e3181a40193
更新日期:2009-05-01 00:00:00
abstract:OBJECTIVE:To compare cancer-specific results of local excision with major resection. BACKGROUND:Technological advances have enabled endoscopic and local excision techniques to be applied in the treatment of early colorectal cancer in preference to radical surgery. METHOD:Patients with stage 0 (carcinoma in situ) or s...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3182a4e85a
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVE:To assess the feasibility and safety of laparoscopic liver resections. SUMMARY BACKGROUND DATA:The use of the laparoscopic approach for liver resections has remained limited for technical reasons. Progress in laparoscopic procedures and the development of dedicated technology have made it possible to conside...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200012000-00004
更新日期:2000-12-01 00:00:00
abstract:OBJECTIVE:The authors determined the incidence of complications in 133 patients who had undergone staging laparotomy with splenectomy before treatment for Hodgkin's disease (stages I-IV). METHODS AND MATERIALS:Medical records were reviewed, and the patients or their relatives were interviewed. Median follow-up after l...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/00000658-199406000-00004
更新日期:1994-06-01 00:00:00
abstract::The diagnosis of intra-abdominal abscess by radiographic means often relies on combining the results of several different imaging modalities. Computed tomography (CT) has been shown to be a safe, accurate and rapid diagnostic method of diagnosing these abscesses. Five patients with a variety of intra-abdominal abscess...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197901000-00006
更新日期:1979-01-01 00:00:00
abstract:OBJECTIVE:To determine the factors that may predict music-induced relaxation in friends and family of patients in the emergency department. BACKGROUND:It remains unclear to date which demographic and experiential factors predict the effectiveness of music-induced relaxation. Furthermore, in-hospital stressors for frie...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0b013e31828ee1da
更新日期:2013-05-01 00:00:00