Perioperative Medicine最新文献

{"title":"Intraoperative magnesium sulfate is not associated with improved pain control after urologic procedures.","authors":"Daniel Salevitz, Kathleen Olson, Molly Klanderman, Lanyu Mi, Mark Tyson, Mitchell Humphreys, Lopa Misra","doi":"10.1186/s13741-024-00448-x","DOIUrl":"10.1186/s13741-024-00448-x","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate effects of intraoperative magnesium sulfate infusion on pain control and analgesic use in the postanesthesia care unit (PACU).</p><p><strong>Methods: </strong>This is a retrospective review of patients undergoing robot-assisted radical prostatectomy (RARP) and endoscopic procedures of the bladder, prostate, and urethra from 2/2021 to 12/2021. Patients receiving Mg infusion (Mg group) received an intravenous 2-g bolus of Mg at anesthesia induction, followed by infusion of 1 g/h until procedure end. Outcomes were compared with patients who underwent similar procedures during this timeframe without Mg (Control). Endpoints were use of anticholinergic (AC) and belladonna and opium suppositories (BO), maximum pain score, and morphine milligram equivalents (MME) in PACU.</p><p><strong>Results: </strong>There were 182 patients, with 89 (48.9%) patients in the Mg group and 93 (51.1%) in the Control. Significantly, fewer patients in the Mg group were given AC/BO in PACU (9.0% vs. 21.7%, p = 0.02), with odds of using AC/BO which was 0.36 (95% CI 0.14, 0.83). No differences were found in pain score (p = 0.62) or MME administration (p = 0.94). In subgroup univariate analysis, only those who underwent bladder procedures had a significant difference in use of AC/BO (9.5% vs. 30.2%; p = 0.02). Across all surgeries, Mg infusion was associated with decreased use of AC/BO in the PACU (OR 0.34, p = 0.02); however, stratifying by procedure type did not find a difference in AC/BO use postoperatively.</p><p><strong>Conclusion: </strong>Intravenous infusion of magnesium was found to decrease use of AC/BO in the PACU; however, this significance was lost after multivariable analysis stratifying by procedure type.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"13 1","pages":"91"},"PeriodicalIF":2.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11380422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased age and the volume of intraoperative fluid administered predict urinary retention after elective inguinal herniorrhaphy.","authors":"Jin-Ming Wu, Chi-Chuan Yeh, Nathan Wei, Hsing-Hua Tsai, Shang-Ming Tseng, Kuang-Cheng Chan, Kuo-Hsin Chen","doi":"10.1186/s13741-024-00446-z","DOIUrl":"10.1186/s13741-024-00446-z","url":null,"abstract":"<p><strong>Background: </strong>Inguinal hernia repair (IHR) is a common surgical procedure worldwide. Although IHR can be performed by the minimally invasive method, which accelerates recovery, postoperative urinary retention (POUR) remains a common complication that significantly impacts patients. Thus, it is essential to identify the risk factors associated with POUR to diminish its negative impact.</p><p><strong>Methods: </strong>We conducted a single-center retrospective review of elective IHR from 2018 to 2021. POUR was defined as the postoperative use of straight catheter or placement of an indwelling catheter to relieve the symptoms. Adjusted multivariate regression analysis was performed to address the associations of clinicodemographic, surgical, and intraoperative factors with POUR.</p><p><strong>Results: </strong>A total of 946 subjects were included in the analysis after excluding cases of emergent surgery, recurrent hernia, or concomitant operations. The median age was 68.4 years, and 92.0% of the patients were male. Twenty-three (2.4%) patients developed POUR. In univariate analysis, POUR in comparison with non-POUR was significantly associated with increased age (72.2 versus 68.3 years, P = 0.012), a greater volume of intraoperative fluid administered (500 versus 400 ml, P = 0.040), and the diagnosis with benign prostate hypertrophy (34.8% versus 16.9%, P = 0.025). In the multivariate model, both increased age (odds ratio [OR] 1.04, 95% CI 1.01-1.08; P = 0.049) and a greater volume of intraoperative fluid administered (OR 1.12 per 100-mL increase, 95% CI 1.01-1.27; P = 0.047) were significantly associated with the occurrence of POUR.</p><p><strong>Conclusions: </strong>We found that increased age and a greater volume of intraoperative fluid administered were significantly associated with the occurrence of POUR. Limiting the administration of intraoperative fluid may prevent POUR. From the perspective of practical implications, specific guidelines or clinical pathways should be implemented for fluid management and patient assessment.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"13 1","pages":"90"},"PeriodicalIF":2.0,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11331662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142004965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of classical and patient-preferred music on anxiety and recovery after ınguinal hernia repair: a prospective randomized controlled study.","authors":"Fatma Kavak Akelma, Savaş Altınsoy, Burak Nalbant, Derya Özkan, Jülide Ergil","doi":"10.1186/s13741-024-00434-3","DOIUrl":"10.1186/s13741-024-00434-3","url":null,"abstract":"<p><strong>Background: </strong>We aimed to evaluate the effects of preoperative listening to patient-preferred music and classical music on postoperative anxiety and recovery.</p><p><strong>Methods: </strong>A prospective, randomized controlled, single-blind study included 255 patients who were scheduled for elective inguinal hernia operation under general anesthesia. Spielberger state State-Trait Anxiety Inventory form 1,2 (STAI-I, STAI-II), Quality of Recovery Score-40 (QoR-40) were applied in the preoperatively. In the preoperative period, the preferential music group (group P) patients listened to their favorite music, while patients in the classical music group (group C) listened to classical music, music was not played in the control group (group N). STAI-I, QoR-40 questionnaire, pain status, and patient satisfaction in the postoperative period were recorded by a blinded investigator.</p><p><strong>Results: </strong>A total of 217 patients participated in the study analysis. Postoperative STAI-1 score was lower in group P than in group N (p = 0.025) and was similar among other groups. The postoperative QoR-40 score was significantly higher in group P than in group N (p = 0.003), and it was similar between the other groups. While SBP, DBP and HR premusic and post-music changes were significant, there was no difference in other groups. There was no difference between the groups in the NRS score. The patient satisfaction score was significantly higher in group P.</p><p><strong>Conclusions: </strong>Preoperative patient-preferred music application reduces postoperative anxiety and improves recovery quality compared to classical music. In addition, regulation of hemodynamic data and patient satisfaction increase in a preferential music application, but pain scores do not change.</p><p><strong>Trial registration: </strong>NCT04277559| https://www.</p><p><strong>Clinicaltrials: </strong>gov/.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"13 1","pages":"89"},"PeriodicalIF":2.0,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11325758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141982952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unplanned hospital admissions within 24 h after 53,185 surgical procedures at a U.S. ambulatory surgery center.","authors":"Syed Shah, Faiza Qureshi, Samuel Stanley, Elliott Bennett-Guerrero","doi":"10.1186/s13741-024-00447-y","DOIUrl":"10.1186/s13741-024-00447-y","url":null,"abstract":"<p><strong>Background: </strong>Unplanned admission after surgery at an ambulatory surgery center (ASC) is an established measure of the quality of care and can affect the patient's experience. Previous studies on this topic are generally dated, focused on a single specialty, or studied 30-day admissions after ambulatory surgery. Few studies have reported admission within 24 h after surgery at an ASC which is a different but important measure of the quality of anesthetic and surgical care. Understanding admissions within 24 h of surgery can identify opportunities for improvement immediately after surgery. Therefore, our study was designed to assess the incidence and risk factors for unplanned hospital admissions within 24 h after surgery performed at a hospital ASC.</p><p><strong>Methods: </strong>After Institutional Review Board approval, a retrospective analysis was performed on all adult patients who underwent surgery at a US ASC between January 1, 2016, and December 31, 2022. Data were obtained from the hospital's electronic medical record. The study sample was divided into two groups: those with an unplanned hospital admission within 24 h after surgery and those without an unplanned hospital admission. To evaluate risk factors for unplanned hospital admissions, univariate analyses with p value < 0.05 were utilized to identify significant patient variables related to hospital admissions. These variables were further adjusted using a multivariable Firth logistic regression. Descriptive statistics were used to explore the number of patients in different variable categories.</p><p><strong>Results: </strong>Overall, 53,185 cases were identified for the 7-year period. The incidence of unplanned hospital admission over this period was 0.09% (95% CI 0.07-0.1122%; ranging from 0.05 to 0.12% per year. In the multivariable model, surgery duration (OR 1.010, 95% CI 1.007-1.012, p value < 0.0001), peripheral vascular disease (OR 14.489, 95% CI 4.862-43.174, p value < 0.0001), and deep venous thrombosis (OR 5.527, 95% CI 1.909-16.001, p value = 0.0016) were significantly associated with unplanned hospital admission.</p><p><strong>Conclusion: </strong>The overall incidence of unplanned hospital admission after surgery at a large tertiary care ambulatory surgery center is very low. This admission rate can also serve as a reference point for future studies and quality improvement initiatives.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"13 1","pages":"88"},"PeriodicalIF":2.0,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11323584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotic prophylaxis in emergency cholecystectomy for mild to moderate acute cholecystitis: a systematic review and meta-analysis of randomized controlled trials.","authors":"Mohamed Hamouda Elkasaby, Hesham Elsayed, Dilawer Chofan Charo, Mohamed Abdalla Rashed, Omar Elkoumi, Islam Mohsen Elhaddad, Ahmed Gadallah, Alaa Ramadan","doi":"10.1186/s13741-024-00441-4","DOIUrl":"10.1186/s13741-024-00441-4","url":null,"abstract":"<p><strong>Background: </strong>Emergency cholecystectomy is the mainstay in treating acute cholecystitis (AC). In actual practice, perioperative prophylactic antibiotics are used to prevent postoperative infectious complications (PIC), but their effectiveness lacks evidence. We aim to investigate the efficacy of prophylactic antibiotics in emergency cholecystectomy.</p><p><strong>Methods: </strong>We searched PubMed, Embase, Cochrane CENTRAL, Web of Science (WOS), and Scopus up to June 14, 2023. We included randomized controlled trials (RCTs) that involved patients diagnosed with mild to moderate AC according to Tokyo guidelines who were undergoing emergency cholecystectomy and were administered preoperative and/or postoperative antibiotics as an intervention group and compared to a placebo group. For dichotomous data, we applied the risk ratio (RR) and the 95% confidence interval (CI), while for continuous data, we used the mean difference (MD) and 95% CI.</p><p><strong>Results: </strong>We included seven RCTs encompassing a collective sample size of 1747 patients. Our analysis showed no significant differences regarding total PIC (RR = 0.84 with 95% CI (0.63, 1.12), P = 0.23), surgical site infection (RR = 0.79 with 95% CI (0.56, 1.12), P = 0.19), distant infections (RR = 1.01 with 95% CI (0.55, 1.88), P = 0.97), non-infectious complications (RR = 0.84 with 95% CI (0.64, 1.11), P = 0.22), mortality (RR = 0.34 with 95% CI (0.04, 3.23), P = 0.35), and readmission (RR = 0.69 with 95% CI (0.43, 1.11), P = 0.13).</p><p><strong>Conclusion: </strong>Perioperative antibiotics in patients with mild to moderate acute cholecystitis did not show a significant reduction of postoperative infectious complications after emergency cholecystectomy. (PROSPERO registration number: CRD42023438755).</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"13 1","pages":"87"},"PeriodicalIF":2.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11312388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141913614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A scoping review of Enhanced Recovery After Surgery (ERAS), protocol implementation, and its impact on surgical outcomes and healthcare systems in Africa.","authors":"Fitsum Kifle, Peniel Kenna, Selam Daniel, Salome Maswime, Bruce Biccard","doi":"10.1186/s13741-024-00435-2","DOIUrl":"10.1186/s13741-024-00435-2","url":null,"abstract":"<p><strong>Background: </strong>Enhanced Recovery After Surgery (ERAS) is a patient-centered approach to surgery designed to reduce stress responses and facilitate faster recovery. ERAS protocols have been widely adopted in high-income countries, supported by robust research demonstrating improved patient outcomes. However, in Africa, there is limited evidence regarding its implementation. This review aims to identify the existing literature on the implementation of ERAS principles in Africa, the reported clinical outcomes, and the challenges and recommendations for successful implementation.</p><p><strong>Methods: </strong>We conducted a librarian-assisted literature search of electronic research databases between October and November 2023. Titles and abstracts were screened for eligibility, and duplicates were then removed, followed by full-text assessment of potentially eligible studies. We utilized the summative content analysis method to synthesize and group the data into fewer categories based on agreed-upon criteria. Descriptive statistics were used to describe the results.</p><p><strong>Results: </strong>The search identified 342 potential studies resulting in 15 eligible studies for inclusion in the review. The publication years ranged from 2016 to 2023. The studies originated from three countries: Egypt (n = 10), South Africa (n = 4), and Uganda (n = 1). Successful implementation was associated with reduced hospital length of stay (n = 12), lower mortality rates (n = 3), and improved pain outcomes (n = 7). Challenges included protocol adherence (n = 5) and limitations of the research design to generate strong evidence (n = 3). Recommendations included formal adoption of ERAS principles (n = 5), the need for sustained research commitment, and exploration of the applicability of ERAS in diverse surgical contexts (n = 8). Large-scale implementation beyond individual institutions was encouraged to further validate its impact on patient outcomes and healthcare costs (n = 1).</p><p><strong>Conclusions: </strong>Despite the limited number of studies on ERAS implementation in Africa, the available evidence suggests that it reduces the length of hospital stays and mortality rates. This is crucial for the region, given its higher mortality rates, necessitating more collaborative, methodically well-designed studies to establish stronger evidence for ERAS in lower-resource environments.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"13 1","pages":"86"},"PeriodicalIF":2.0,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11297632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Optimization of kidney function in cardiac surgery patients with intra-abdominal hypertension: expert opinion.","authors":"Vanessa Moll, Ashish K Khanna, Andrea Kurz, Jiapeng Huang, Marije Smit, Madhav Swaminathan, Steven Minear, K Gage Parr, Amit Prabhakar, Manxu Zhao, Manu L N G Malbrain","doi":"10.1186/s13741-024-00444-1","DOIUrl":"10.1186/s13741-024-00444-1","url":null,"abstract":"","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"13 1","pages":"85"},"PeriodicalIF":2.0,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11285340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141793002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experience sharing on perioperative clinical management of gastric cancer patients based on the \"China Robotic Gastric Cancer Surgery Guidelines\".","authors":"Shixun Ma, Wei Fang, Leisheng Zhang, Dongdong Chen, Hongwei Tian, Yuntao Ma, Hui Cai","doi":"10.1186/s13741-024-00402-x","DOIUrl":"10.1186/s13741-024-00402-x","url":null,"abstract":"<p><strong>Background: </strong>With the popularization of robotic surgical systems in the field of surgery, robotic gastric cancer surgery has also been fully applied and promoted in China. The Chinese Guidelines for Robotic Gastric Cancer Surgery was published in the Chinese Journal of General Surgery in August 2021.</p><p><strong>Methods: </strong>We have made a detailed interpretation of the process of robotic gastric cancer surgery regarding the indications, contraindications, perioperative preparation, surgical steps, complication, and postoperative management based on the recommendations of China's Guidelines for Robotic Gastric Cancer Surgery and supplemented by other surgical guidelines, consensus, and single-center experience.</p><p><strong>Results: </strong>Twenty experiences of perioperative clinical management of robotic gastric cancer surgery were described in detail.</p><p><strong>Conclusion: </strong>We hope to bring some clinical reference values to the front-line clinicians in treating robotic gastric cancer surgery.</p><p><strong>Trial registration: </strong>The guidelines were registered on the International Practice Guideline Registration Platform ( http://www.guidelines-registry.cn ) (registration number: IPGRP-2020CN199).</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"13 1","pages":"84"},"PeriodicalIF":2.0,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11271040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141760247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring biomarkers for diagnosing and predicting organ dysfunction in patients with perioperative sepsis: a preliminary investigation.","authors":"Linghui Jiang, Shiyu Chen, Shichao Li, Jiaxing Wang, Wannan Chen, Yuncen Shi, Wanxia Xiong, Changhong Miao","doi":"10.1186/s13741-024-00438-z","DOIUrl":"10.1186/s13741-024-00438-z","url":null,"abstract":"<p><strong>Objective: </strong>Early diagnosis and prediction of organ dysfunction are critical for intervening and improving the outcomes of septic patients. The study aimed to find novel diagnostic and predictive biomarkers of organ dysfunction for perioperative septic patients.</p><p><strong>Method: </strong>This is a prospective, controlled, preliminary, and single-center study of emergency surgery patients. Mass spectrometry, Gene Ontology (GO) functional analysis, and the protein-protein interaction (PPI) network were performed to identify the differentially expressed proteins (DEPs) from sepsis patients, which were selected for further verification via enzyme-linked immunosorbent assay (ELISA). Logistic regression analysis was used to estimate the relative correlation of selected serum protein levels and clinical outcomes of septic patients. Calibration curves were plotted to assess the calibration of the models.</p><p><strong>Results: </strong>Five randomized serum samples per group were analyzed via mass spectrometry, and 146 DEPs were identified. GO functional analysis and the PPI network were performed to evaluate the molecular mechanisms of the DEPs. Six DEPs were selected for further verification via ELISA. Cathepsin B (CatB), vascular cell adhesion protein 1 (VCAM-1), neutrophil gelatinase-associated lipocalin (NGAL), protein S100-A9, prosaposin, and thrombospondin-1 levels were significantly increased in the patients with sepsis compared with those of the controls (p < 0.001). Logistic regression analysis showed that CatB, S100-A9, VCAM-1, prosaposin, and NGAL could be used for preoperative diagnosis and postoperative prediction of organ dysfunction. CatB and S100-A9 were possible predictive factors for preoperative diagnosis of renal failure in septic patients. Internal validation was assessed using the bootstrapping validation. The preoperative diagnosis of renal failure model displayed good discrimination with a C-index of 0.898 (95% confidence interval 0.843-0.954) and good calibration.</p><p><strong>Conclusion: </strong>Serum CatB, S100-A9, VCAM-1, prosaposin, and NGAL may be novel markers for preoperative diagnosis and postoperative prediction of organ dysfunction. Specifically, S100-A9 and CatB were indicators of preoperative renal dysfunction in septic patients. Combining these two biomarkers may improve the accuracy of predicting preoperative septic renal dysfunction.</p><p><strong>Trial registration: </strong>The study was registered at the Chinese Clinical Trials Registry (ChiCTR2200060418) on June 1, 2022.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"13 1","pages":"81"},"PeriodicalIF":2.0,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11267738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141760248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between preoperative serum cholinesterase and all-cause mortality in geriatric patients with hip fractures: a cohort study of 2387 patients.","authors":"Yan-Ning Zhang, Peng Xiao, Bin-Fei Zhang","doi":"10.1186/s13741-024-00443-2","DOIUrl":"10.1186/s13741-024-00443-2","url":null,"abstract":"<p><strong>Objective: </strong>This study is to evaluate the association between preoperative cholinesterase levels and all-cause mortality in geriatric hip fractures.</p><p><strong>Methods: </strong>Elderly patients with hip fractures were screened between Jan 2015 and Sep 2019. Demographic and clinical characteristics of patients were collected. Linear and nonlinear multivariate Cox regression models were used to identify the association between preoperative cholinesterase levels and mortality in these patients. Analyses were performed using EmpowerStats and the R software.</p><p><strong>Results: </strong>Two thousand three hundred eighty-seven patients were included in this study. The mean follow-up period was 37.64 months. Seven hundred eighty-seven (33.0%) patients died due to all-cause mortality. Preoperative cholinesterase levels were 5910 ± 1700 U/L. Linear multivariate Cox regression models showed that preoperative cholinesterase level was associated with mortality (HR = 0.83, 95% CI: 0.78-0.88), P < 0.0001) for every 1000 U/L. However, the linear association was unstable, and nonlinearity was identified. A cholinesterase concentration of 5940 U/L was an inflection point. When preoperative cholinesterase level < 5940 U/L, the mortality decreased by 28% for every 1000 U/L increase in cholinesterase (HR = 0.72, 95%CI: 0.66-0.79, P < 0.0001). When cholinesterase was > 5940 U/L, the mortality was no longer decreased with the rise of cholinesterase (HR = 1.01, 95%CI: 0.91-1.11, P = 0.9157). We found the nonlinear association was very stable in the propensity score-matching sensitive analysis.</p><p><strong>Conclusions: </strong>Preoperative cholinesterase levels were nonlinearly associated with mortality in elderly hip fractures, and cholinesterase was a risk indicator of all-cause mortality.</p><p><strong>Trial registration: </strong>This study is registered on the website of the Chinese Clinical Trial Registry (ChiCTR: ChiCTR2200057323) (08/03/2022).</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"13 1","pages":"82"},"PeriodicalIF":2.0,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11267686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141760249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}