Perioperative Medicine最新文献

{"title":"The effect of continuous positive airway pressure (CPAP) application on airway problems in pediatric patients with subglottic stenosis who undergo balloon dilatation.","authors":"Zeliha Tuncel, Şenay Göksu, Özlem Deligöz, Kemal Tolga Saracoglu, Abdulatif Albasha, Bushra M Abdallah, Ayten Saracoglu","doi":"10.1186/s13741-024-00478-5","DOIUrl":"10.1186/s13741-024-00478-5","url":null,"abstract":"<p><strong>Background: </strong>Subglottic stenosis is a significant clinical challenge in pediatric anesthesia, often necessitating interventions that can lead to various postoperative complications. The aim of this study was to determine the effect of prophylactic continuous positive airway pressure (CPAP) application on recovery time and airway complications in pediatric patients with subglottic stenosis undergoing balloon dilatation.</p><p><strong>Methods: </strong>A prospective, double-blinded, parallel-group, randomized controlled study was conducted at Health Sciences University Ümraniye Training and Research Hospital on pediatric patients with subglottic stenosis, aged from 0 to 12 years and who underwent elective balloon dilatation under general anesthesia. Patients were randomized in a 1:1 ratio into the CPAP or non-CPAP group. The primary outcome was the duration of recovery time. Secondary outcomes included bronchospasm, the number of desaturation episodes, intubation, tracheostomy, and the need for intensive care.</p><p><strong>Results: </strong>A total of 84 patients were enrolled in this randomized controlled trial, 81 of which received the allocated treatment and were analyzed (non-CPAP n = 41, CPAP n = 40). Compared to controls, the proportions of bronchospasm, tracheal secretion, need for intensive care, and tracheostomy were consistently lower in the CPAP group, whereas the requirement of intubation was higher. Further, the mean recovery time was significantly shorter in the CPAP group compared to the non-CPAP group (mean difference - 3.3 min, 95%CI - 5.16 to - 1.44, p = 0.0007). Despite lacking statistical significance, the CPAP group had reduced odds of developing bronchospasm, tracheal secretion, need for intensive care, and tracheostomy, but higher odds of requiring intubation when compared to the controls.</p><p><strong>Conclusion: </strong>Prophylactic CPAP application following therapeutic balloon dilatation in pediatric patients who have developed subglottic stenosis due to acquired or congenital causes appears to effectively shorten recovery time and may have a role in decreasing postoperative pulmonary complications; however, more research is recommended to further confirm these findings.</p><p><strong>Trial registration: </strong>The protocol for this clinical trial was retrospectively registered on clinicaltrials.gov with registration ID NCT06183515 on 30 November 2023.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"14 1","pages":"10"},"PeriodicalIF":2.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11756109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024269","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":"Analgesic efficacy and safety of methylene blue combined with cocktail for periarticular infiltration following total knee arthroplasty: a prospective, randomized, controlled study.","authors":"Yijiang Deng, Yong Yang, Feng Zhu, Wenzhi Liu, Jiarui Chen, Guangmin Xu","doi":"10.1186/s13741-025-00493-0","DOIUrl":"10.1186/s13741-025-00493-0","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to explore the analgesic effects and safety of periarticular injections of methylene blue (MB) combined with a cocktail formulation following total knee arthroplasty (TKA).</p><p><strong>Methods: </strong>A total of 70 patients undergoing total knee arthroplasty were selected and divided into two groups based on the cocktail formula used for periarticular infiltration, including the methylene blue group (M group, n = 35) and the control group (C group, n = 35). Both groups underwent spinal anesthesia. At the end of the surgery, the M group received a 0.05% methylene blue combined cocktail for periarticular infiltration block, while the C group received a conventional cocktail infiltration block. Postoperatively, both groups used intravenous patient-controlled analgesia. Then, the rest and movement Numeric Rating Scale (NRS) scores, postoperative sufentanil consumption, postoperative inflammatory markers, and the occurrence of adverse reactions such as wound infection and poor wound healing were compared after postoperative 24 h, 48 h, 72 h, and 7-day, 14-day, 28-day between the two groups.</p><p><strong>Results: </strong>The rest and during movement, NRS scores at postoperative 24 h, 48 h, 72 h, 7-day, 14-day, and 28-day were significantly lower in the C group compared with the M group (P < 0.05). The total sufentanil consumption at postoperative 72 h was less in the M group (98.9 ± 11.3 µg) compared to the C group (129.1 ± 12.3 µg) (P < 0.01). It also showed a lower IL-6 in the M group at postoperative 24 h and 72 h (P < 0.05). However, there were no significant differences in CRP levels between the two groups at 24 h and 72 h post-surgery (P > 0.05), and neither group experienced complications such as wound infection or poor wound healing.</p><p><strong>Conclusion: </strong>Methylene blue combined with a cocktail can be safely used for local infiltration after knee arthroplasty, which reduces postoperative opioid consumption and suppresses the release of inflammatory factors. Moreover, it synergistically enhanced the local anesthetic analgesia and provided sustained pain relief for at least 4 weeks.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"14 1","pages":"9"},"PeriodicalIF":2.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008145","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":"Surgical fear and sleep quality effect the postoperative quality of recovery in patients undergoing brain tumor surgery: cross sectional study.","authors":"Özge Çimen, Yeliz Sürme","doi":"10.1186/s13741-025-00491-2","DOIUrl":"10.1186/s13741-025-00491-2","url":null,"abstract":"<p><strong>Background: </strong>Patients with a brain tumor experience high levels of anxiety because of the fear of remaining functional and neuropsychological sequelae. This situation affects the postoperative quality of recovery. This study was conducted to determine the effect of surgical fear and sleep quality on the postoperative quality of recovery and pain.</p><p><strong>Method: </strong>This cross-sectional study was completed with 101 patients who met the inclusion criteria and underwent craniotomy under general anesthesia for a brain tumor between October 2020 and August 2021 in a university hospital. The data were collected using the Patient Information Form, Surgical Fear Scale, Richard Champell Sleep Scale, Quality of Recovery Questionnaire, and Patient Follow-up Form. Hierarchical regression analysis was used to reveal the determinants of postoperative quality of recovery.</p><p><strong>Results: </strong>The mean fear of surgery score of women was higher than men, and sleep quality and postoperative quality of recovery were lower than men (p = 0.045). A moderate negative correlation between fear of surgery and sleep quality was found (r = -0.377; p = 0.000). There was a weak negative correlation between fear of surgery and postoperative recovery quality (r = -0.252; p = 0.011), and a weak positive correlation between preoperative sleep quality and recovery quality (r = 0.297; p = 0.003). The variables of fear, sleep, duration of hospital stay, pain, and age were found to be statistically the best predictors of postoperative quality of recovery (R2 = 0.295; p = 0.000).</p><p><strong>Conclusion: </strong>As a result, surgical fear, sleep deprivation, and pain during the perioperative period negatively impact recovery quality and prolong the healing process. Psychological preparation by starting from the pre-operative period, providing sleep and rest, evaluation, and management of postoperative pain would contribute to the early recovery and discharge of patients.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"14 1","pages":"8"},"PeriodicalIF":2.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008824","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 challenges of evidence-based prehabilitation in a real-life context for patients preparing for colorectal surgery-a cohort study and multiple case analysis.","authors":"A D Talen, N L U van Meeteren, J A Barten, I Pereboom, W P Krijnen, H Jager-Wittenaar, B C Bongers, G van der Sluis","doi":"10.1186/s13741-024-00481-w","DOIUrl":"10.1186/s13741-024-00481-w","url":null,"abstract":"<p><strong>Background: </strong>Multimodal prehabilitation programs are effective at reducing complications after colorectal surgery in patients with a high risk of postoperative complications due to low aerobic capacity and/or malnutrition. However, high implementation fidelity is needed to achieve these effects in real-life practice. This study aimed to investigate the implementation fidelity of an evidence-based prehabilitation program in the real-life context of a Dutch regional hospital.</p><p><strong>Methods: </strong>In this observational cohort study with multiple case analyses, all patients who underwent colorectal surgery from January 2023 to June 2023 were enrolled. Patients meeting the criteria for low aerobic capacity or malnutrition were advised to participate in a prehabilitation program. According to recent scientific insights and the local care context, this program consisted of four exercise modalities and three nutrition modalities. Implementation fidelity was investigated by evaluating: (1) coverage (participation rate), (2) duration (number of days between the start of prehabilitation and surgery), (3) content (delivery of prescribed intervention modalities), and (4) frequency (attendance of sessions and compliance with prescribed parameters). An aggregated percentage of content and frequency was calculated to determine overall adherence.</p><p><strong>Results: </strong>Fifty-eight patients intended to follow the prehabilitation care pathway, of which 41 performed a preoperative risk assessment (coverage 80%). Ten patients (24%) were identified as high-risk and participated in the prehabilitation program (duration of 33-84 days). Adherence was high (84-100%) in five and moderate (72-73%) in two patients. Adherence was remarkably low (25%, 53%, 54%) in three patients who struggled to execute the prehabilitation program due to multiple physical and cognitive impairments.</p><p><strong>Conclusion: </strong>Implementation fidelity of an evidence-based multimodal prehabilitation program for high-risk patients preparing for colorectal surgery in real-life practice was moderate because adherence was high for most patients, but low for some patients. Patients with low adherence had multiple impairments, with consequences for their preparation for surgery. For healthcare professionals, it is recommended to pay attention to high-risk patients with multiple impairments and further personalize the prehabilitation program. More knowledge about identifying and treating high-risk patients is needed to provide evidence-based recommendations and to obtain higher effectiveness.</p><p><strong>Trial registration: </strong>NCT06438484.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"14 1","pages":"7"},"PeriodicalIF":2.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11742220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008940","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":"Preoperative risk assessment and optimization integrating surgical and anesthetic principles and practices: a national survey for internists.","authors":"Marc-Antoine Lepage, Annie Lecavalier, Gabriele Baldini, Ning-Zi Sun, Amal Bessissow","doi":"10.1186/s13741-024-00489-2","DOIUrl":"10.1186/s13741-024-00489-2","url":null,"abstract":"<p><strong>Background: </strong>The integration of procedure-specific risks into preoperative patient assessment and optimization are crucial aspects of perioperative care. However, data on internists' knowledge of surgical and anesthetic principles and practices are limited. We thus sought to identify internists' knowledge gaps in terms of surgical- and anesthetic-specific risk factors and characteristics.</p><p><strong>Methods: </strong>An open and voluntary e-survey was conducted via LimeSurvey between April and July 2021 to evaluate Canadian internists' knowledge of surgical and anesthetic principles and practices. The survey included the perceived importance and knowledge of several key surgical and anesthetic aspects, such as surgery duration, procedure-specific cardiac risk, bleeding risk, and thrombotic risk. It also assessed pre- and post-survey self-reported confidence levels in one's knowledge of these characteristics. Finally, we investigated how internists optimize some of the preoperative risks.</p><p><strong>Results: </strong>A total of 173 Canadian internists opened the survey link, and 121 completed it (completion rate 70%). While the majority of respondents considered surgical and anesthetic principles and practices as important, most identified knowledge gaps. Participants generally estimated surgery duration and procedure-specific cardiac risk adequately. However, they tended to underestimate procedure-specific bleeding risk for general (58%) and orthopedic (76%) surgeries and to overestimate procedure-specific thrombotic risk for vascular (63%) and genitourinary (60%) surgeries. Furthermore, there is a lack of consensus regarding the appropriate hemoglobin A1c target and 0% of respondents reported using the guideline-suggested hemoglobin threshold for investigation and intervention.</p><p><strong>Conclusions: </strong>Overall, our findings identify significant knowledge gaps among Canadian internists in preoperative assessment of procedure-specific risk factors and can be used to inform both the development of educational initiatives and future research to improve the quality of preoperative patient care.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"14 1","pages":"6"},"PeriodicalIF":2.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11727565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979458","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":"Characterization of trends in preoperative hemoglobin A1c testing prior to metabolic and bariatric surgery: a retrospective, observational study.","authors":"Safraz A Hamid, Elena Graetz, Emily J Zolfaghari, Kurt S Schultz, Eric B Schneider, Karen E Gibbs","doi":"10.1186/s13741-024-00483-8","DOIUrl":"10.1186/s13741-024-00483-8","url":null,"abstract":"<p><strong>Background: </strong>Irrespective of baseline diabetes status, preoperative hemoglobin A1c (A1C) influences perioperative care in patients undergoing metabolic and bariatric surgery (MBS). Accordingly, the American Society of Metabolic and Bariatric Surgery (ASMBS) endorses that patients undergoing MBS should receive a preoperative A1C test. We aimed to assess the proportion of MBS patients who received a preoperative A1C test and determine whether baseline diabetes status influences receipt of a test.</p><p><strong>Methods: </strong>We queried the 2017 to 2022 MBSAQIP database for patients undergoing open, laparoscopic, or robotic Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy. Using descriptive methods, we compared the clinical and demographic characteristics of patients who received a preoperative A1C test with patients who did not. We performed logistic regression analysis using diabetes status as a predictor variable and receipt of a test as the outcome, covarying for sociodemographic and clinical factors.</p><p><strong>Results: </strong>We identified 996,217 patients who underwent RYGB or sleeve gastrectomy between 2017 to 2022. The average age of the cohort was 43.8 years (SD = 11.9) and 81.0% were female. Overall, 45.7% received a preoperative A1C test. The proportion who was tested increased over the six-year study period, from 35.5% in 2017 to 56.0% in 2022. Compared to those who were not tested, patients who were tested were more likely to have several cardiopulmonary comorbidities, including COPD (1.4% vs 1.2%, p < 0.001), PE (1.4% vs 1.2%, p < 0.001), sleep apnea (39.3 vs. 36.4%, p < 0.001), HTN (47.1% vs 44.0%, p < 0.001), and MI (1.2% vs. 1.0%, p < 0.001), though the differences in proportions were small and may not be clinically significant. Compared to patients who did not have diabetes or had diabetes controlled by diet alone, patients with non-insulin dependent diabetes had 77% increased odds of receiving a A1C test (adjusted OR (aOR) 1.77, p < 0.001); insulin dependent patients had 113% increased odds (aOR 2.13, p < 0.001).</p><p><strong>Conclusion: </strong>Despite society recommendations endorsing measurement of preoperative A1C prior to MBS, less than half of patients undergoing MBS between 2017 and 2022 received a preoperative A1C test. Additionally, there were differential patterns in testing based on diabetes status. Preoperative glycemic evaluation is an area for continued quality improvement.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"14 1","pages":"3"},"PeriodicalIF":2.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11720298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952823","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":"Retrospective analysis of the occurrence, potential risk factors and medical significance of pulmonary complications after total shoulder arthroplasty from the National Inpatient Sample database (2010-2019).","authors":"Mengning Dong, Huitong Liang, Jinlang Fu, Zeying Guo, Hao Xie, Qinfeng Yang, Qingmei Yu, Xiaomin Hou","doi":"10.1186/s13741-024-00490-9","DOIUrl":"10.1186/s13741-024-00490-9","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;In USA, total shoulder arthroplasty (TSA) ranks amongst the top five surgeries that require hospitalization. As a result, the healthcare system in USA could face a considerable financial strain due to the emergence of subsequent pulmonary problems. This study aimed to conduct a thorough examination of the prevalence, influential factors and medical importance of pulmonary complications, with emphasis on pneumonia, respiratory failure and pulmonary embolism (PE) following total shoulder arthroplasty (TSA) procedures in USA.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The National Inpatient Sample (NIS) was utilized to survey all patients who underwent primary elective TSA from 2010 to 2019. Pneumonia, respiratory failure and PE following TSA were considered to be pulmonary consequences. The inpatient expenses, length of hospitalization, death rates and patient characteristics of those with and without reported perioperative pulmonary problems were compared. The utilization of trend weights was necessary to obtain incidence estimates across USA, considering the stratified framework of the NIS database and the dependence on observed frequencies within the database. Two assessments were utilized to assess the projected annual rates of complications.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Between 2010 and 2019, a total of 189,695 patients were estimated to underwent primary elective TSA. Infections, such as pneumonia, respiratory failure or PE, complicated 1.4% (95% CI, 1.52%-1.64%) of TSA operations. The ailments at this period that were most likely to result in pulmonary problems were ulcer (adjusted odds ratio [AOR] = 9.43; 95% CI, 4.99-46.91), pulmonary circulation disorders (AOR = 9.01; 95% CI, 4.56- 31.92), weight loss (AOR = 4.84; 95% CI, 2.15-10.88), fluid and electrolyte disorders (AOR = 3.55; 95% CI, 2.55-4.95), alcohol abuse (AOR = 1.56; 95% CI, 1.08-2.26), congestive heart failure (AOR = 3.09; 95% CI, 1.83-5.24), chronic pulmonary disease (AOR = 2.45; 95% CI, 1.60-3.75), deficiency anaemia (AOR = 1.56; 95% CI, 1.08-2.26), depression (AOR = 1.47; 95% CI, 1.03-2.11) and obesity (AOR = 1.46; 95% CI, 1.01-2.11). A correlation was found between perioperative pulmonary problems and extended LOS (+ 3 days; 95% CI, 2-6) and increased hospitalization costs (= + 20,514 US dollars; 95% CI, 14,109-35,281).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This investigation primarily aimed to ascertain potential risk factors linked to pulmonary issues that may occur after TSA. The analysis revealed that the pneumonia rates decreased each year, whereas the PE rates remained relatively stable. A noticeable and consistent increase was found in respiratory failure from 2010 to 2019. The findings suggests that individuals who are older (primarily between the ages of 60 and 80 years) and female exhibit increased rates. These factors could help stratify patients and reduce the risk of potential complications. This claim is especially applicable in PE because ","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"14 1","pages":"4"},"PeriodicalIF":2.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11720511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952826","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":"Preoperative smoking cessation interventions: a systematic review and meta-analysis.","authors":"Mohammed Alsanad, Mohammed Aljanoubi, Faraj K Alenezi, Amanda Farley, Babu Naidu, Joyce Yeung","doi":"10.1186/s13741-024-00479-4","DOIUrl":"10.1186/s13741-024-00479-4","url":null,"abstract":"<p><strong>Background: </strong>Smoking is the leading single cause of preventable death in England and also increases the risk of postoperative complications. The preoperative period is a potential opportunity to introduce smoking cessation interventions to smokers to reduce the risk of postoperative complications. A systematic search was conducted to find all studies that investigated the effectiveness of preoperative smoking cessation interventions. The primary outcome was smoking cessation at surgical time to the last follow-up, and the secondary outcome was postoperative complications that required treatment or ICU admission. A random-effects meta-analysis was used to synthesize the outcomes. Sixteen studies were included in the review (3505 participants), and 14 studies were included in the meta-analysis (2940 randomized participants). The quality of evidence was moderate due to the high risk of bias and heterogeneity. We found that patients who were provided with a smoking cessation intervention had significantly increased odds of quitting smoking by the time of surgery compared with usual care, with a reported relative risk (95% CI) 1.64 (1.30-2.07) and at the longest follow-ups with RR (95% CI) 1.38 (1.12-1.70). Moreover, there was no difference found in the rate of postoperative complications between intervention and control conditions with RR (95% CI) 0.81 (0.62-1.06). The use of standardized outcome measurements is recommended to reduce heterogeneity for future studies, and further investigation focusing on patient perspectives is needed.</p><p><strong>Trial registration: </strong>PROSPERO CRD42023423202.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"14 1","pages":"5"},"PeriodicalIF":2.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142965889","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 relationship between preoperative anemia and length of hospital stay among patients undergoing orthopedic surgery at a teaching hospital in Ethiopia: a retrospective cohort study.","authors":"Amanuel Sisay Endeshaw, Fikadu Tadesse Diress, Melatmariam Sisay Endeshaw, Workineh Mengesha Kefale, Biniyam Teshome Addisu, Atalay Eshetie Demilie, Fantahun Tarekegn Kumie","doi":"10.1186/s13741-024-00482-9","DOIUrl":"10.1186/s13741-024-00482-9","url":null,"abstract":"<p><strong>Introduction: </strong>Preoperative anemia in orthopedic surgery is linked to adverse outcomes such as longer hospital stays, higher rates of blood transfusion, and increased risk of death. Effectively addressing and managing this condition is essential for improving patient outcomes and shortening the length of hospital stays. In Ethiopia and other low-income countries, studies on preoperative anemia and its impact on the length of hospital stay following orthopedic surgery are limited. Therefore, this study aimed to assess the relationship between preoperative anemia and length of hospital stay among patients who underwent orthopedic surgery in Northwest Ethiopia.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted from June 01, 2019, to June 30, 2021, at Tibebe Ghion Specialized Hospital, Bahir Dar, Ethiopia. Data on demographic and clinical characteristics were collected using the Research Electronic Data Capture (REDCap) data collection system. Prolonged length of stay was defined as when a patient stays more than the 75th percentile of the LOS of all patients after orthopedic surgery. Multivariable logistic regression assessed the association between preoperative anemia and prolonged hospital stay length.</p><p><strong>Results: </strong>Of 959 orthopedic patients enrolled in this study, 481 (50.16%) had preoperative anemia. The majority of patients underwent intramedullary nailing (27.63%) followed by debridement and irrigation (19.29%), and open reduction and internal fixation (17.00%) orthopedic procedures. The median length of hospital stays of all patients who underwent orthopedic surgery was 6 days (IQR 3, 13). During the follow-up, 212 patients had a prolonged length of stay following orthopedic surgery in the hospital. Of 212 patients who had prolonged hospital stays, 124 (58.49%) patients were anemic compared to 88 (41.51%) non-anemic patients. The odds of prolonged stay after orthopedic surgery were 1.77 (AOR = 1.77, 95% CI 1.25, 2.50) times higher among patients with preoperative anemia than those without preoperative anemia.</p><p><strong>Conclusion: </strong>Preoperative anemia was independently associated with prolonged hospital stay among orthopedic surgery patients. Appropriate screening and treatment of preoperative anemia in orthopedic patients is essential.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"13 1","pages":"120"},"PeriodicalIF":2.0,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11665082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882657","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":"Artificial intelligence in anesthesiology: a bibliometric analysis.","authors":"Bi-Hua Xie, Ting-Ting Li, Feng-Ting Ma, Qi-Jun Li, Qiu-Xia Xiao, Liu-Lin Xiong, Fei Liu","doi":"10.1186/s13741-024-00480-x","DOIUrl":"10.1186/s13741-024-00480-x","url":null,"abstract":"<p><p>The application of artificial intelligence (AI) in anesthesiology has become increasingly widespread. However, no previous study has analyzed this field from the bibliometric analysis dimension. The objective of this paper was to assess the global research trends in AI in anesthesiology using bibliometric software. Literatures relevant to AI and anesthesiology were retrieved from the Web of Science until 10 April 2024 and were visualized and analyzed using Excel, CiteSpace, and VOSviewer. After screening, 491 studies were included in the final bibliometric analysis. The growth rate of publications, countries, institutions, authors, journals, literature co-citations, and keyword co-occurrences was computed. The number of publications increased annually since 2018, with the most significant contributions from the USA, China, and England. The top 3 institutions were Yuan Ze University, National Taiwan University, and Brunel University London. The top three journals were Anesthesia & Analgesia, BMC Anesthesiology, and the British Journal of Anaesthesia. The researches on the application of AI in predicting hypotension have been extensive and represented a hotspot and frontier. In terms of keyword co-occurrence cluster analysis, keywords were categorized into four clusters: ultrasound-guided regional anesthesia, postoperative pain and airway management, prediction, depth of anesthesia (DoA), and intraoperative drug infusion. This analysis provides a systematic analysis on the literature regarding the AI-related research in the field of anesthesiology, which may help researchers and anesthesiologists better understand the research trend of anesthesia-related AI.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"13 1","pages":"121"},"PeriodicalIF":2.0,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882655","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}