Article
Surgery
Carina E. Riediger, Steffen Loeck, Laura Frohneberg, Raphael Hoffmann, Christoph Kahlert, Juergen Weitz
Summary: Due to demographic changes and higher life expectancy, the number of liver resections in patients aged 70 and above is increasing. This analysis compared the postoperative outcome between patients below and above 70 years old who underwent liver resections for malignancies. The results showed that patients aged 70 and above had higher rates of postoperative complications and mortality compared to younger patients. Factors such as major resections, longer operating time, blood transfusion requirement, and certain organ resections were associated with worse postoperative outcomes.
INTERNATIONAL JOURNAL OF SURGERY
(2022)
Article
Multidisciplinary Sciences
Joseph Hadaya, Arjun Verma, Yas Sanaiha, Ramin Ramezani, Nida Qadir, Peyman Benharash
Summary: This study developed machine learning-based prediction models for postoperative respiratory failure (PRF) following emergency general surgery (EGS) and compared their performance to traditional regression models. The results showed that machine learning models demonstrated superior calibration at the extremes of risk and may be more useful in the clinical setting.
Article
Surgery
Daniele Fusario, Alessandro Neri, Ludovico Carbone, Luca Resca, Luigi Marano, Giulia Gassi, Natale Calomino, Luigi Verre, Franco Roviello, Daniele Marrelli
Summary: This study validated the effectiveness of the Emergency Surgery Frailty Index (EmSFI) in elderly patients over 65 with acute appendicitis, supporting surgeons in making surgical decisions. Patients aged 80 and over had a higher risk of complications, and for younger elderly patients, factors such as intestinal obstruction, peri-appendicular abscess, peritonitis, and longer surgery duration were associated with increased risk of complications.
WORLD JOURNAL OF SURGERY
(2023)
Article
Surgery
Konstantinos Lasithiotakis, Evangelos Kritsotakis, Stamatios Kokkinakis, Georgia Petra, Konstantinos Paterakis, Garyfallia-Apostolia Karali, Vironas Malikides, Charalampos S. Anastasiadis, Odysseas Zoras, Nikolas Drakos, Ioannis Kehagias, Dimitrios Kehagias, Nikolaos Gouvas, Georgios Kokkinos, Ioanna Pozotou, Panayiotis Papatheodorou, Kyriakos Frantzeskou, Dimitrios Schizas, Athanasios Syllaios, Ifaistion M. Palios, Konstantinos Nastos, Markos Perdikaris, Nikolaos Michalopoulos, Ioannis Margaris, Evangelos Lolis, Georgia Dimopoulou, Dimitrios Panagiotou, Vasiliki Nikolaou, Georgios K. Glantzounis, George Pappas-Gogos, Kostas Tepelenis, Georgios Zacharioudakis, Savvas Tsaramanidis, Ioannis Patsarikas, Georgios Stylianidis, Georgios Giannos, Michael Karanikas, Konstantinia Kofina, Markos Markou, Emmanuel Chrysos
Summary: Patients in Greece undergoing emergency laparotomy have higher post-operative mortality and occurrence of serious complications. Greek patients have similar characteristics and preoperative risks compared to British patients, but they have lower utilization of intensive care units after surgery.
WORLD JOURNAL OF SURGERY
(2023)
Article
Surgery
Shahab Hajibandeh, Shahin Hajibandeh, George A. Antoniou, Stavros A. Antoniou
Summary: The risk of perioperative mortality in octogenarians undergoing emergency general surgical operations is significantly higher, especially in cases of emergency laparotomy, bowel resection, and ASA status above 3.
Article
Surgery
Hogan Wang, Veronica Luu, Eric Jiang, Olivia Kirkland, Shahrir Kabir, Sean S. Davis, Thomas J. Hugh
Summary: This study validates the accuracy of a modified Emergency Surgical Acuity Score (mESAS) in predicting death before discharge and prolonged length of stay (LOS) in Emergency General Surgery (EGS) patients. It is the first to validate the mESAS in a non-operatively managed EGS population internationally and in Australia. The mESAS provides a highly useful tool for surgeons and EGS units worldwide.
ANZ JOURNAL OF SURGERY
(2023)
Article
Multidisciplinary Sciences
Zhao-Ying Zhu, Li-Fang Hao, Li-Chuan Gao, Xiao-Long Li, Jie-Yi Zhao, Tao Zhang, Gui-Jun Zhang, Chao You, Xiao-Yu Wang
Summary: This study aimed to develop a valid and simple prediction nomogram for the survival of elderly patients with hypertensive intracerebral hemorrhage (HICH). The results showed that hematoma volume and Glasgow Coma Scale (GCS) score were significant factors for predicting the survival of HICH patients.
Article
Multidisciplinary Sciences
Yunhe Gao, Hongqing Xi, Fredrik Mattsson, Wenquan Liang, Shao-Hua Xie, Lin Chen, Jesper Lagergren
Summary: Previous studies have shown that the surgical starting time of the day may affect the long-term survival of gastric cancer patients. This cohort study included 2728 patients who underwent curatively intended gastrectomy for gastric cancer in China. The results indicated that starting surgery in the early morning might be associated with better long-term survival, especially for patients who underwent laparoscopic gastrectomy and those with stage II tumors.
SCIENTIFIC REPORTS
(2023)
Article
Geriatrics & Gerontology
Gianluca Costa, Laura Bersigotti, Giulia Massa, Luca Lepre, Pietro Fransvea, Alessio Lucarini, Paolo Mercantini, Genoveffa Balducci, Gabriele Sganga, Antonio Crucitti
Summary: Frailty assessment is crucial in emergency surgery for elderly patients, and the EmSFI index has been developed to accurately stratify surgical risk. The model showed good accuracy in predicting mortality but performed poorly in predicting complications. Further studies are needed to validate its prognostic role in assessing procedure-related morbidity risk.
AGING CLINICAL AND EXPERIMENTAL RESEARCH
(2021)
Article
Surgery
Gianluca Costa, Pietro Fransvea, Caterina Puccioni, Francesco Giovinazzo, Filippo Carannante, Gianfranco Bianco, Alberto Catamero, Gianluca Masciana, Valentina Miacci, Marco Caricato, Gabriella Teresa Capolupo, Gabriele Sganga
Summary: Gastrointestinal emergencies are common in the emergency department, with patients presenting with a variety of symptoms. To improve care, it is important to analyze the outcomes and treatment strategies for gastrointestinal emergency procedures, as well as evaluate the predictive role of risk scores.
FRONTIERS IN SURGERY
(2022)
Article
Surgery
Aubrey Place, Marta McCrum, Teresa Bell, Raminder Nirula
Summary: This study analyzed 1805 LVAD patients in need of EGS surgery and found that LVAD patients over 70 years old with sepsis or intestinal ischemia have a high risk of in-hospital mortality, while younger patients have a lower risk.
AMERICAN JOURNAL OF SURGERY
(2022)
Article
Surgery
Anthony Gebran, Annita Vapsi, Lydia R. Maurer, Mohamad El Moheb, Leon Naar, Sumiran S. Thakur, Robert Sinyard, Dania Daye, George C. Velmahos, Dimitris Bertsimas, Haytham M. A. Kaafarani
Summary: This study developed a preoperative predictor using interpretable artificial intelligence technology to predict the need for postoperative intensive care unit admission in emergency surgery patients. The application showed excellent predictive performance and can assist in triaging patients and reducing failure to rescue.
Article
Surgery
Alexander H. Seeto, Hajir Nabi, Matthew J. Burstow, Raymond P. Lancashire, Joshua Grundy, Christopher Gillespie, Khuong Nguyen, Sanjeev Naidu, Terence C. Chua
Summary: Emergency colorectal resection is associated with a higher overall complication rate compared to elective surgery, but rates of major complications and mortality are similar between the two groups. Independent predictors for postoperative complications include emergency surgery and an ASA Score of III to IV.
ANZ JOURNAL OF SURGERY
(2023)
Article
Surgery
Kat L. Parmar, Jennifer Law, Ben Carter, Jonathan Hewitt, Jemma M. Boyle, Patrick Casey, Ishaan Maitra, Ian S. Farrell, Lyndsay Pearce, Susan J. Moug
Summary: This study on frailty in older adults undergoing emergency laparotomy found that 20% of older adults were frail, which was directly associated with increased risks of postoperative mortality and morbidity. Frailty scoring can aid decision-making and development of novel postoperative strategies.
Article
Health Care Sciences & Services
Jakob F. Mathiszig-Lee, Finneas J. R. Catling, S. Ramani Moonesinghe, Stephen J. Brett
Summary: This study presents a mortality risk model for emergency laparotomy that highlights uncertainty by presenting a distribution of predicted risks. The model showed good discrimination and calibration, consistently outperforming the current gold-standard model. It has the potential to improve mortality risk prediction in emergency laparotomy and assist decision-making and discussions with patients and their families.
NPJ DIGITAL MEDICINE
(2022)
Review
Peripheral Vascular Disease
James E. Sharman, Isabella Tan, George S. Stergiou, Carolina Lombardi, Francesca Saladini, Mark Butlin, Raj Padwal, Kei Asayama, Alberto Avolio, Tammy M. Brady, Alan Murray, Gianfranco Parati
Summary: Automated oscillometric blood pressure measuring devices have replaced manual auscultatory blood pressure measurement by mercury sphygmomanometers in clinical settings. These validated devices provide similar blood pressure values to manual measurement, making them the recommended standard for hypertension diagnosis and management globally.
JOURNAL OF HUMAN HYPERTENSION
(2023)
Review
Peripheral Vascular Disease
Dean S. Picone, Raj Padwal, George S. Stergiou, Jordana B. Cohen, Richard J. McManus, Siegfried Eckert, Kei Asayama, Neil Atkins, Michael Rakotz, Cintia Lombardi, Tammy M. Brady, James E. Sharman
Summary: Clinically validated, automated arm-cuff blood pressure measuring devices are recommended for accurate measurement. However, most devices available for consumers lack proper validation, which increases the risk of misdiagnosis and mismanagement of blood pressure. Validated device lists have been developed to address this issue, but there are still challenges to overcome.
JOURNAL OF HUMAN HYPERTENSION
(2023)
Editorial Material
Oncology
Mehmet Sitki Copur, Soe Min Tun, Luciano Vargas, Shaheed Merani, Whitney Wedel, Randy Duckert, Adam Horn, Nicholas Lintel, Daniel Herold, Swathi Lavudi
CLINICAL COLORECTAL CANCER
(2023)
Review
Peripheral Vascular Disease
Jennifer S. Ringrose, Raj Padwal
Summary: Accurate blood pressure measurement is crucial for hypertension diagnosis and management. Automated cuff blood pressure measuring devices (BPMD) are recommended, but most devices lack clinical validation. Existing clinical validation standards have differences and controversies, highlighting the need for a unified standard. Regulatory oversight is necessary to ensure only clinically validated BPMDs are marketed.
JOURNAL OF HUMAN HYPERTENSION
(2023)
Article
Surgery
Michael T. Meschino, Kelly N. Vogt, Laura Allen, Maisa Saddik, Rahima Nenshi, Rardi Van Heest, Fady Saleh, Sandy Widder, Samuel Minor, Emilie Joos, Neil G. Parry, Patrick B. Murphy, Chad G. Ball, Morad Hameed, Paul T. Engels
Summary: Access to the operating room for emergency general surgery (EGS) services in Canada varies, with some services having dedicated EGS ORs while others have only a shared queue. This study aimed to examine the burden of after-hours EGS operating in Canada and differences associated with OR access. The results showed substantial variation in OR booking priority among EGS patients in Canada, with sites that have dedicated EGS ORs performing more cases during weekday daytime.
CANADIAN JOURNAL OF SURGERY
(2023)
Article
Surgery
Paul T. Engels, Jennie Lee, Timothy R. Rice, Rahima Nenshi, Chad G. Ball, Morad Hameed, Sandy Widder, Samuel Minor, Najma Ahmed, Neil Parry, Kelly Vogt, Emilie Joos, Kristin DeGirolamo, Andy Kirkpatrick, Jacinthe Lampron, Najma Ahmed, Cecily Bos, Joao Rezende Neto, Morgan Schellenberg, Rich Hilsden, Chad Ball, Phil Dawe, Mike Kim, Jag Rao, Laura Allen, David Gomez, Jordan Nantais, Erin Sadler, Jeremy Grushka, Sarah Miller, Karan D'Souza, Nori Bradley, Sarah Mueller, Nicole Koloszsvari, Ashlie Nadler, Ken Leslie, Maggie Gordon, Darrell Boone, Morad Hameed, Lily Tung, Brett Mador, Lawrence Gillman, Rardi Van Heest, Stephanie Mason, Tim Rice, Lily Park, Steve Quigley, Sam Minor, Neil Parry, Matt Strickland, Markus Ziesmann, Derek Roberts, Brad Moffat, Eric Walser, Kosar Khwaja, Mary Wells, Rahima Nenshi, Pat Murphy, Erica Lester, Ken Leslie, Shane Smith, Rob Leeper, Shiva Jayaraman, Evan Wong, Emily Roswell
Summary: Acute care surgery (ACS) has become a specialized area within general surgery that has greatly evolved over the past two decades. Canada has both academic and community models of ACS, which help manage patients in need of emergency general surgery (EGS) care, with or without trauma care. The implementation of ACS has had a significant impact on patient care, surgical education, and workforce, allowing some general surgeons to specialize in excluding EGS care from their practice. This has led to the establishment of dedicated ACS fellowship training programs, marking a milestone in the field of general surgery and contributing to the improvement of patient care, surgical education, and scholarly endeavors.
CANADIAN JOURNAL OF SURGERY
(2023)
Article
Surgery
Daniel J. Cloonan, Madeline R. Cloonan, Scott G. Westphal, Leigh Anne Dageforde, Shaheed Merani
Summary: Patients with acute liver failure (ALF) who have kidney injury (KI) at the time of liver transplantation (LT) are at risk for persistent post-transplant kidney injury, lower survival rate, and increased need for kidney transplantation (KT).
CLINICAL TRANSPLANTATION
(2023)
Review
Peripheral Vascular Disease
James E. Sharman, Pedro Ordunez, Tammy Brady, Gianfranco Parati, George Stergiou, Paul K. Whelton, Raj Padwal, Michael Hecht Olsen, Christian Delles, Aletta E. Schutte, Maciej Tomaszewski, Daniel T. Lackland, Nadia Khan, Richard J. McManus, Ross T. Tsuyuki, Xin-Hua Zhang, Lisa D. Murphy, Andrew E. Moran, Markus P. Schlaich, Norm R. C. Campbell
JOURNAL OF HUMAN HYPERTENSION
(2023)
Review
Peripheral Vascular Disease
Debra McGrath, Margaret Meador, Hilary K. Wall, Raj S. Padwal
Summary: Self-measured blood pressure (SMBP) telemonitoring is an important component of hypertension control strategy. Implementing SMBP involves defining goals, selecting the target population, choosing appropriate BP devices, and ensuring data security. Clinical workflow includes patient training, reviewing telemonitored data, and adjusting medications according to clinical best practices. Adoption of SMBP is expected to increase with familiarity, platform availability, interoperability improvements, and cost reductions.
AMERICAN JOURNAL OF HYPERTENSION
(2023)
Article
Surgery
Shaun Cowan, Patrick Murphy, Michael Kim, Brett Mador, Eddie Chang, Alison Kabaroff, Emerson North, Cheryl Cameron, Kevin Verhoeff, Sandy Widder
Summary: Handover to the trauma team is crucial and effective handover formats with concise, key details are preferred. A single-blind randomized simulation trial compared ad-lib communication to structured handover formats (ISOBAR and IMIST) with positive results. Factors such as confident delivery, a logical format, and uninterrupted handover by a trauma team leader were identified as contributing to higher quality handovers.
CANADIAN JOURNAL OF SURGERY
(2023)
Article
Acoustics
Mariana Alvarado Alvarez, Raj Padwal, Wayne Hiebert
Summary: The measurement of blood pressure using manual auscultation and observation of Korotkoff sounds is currently the most accurate method. This paper proposes a new approach to determine the audibility of Korotkoff sounds based on psychoacoustic masking. By collecting Korotkoff sounds using an electronic stethoscope and comparing sound audibility with electronically recorded sound levels, a threshold for sound audibility can be approximated. This approach could have significant implications for the development of automated auscultation blood pressure measurements.
JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA
(2023)
Meeting Abstract
Surgery
David Reich, Andrea Schlegel, Michael Rizzari, Koji Hashimoto, Sander Florman, Michael De Vera, David Foley, Shennen Mao, William Chapman, Garrett Roll, Antonio Pinna, Ashish Saharia, Shaheed Merani, Humberto Bohorquez, Mohamed Akoad, Shekhar Kubal, Sophoclis Alexopoulos
AMERICAN JOURNAL OF TRANSPLANTATION
(2023)
Meeting Abstract
Peripheral Vascular Disease
Jennifer Ringrose, Patricia Araneta, Lillian Chan, Jalisa Kassam, Mira Wirzba, Kate Greef, Gillian Ramsay, Winnie Sia, Rshmi Khurana, Erin Bader, Sangita Sridar, Raj Padwal
JOURNAL OF HYPERTENSION
(2023)
Meeting Abstract
Peripheral Vascular Disease
Dean S. Picone, Tan Bui, Niamh Chapman, Martin G. Schultz, Christian Delles, Michael Hecht Olsen, Aletta E. Schutte, George Stergiou, Raj Padwal, Paul K. Whelton, James E. Sharman
JOURNAL OF HYPERTENSION
(2023)
Article
Pediatrics
Kelsey Klein, Megan Keck, Eric Langewisch, Shaheed Merani, Kelley Hitchman, Mary Leick
Summary: This study aimed to assess the appearance, clearance, specificity, and impact of anti-HLA donor-specific antibodies (DSA) in intestinal/multivisceral (MV) transplant and the value of serial monitoring. The results showed that DSA may lead to increased biopsy-proven acute rejection (BPAR) or shorter time to BPAR, although the differences were not statistically significant. DSA were usually identified within the first month after transplant and could serve as early rejection biomarkers. The study also identified a wide range of HLA alleles targeted by DSA in intestinal/MV patients.
PEDIATRIC TRANSPLANTATION
(2023)