Abstract:
STUDY OBJECTIVE:We evaluated the efficacy of a multidisciplinary approach to reduce postoperative complications and 1-year mortality in patients, undergoing hip fracture surgery and the impact of surgical delay on mortality. DESIGN:A non-randomized intervention study with a historical control group (CG). SETTING:During the hospital stay of patients undergoing hip fracture surgery and subsequent follow-up during 12 months post-discharge. PATIENTS:240 patients undergoing hip fracture surgery were included in the CG. 272 patients were included in the intervention group (IG). INTERVENTIONS:CG patients received the standard care given at our hospital. Patients in the IG received a new model of multidisciplinary approach to care. MEASUREMENTS:The following variables were collected: study group, age, gender, ASA physical status, comorbidity, type of fracture, type of anaesthesia, surgical delay, postoperative complications, hospital stay, destination after discharge and postoperative mortality. MAIN RESULTS:512 patients (CG = 240; IG = 272). Mean age was 83.8 years in CG and 84.9 years in IG. Patients in the IG had a worse health status according to ASA (III-IV: 68.8% vs 51.7%; p < 0.001) and took more drugs (p < 0.001). Surgery was performed within 48 h of admission in 55.1% of patients of the IG (38.3% CG; p < 0.001). Incidence of postoperative complications (67.3% IG vs 76.2% CG p = 0.025) and hospital stay was shorter in the IG (p < 0.001). A surgical delay of >48 h (HR = 0.61; CI95%: 0.42-0.88) and allocation to the IG (HR = 0.64; CI95%: 0.44-0.93) were the protective factors for mortality. CONCLUSIONS:The multidisciplinary approach could be associated with a decrease in postoperative complications, hospital stay and mortality. Surgical delay may not increase the risk of mortality. The main objective in the management of these patients should be the optimization of their general health status before surgery rather than surgical delay.
journal_name
J Clin Anesthjournal_title
Journal of clinical anesthesiaauthors
Reguant F,Arnau A,Lorente JV,Maestro L,Bosch Jdoi
10.1016/j.jclinane.2018.09.029subject
Has Abstractpub_date
2019-03-01 00:00:00pages
11-19eissn
0952-8180issn
1873-4529pii
S0952-8180(18)30762-1journal_volume
53pub_type
临床试验,杂志文章abstract:STUDY OBJECTIVE:To evaluate the effects on systemic hemodynamics of sequential pneumatic compression of the lower limbs in healthy volunteers. DESIGN:Prospective, self-controlled, volunteer study. SETTING:University teaching hospital. PATIENTS:11 healthy volunteers, aged 25 +/- 1.3 years. INTERVENTIONS AND MEASUREM...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章
doi:10.1016/j.jclinane.2008.02.005
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abstract:STUDY OBJECTIVES:To study the effect of tracheal intubation or laryngeal mask airway (LMA) insertion on intraocular pressure (IOP) in strabismus patients undergoing balanced anesthesia with sevoflurane and remifentanil. DESIGN:Open, prospective, randomized study. SETTING:Tertiary care academic medical institution. P...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0952-8180(01)00259-8
更新日期:2001-06-01 00:00:00
abstract::High frequency ventilation has been claimed to improve the efficiency of extracorporeal shock wave lithotripsy (ESWL) by minimizing the movement of urinary stones during the procedure. A ventilatory mode, QRS-activated ventilation, was developed in which the stones remain motionless during the delivery of shock waves....
journal_title:Journal of clinical anesthesia
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doi:10.1016/0952-8180(89)90025-1
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abstract::We present the case report of a 49-year-old gentleman with a history of adenoid cystic carcinoma of the left nare status post curative bifrontal craniotomy, left lateral rhinotomy and medial maxillectomy, adjuvant radiotherapy, and orbital exenteration for optic neuropathy, complicated by medial wall dehiscence. His c...
journal_title:Journal of clinical anesthesia
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abstract:STUDY OBJECTIVE:To investigate whether gender difference has an effect on an anesthesia resident's ability to perform successful mask ventilation. DESIGN:Cohort study. SETTING:Surgical operation theater of a university-affiliated hospital. PATIENTS:839 ASA physical status I, II, and III patients undergoing general a...
journal_title:Journal of clinical anesthesia
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doi:10.1016/j.jclinane.2008.06.037
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abstract::The most frequent and acute complications of subclavian vein catheterization are arterial puncture to the subclavian artery and pneumothorax. We report an arterial puncture directly to the pulmonary artery in infant during subclavian vein catheterization. ...
journal_title:Journal of clinical anesthesia
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doi:10.1016/j.jclinane.2007.10.012
更新日期:2008-05-01 00:00:00
abstract::Kearns-Sayre syndrome (KSS) is a rare mitochondrial myopathy and often involves cardiac conduction abnormality and muscle weakness. We report a patient with KSS who had an implantable cardioverter-defibrillator (ICD) implanted during general anesthesia with propofol and nitrous oxide (N2O). These anesthetics did not s...
journal_title:Journal of clinical anesthesia
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doi:10.1016/j.jclinane.2004.08.002
更新日期:2004-11-01 00:00:00
abstract:STUDY OBJECTIVE:To define the optimal dose of lidocaine to be added to propofol to reduce the incidence of pain during its injection. DESIGN:Double-blind, randomized, placebo-controlled study. SETTING:Medical center operating rooms. PATIENTS:135 ASA I and II female patients undergoing minor outpatient surgery. INTE...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1996-11-01 00:00:00
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journal_title:Journal of clinical anesthesia
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journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,meta分析
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journal_title:Journal of clinical anesthesia
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journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,随机对照试验
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更新日期:2015-12-01 00:00:00
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journal_title:Journal of clinical anesthesia
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更新日期:2016-09-01 00:00:00
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更新日期:2017-06-01 00:00:00
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journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0952-8180(00)00196-3
更新日期:2000-11-01 00:00:00
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更新日期:2019-11-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2017-05-01 00:00:00
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journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,随机对照试验
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更新日期:2009-02-01 00:00:00
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journal_title:Journal of clinical anesthesia
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更新日期:2003-03-01 00:00:00
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journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/0952-8180(91)90188-s
更新日期:1991-09-01 00:00:00
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journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
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更新日期:2019-05-01 00:00:00
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journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2007.06.026
更新日期:2008-03-01 00:00:00
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journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/s0952-8180(00)00133-1
更新日期:2000-05-01 00:00:00
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journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章
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更新日期:1996-06-01 00:00:00
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journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2019.109666
更新日期:2020-05-01 00:00:00
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journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2004.09.010
更新日期:2005-09-01 00:00:00
abstract::Although digoxin remains one of the most widely prescribed drugs in the United States, potential pharmacodynamic and pharmacokinetic interactions between this compound and other drugs, diseases, and events commonly encountered in the perioperative period remain largely unappreciated. Furthermore, the therapeutic benef...
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pub_type: 杂志文章,评审
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更新日期:1992-09-01 00:00:00