Abstract:
OBJECTIVES:When physicians become patients, they may expect special privileges, extra attention from caregivers, and non-routine treatments. Consequently, physician patients may not be treated per routine-which possibly worsens care rather than improving it. We thus tested the primary hypothesis that in-hospital mortality and major complications after non-cardiac surgery are more common in physician patients than in non-physician patients. PATIENTS AND METHODS:Perioperative data were extracted for patients who had non-cardiac surgery at the Cleveland Clinic between 2005 and 2013. We used propensity score matching to identify comparable groups of physician and non-physician patients. Matched physician and non-physician patients were compared on a composite of in-hospital mortality and major postoperative complications using a generalized equation average relative effects model. Secondly, the matched patients were also compared on reoperation using logistic regression and on duration of hospitalization using Kaplan-Meier analysis with the log-rank test and Cox proportional hazards regression. RESULTS:Among 21,173 qualifying patients, we matched 522 physician patients to 2448 non-physician controls. There were no significant differences between physician and non-physician patients in the composite of in-hospital mortality and major complications, with an estimated odds ratio across the outcome components (average relative effect) of 1.20 (95% confidence interval 0.77-1.87) for physicians vs. non-physicians, P = 0.41. There was also no difference in the risk of re-operation or duration of hospitalization. CONCLUSIONS:A variety of important outcomes were similar in physician patients and matched non-physician patients after non-cardiac surgery.
journal_name
J Anesthjournal_title
Journal of anesthesiaauthors
Panjasawatwong K,Lin P,Karimi N,You J,Sessler DIdoi
10.1007/s00540-016-2273-3subject
Has Abstractpub_date
2017-02-01 00:00:00pages
111-119issue
1eissn
0913-8668issn
1438-8359pii
10.1007/s00540-016-2273-3journal_volume
31pub_type
杂志文章abstract::Mechanical influences independent of chemoreceptor function on ventilatory control were studied in halothane-anesthetized, artificially ventilated patients using the technique reported by Altose et al. (Respir Physiol 66: 171-180, 1986). Contribution of mechanical factor was indirectly assessed by comparing the values...
journal_title:Journal of anesthesia
pub_type: 杂志文章
doi:10.1007/s0054020060387
更新日期:1992-10-01 00:00:00
abstract::We compared the characteristics of postoperative pharyngeal morbidity in intubation between the AirWay Scope (AWS) and Macintosh laryngoscope in 68 ASA I-II female patients aged 35-77 years in a randomized, double-blinded, controlled fashion. After induction of general anesthesia, the patient's trachea was intubated u...
journal_title:Journal of anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00540-011-1195-3
更新日期:2011-10-01 00:00:00
abstract::Laparoscopic surgery has advanced remarkably in recent years, resulting in reduced morbidity and shorter hospital stay compared with open surgery. Despite challenges from the expanding array of laparoscopic procedures performed with the use of pneumoperitoneum on increasingly sick patients, anesthesia has remained lar...
journal_title:Journal of anesthesia
pub_type: 杂志文章,评审
doi:10.1007/s00540-013-1736-z
更新日期:2014-06-01 00:00:00
abstract::Thirty six patients were received epidural anesthesia with or without buprenorphine (BPN) during upper abdominal surgery. They were divided into three groups of 12 patients as follows; G-I received 20 ml of 1% lidocaine epidurally, G-II received 20 ml of 1% lidocaine epidurally and 0.6 mg BPN intravenously, G-III rece...
journal_title:Journal of anesthesia
pub_type: 杂志文章
doi:10.1007/s0054000040242
更新日期:1990-07-01 00:00:00
abstract:PURPOSE:Although non-steroidal anti-inflammatory drugs and acetaminophen have no proven efficacy against neuropathic pain, they are frequently prescribed for neuropathic pain patients. We examined whether the combination of opioids (tramadol and morphine) with indomethacin or acetaminophen produce favorable effects on ...
journal_title:Journal of anesthesia
pub_type: 杂志文章
doi:10.1007/s00540-014-1953-0
更新日期:2015-06-01 00:00:00
abstract::We tested hypertonic saline solution (HS) to determine its effectiveness in surgical procedures for prostatic hypertrophy. We randomly selected 40 patients undergoing elective transurethral resection of the prostate for either infusion of HS (3% NaCl) at 4ml·kg(-1)·min(-1) (HS group) or lactated Ringer's solution (LR)...
journal_title:Journal of anesthesia
pub_type: 杂志文章
doi:10.1007/BF02471385
更新日期:1996-09-01 00:00:00
abstract:PURPOSE:This study aimed to examine the incidence, case fatality rate, and characteristics of perioperative symptomatic pulmonary thromboembolism (PS-PTE) throughout Japan. METHODS:From 2002 to 2011, confidential questionnaires were mailed annually to all Japanese Society of Anesthesiologists-certified training hospit...
journal_title:Journal of anesthesia
pub_type: 杂志文章
doi:10.1007/s00540-014-1939-y
更新日期:2015-06-01 00:00:00
abstract:PURPOSE:This study aimed to evaluate whether the three ryanodine receptor type 1 (RYR1) variants (p.Ser2345Thr, p.Ser2345Arg, and p.Lys3367Arg) which we identified in Japanese malignant hyperthermia (MH) patients with a clinical grading scale rank of 6 were causative for MH. METHODS:We prepared human embryonic kidney ...
journal_title:Journal of anesthesia
pub_type: 杂志文章,收录出版
doi:10.1007/s00540-020-02803-w
更新日期:2020-10-01 00:00:00
abstract::The effect-compartment concentration (C(e)) of a drug at a specific pharmacodynamic endpoint should be independent of the rate of drug injection. We used this assumption to derive an effect-compartment equilibrium rate constant (k(eo)) for propofol during induction of anesthesia, using a target controlled infusion dev...
journal_title:Journal of anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00540-005-0378-1
更新日期:2006-01-01 00:00:00
abstract:PURPOSE:Stroke volume variation (SVV) is affected by many factors. Although elevated intra-abdominal pressure and a pneumoperitoneum have been shown to increase SVV in animals, a recent human study showed that SVV did not change as a pneumoperitoneum was established. However, we considered the results of this study que...
journal_title:Journal of anesthesia
pub_type: 杂志文章
doi:10.1007/s00540-014-1963-y
更新日期:2015-08-01 00:00:00
abstract:PURPOSE:Hereditary hemorrhagic telangiectasia is a rare autosomal dominant disease characterized by capillary malformation leading to multisite cutaneomucosal telangiectasias and multiorgan arteriovenous malformations, which can present challenges to anesthetic care. The primary aim of this report is to present a large...
journal_title:Journal of anesthesia
pub_type: 杂志文章
doi:10.1007/s00540-013-1601-0
更新日期:2013-10-01 00:00:00
abstract::May-Hegglin anomaly (MHA) is an inherited autosomal dominant disorder characterized by giant platelets and inclusion bodies in granulocytes, and thrombocytopenia. There is no consensus on the perioperative management of this disorder. We report a case involving a patient with MHA who was perioperatively managed withou...
journal_title:Journal of anesthesia
pub_type: 杂志文章
doi:10.1007/s00540-018-2522-8
更新日期:2018-08-01 00:00:00
abstract::We report a case of hypermagnesemia in a hospitalized patient after prolonged laxative use; due to preexisting impaired consciousness and digestive problems, the hypermagnesemia was difficult to detect until it almost became fatal. A 64-year-old man who was a patient at another hospital for treatment of head injury an...
journal_title:Journal of anesthesia
pub_type: 杂志文章
doi:10.1007/s00540-006-0492-8
更新日期:2007-01-01 00:00:00
abstract::We aimed to perform an epidural patch using platelet rich plasma (PRP), which has the potential to regenerate and heal tissues via degranulation of platelets, in a 34-year-old parturient suffering from persistent post-dural puncture headache (PDPH) after failed epidural blood patch (EBP). After her admission to our un...
journal_title:Journal of anesthesia
pub_type: 杂志文章
doi:10.1007/s00540-017-2400-9
更新日期:2017-12-01 00:00:00
abstract:PURPOSE:To elucidate the mechanisms of the more profound hypotensive effects of propofol relative to thiamylal, we monitored changes in left ventricular (LV) preload, afterload, and contractility during the course of anesthetic induction with propofol and thiamylal. METHODS:Thirty-two patients (ASA I) were randomly as...
journal_title:Journal of anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s005400070021
更新日期:2000-01-01 00:00:00
abstract::Anesthesia requires informed consent because it is an invasive procedure with certain risks. However, the state of informed consent for anesthesia in Japan remains unclear. The purpose of this survey was to examine the state of informed consent for anesthesia in Japan. A questionnaire was sent to all hospitals certifi...
journal_title:Journal of anesthesia
pub_type: 杂志文章
doi:10.1007/s00540-005-0332-2
更新日期:2005-01-01 00:00:00
abstract::This study investigated right ventricular (RV) performance during hypotensive anesthesia and compared the effect of the vasodilators prostaglandin E1 (PGE1), nicardipine HCl (Nic), glycerin trinitrate (GTN), and isosorbide dinitrate (ISDN) on RV function. Fifty patients were allocated into four groups [PGE1 (n=20), Ni...
journal_title:Journal of anesthesia
pub_type: 杂志文章
doi:10.1007/BF02480070
更新日期:1997-06-01 00:00:00
abstract::Arthrogryposis multiplex congenita (AMC) consists of complex congenital anomalies characterized by multiple contractures. Anesthetic management of these patients requires special care: as this disease often progresses until dysfunction of multiple organ systems occur, it may have an impact on the anesthetic management...
journal_title:Journal of anesthesia
pub_type: 杂志文章
doi:10.1007/s00540-011-1309-y
更新日期:2012-04-01 00:00:00
abstract::Alveolar capillary dysplasia (ACD), which is a rare and lethal congenital pulmonary anomaly found in newborns, begins its onset or causes deterioration of the infant's condition some time after birth. Various congenital anomalies in combination with ACD have been reported, except for subglottic stenosis. Therefore, we...
journal_title:Journal of anesthesia
pub_type: 杂志文章
doi:10.1007/s00540-010-1080-5
更新日期:2011-04-01 00:00:00
abstract::Recently, gastric ultrasonography has been used as a noninvasive portable tool for evaluating gastric content and volume in adults and children. Pediatric patients are not always cooperative, especially younger ones, and it may be difficult to keep them in the appropriate scanning position without sedation. Hence, we ...
journal_title:Journal of anesthesia
pub_type: 杂志文章
doi:10.1007/s00540-016-2204-3
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:Postanesthetic shivering can be triggered by surgical stress and several aspects of anesthetic management and is frequently preceded by a decrease in peripheral blood flow due to thermoregulatory vasoconstriction. As perfusion index correlates with peripheral blood flow, we examined whether perioperative per...
journal_title:Journal of anesthesia
pub_type: 临床试验,杂志文章
doi:10.1007/s00540-013-1658-9
更新日期:2014-02-01 00:00:00
abstract:PURPOSE:The present study, conducted in rats, investigated whether propofol attenuates lipopolysaccharide (LPS)-triggered liver dysfunction via regulation of tumor necrosis factor (TNF)-α production in activated Kupffer cells. METHODS:Rats received LPS (500 μg/kg) under Urethane™ sedation (1 g/kg) in combination with ...
journal_title:Journal of anesthesia
pub_type: 杂志文章
doi:10.1007/s00540-016-2145-x
更新日期:2016-06-01 00:00:00
abstract:PURPOSE:The use of volatile anesthetics is reportedly related to altered cerebrovascular carbon dioxide (CO2) reactivity. We examined the comparative effects of sevoflurane versus isoflurane on cerebrovascular CO2 reactivity in patients with previous stroke. METHODS:Twenty-four patients with previous stroke and 20 pat...
journal_title:Journal of anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00540-008-0608-4
更新日期:2008-01-01 00:00:00
abstract:PURPOSE:Because blood concentrations of local anesthetics sometimes reach toxic levels after transversus abdominis plane (TAP) block, reduction of the dose has been necessary to reduce the risk of systemic toxicity. We therefore investigated the effects of TAP block with 0.25 % levobupivacaine (100 mg) on postoperative...
journal_title:Journal of anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00540-015-1993-0
更新日期:2015-08-01 00:00:00
abstract::The concentrations of extracellular glutamate (Glu), aspartate (Asp) and glycine (Gly) were measured by microdialysis method in the cortex and hippocampus before, during and after 15 min of total cerebral ischemia in dogs. The correlations between the concentrations of amino acids and the changes in EEG and evoked pot...
journal_title:Journal of anesthesia
pub_type: 杂志文章
doi:10.1007/s0054030070334
更新日期:1993-07-01 00:00:00
abstract::The relationship between tumor size and the complexity of anesthetic management was studied using several values: plasma catecholamine concentrations, requirement of vasoactive agents, surgical time, blood loss, plasma glucose concentrations, and hemodynamic variables. Ten patients with clinical and laboratory diagnos...
journal_title:Journal of anesthesia
pub_type: 杂志文章
doi:10.1007/BF02514621
更新日期:1994-12-01 00:00:00
abstract::We explored whether there were large differences in operating room (OR) times for two common procedures performed by multiple surgeons at each of several hospitals thousands of miles apart. Mean OR time, "wheels in" to "wheels out," for ten consecutive cases of each of laparoscopic cholecystectomy and lung lobectomy w...
journal_title:Journal of anesthesia
pub_type: 杂志文章,多中心研究
doi:10.1007/s00540-006-0419-4
更新日期:2006-01-01 00:00:00
abstract:PURPOSE:In emergency situations, rescuers occasionally must secure the airway while the patient is in a position other than the ideal supine position. We hypothesized that the laryngeal mask airway Supreme(®) (Supreme) may be useful for emergent airway management in several positions and compared the utility of the Sup...
journal_title:Journal of anesthesia
pub_type: 杂志文章
doi:10.1007/s00540-011-1145-0
更新日期:2011-08-01 00:00:00
abstract::The purpose of this multi-center study was to evaluate the efficacy and safety of prostaglandin E1 (PGE1) administration in achieving deliberate hypotension and in treating intraoperative hypertension for patients with a history of hypertension and ischemic heart disease. PGE1 (0.08 microg.kg(-1).min(-1)) decreased sy...
journal_title:Journal of anesthesia
pub_type: 杂志文章
doi:10.1007/s0054030070173
更新日期:1993-04-01 00:00:00
abstract::While the demand for bariatric surgery is increasing, hospital capacity remains limited. The ERABS (Enhanced Recovery After Bariatric Surgery) protocol has been implemented in a number of bariatric centers. We retrospectively compared the operating room logistics and postoperative complications between pre-ERABS and E...
journal_title:Journal of anesthesia
pub_type: 杂志文章
doi:10.1007/s00540-015-2089-6
更新日期:2016-02-01 00:00:00