CJC Open最新文献

{"title":"Better Respiratory Function in Heart Failure Patients With Use of Central-Acting Therapeutics","authors":"Julie K.K. Vishram-Nielsen MD, PhD ,&nbsp;Fernando Luis Scolari MD, PhD ,&nbsp;Chun-Po Steve Fan PhD ,&nbsp;Yas Moayedi MD ,&nbsp;Heather J. Ross MD, MHSc ,&nbsp;Cedric Manlhiot PhD ,&nbsp;Melissa A. Allwood MD, PhD ,&nbsp;Ana Carolina Alba MD, PhD ,&nbsp;Keith R. Brunt PhD ,&nbsp;Jeremy A. Simpson PhD ,&nbsp;Filio Billia MD, PhD","doi":"10.1016/j.cjco.2024.01.003","DOIUrl":"10.1016/j.cjco.2024.01.003","url":null,"abstract":"<div><h3>Background</h3><p>Diaphragm atrophy can contribute to dyspnea in patients with heart failure (HF) with its link to central neurohormonal overactivation. HF medications that cross the blood-brain barrier could act centrally and improve respiratory function, potentially alleviating diaphragmatic atrophy. Therefore, we compared the benefit of central- vs peripheral-acting HF drugs on respiratory function, as assessed by a single cardiopulmonary exercise test (CPET) and outcomes in HF patients.</p></div><div><h3>Methods</h3><p>A retrospective study was conducted of 624 ambulatory adult HF patients (80% male) with reduced left ventricular ejection fraction ≤ 40% and a complete CPET, followed at a single institution between 2001 and 2017. CPET parameters, and the outcomes all-cause death, a composite endpoint (all-cause death, need for left ventricular assist device, heart transplantation), and all-cause and/or HF hospitalizations, were compared in patients receiving central-acting (n = 550) vs peripheral-acting (n = 74) drugs.</p></div><div><h3>Results</h3><p>Compared to patients who receive peripheral-acting drugs, patients who receive central-acting drugs had better respiratory function (peak breath-by breath oxygen uptake [VO₂], <em>P</em> = 0.020; forced expiratory volume in 1 second [FEV1], <em>P</em> = 0.007), and ventilatory efficiency (minute ventilation / carbon dioxide production [VE/VCO₂], <em>P</em> &lt; 0.001; end-tidal carbon dioxide tension [PETCO₂], <em>P</em> = 0.015; and trend for forced vital capacity [FVC], <em>P</em> = 0.056). Many of the associations between the CPET parameters and drug type remained significant after multivariate adjustment. Moreover, patients receiving central-acting drugs had fewer composite events (<em>P</em> = 0.023), and HF hospitalizations (<em>P</em> = 0.044), although significance after multivariant correction was not achieved, despite the hazard ratio being 0.664 and 0.757, respectively.</p></div><div><h3>Conclusions</h3><p>Central-acting drugs were associated with better respiratory function as measured by CPET parameters in HF patients. This could extend to clinically meaningful composite outcomes and hospitalizations but required more power to be definitive in linking to drug effect. Central-acting HF drugs show a role in mitigating diaphragm weakness.</p></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589790X24000246/pdfft?md5=17508265fa99001010df60e7f6fdc99f&pid=1-s2.0-S2589790X24000246-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139632727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of the Buddy Judkins Catheter and Stiff Wire Technique to Deliver Sheaths for Catheter Ablation Through Iliac Vein Tortuosity","authors":"Yuhei Kasai MD, FHRS ,&nbsp;Takayuki Kitai MD ,&nbsp;Junji Morita MD ,&nbsp;Takuya Okada ,&nbsp;Yumetsugu Munakata ,&nbsp;Jungo Kasai PhD ,&nbsp;Tsutomu Fujita MD","doi":"10.1016/j.cjco.2024.01.014","DOIUrl":"10.1016/j.cjco.2024.01.014","url":null,"abstract":"","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589790X24001008/pdfft?md5=f65105d53aa303179d7df3d26e5f2362&pid=1-s2.0-S2589790X24001008-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139966966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Refractory Hypoxemia Secondary to Intracardiac Shunt Diagnosed in the Catheterization Laboratory","authors":"Ali Hillani MD ,&nbsp;Mohammed El Mehdi El Yamani MD ,&nbsp;Hamza Ouazani Chahdi MD ,&nbsp;Alexis Matteau MD, MSc","doi":"10.1016/j.cjco.2024.01.004","DOIUrl":"10.1016/j.cjco.2024.01.004","url":null,"abstract":"","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589790X24000258/pdfft?md5=b032235ecb4c2e75cbd4167eca3afa90&pid=1-s2.0-S2589790X24000258-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139636047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Six-Month Progression of Massive Left Ventricular Pseudoaneurysm","authors":"Nick S.R. Lan MBBS(Hons), MClinUS, MClinRes(Dist), MSc, FRACP ,&nbsp;Eric Slimani MBBS, FRACS ,&nbsp;Aife O’Brien MB, BCh, BAO ,&nbsp;Lawrence Dembo MBBS, FRACP ,&nbsp;Kalilur Anvardeen MBBS, FRACP ,&nbsp;Kaitlyn Lam MBBS, FRACP","doi":"10.1016/j.cjco.2024.01.007","DOIUrl":"10.1016/j.cjco.2024.01.007","url":null,"abstract":"","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589790X24000283/pdfft?md5=c2d376a7891b174ae5d8e844fb6a9664&pid=1-s2.0-S2589790X24000283-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139892188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of SGLT2 Inhibitors on Quality of Life in Heart Failure Across the Ejection Fraction Spectrum: Systematic Review and Meta-analysis","authors":"Yaksh R. Shah ,&nbsp;Ricky D. Turgeon BSc(Pharm), ACPR, PharmD","doi":"10.1016/j.cjco.2023.12.002","DOIUrl":"10.1016/j.cjco.2023.12.002","url":null,"abstract":"<div><h3>Background</h3><p>Use of a sodium-glucose cotransporter-2 inhibitor (SGLT2i) reduces hospitalization in heart failure (HF) patients across the spectrum of ejection fraction, but no study has comprehensively explored their impact on quality of life (QoL) with respect to different subgroup populations. We aimed to explore the QoL impact of SGLT2i use in HF patients across the spectrum of ejection fraction and over time.</p></div><div><h3>Methods</h3><p>We searched MEDLINE, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) covering the period from 2019 to February 2022. We included placebo-controlled randomized controlled trials (RCTs) enrolling HF patients that evaluated QoL as an outcome. Two reviewers independently assessed studies for eligibility, extracted data, and assessed risk of bias (RoB), using the Cochrane RoB2 tool, and certainty of evidence, using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. Primary and secondary outcomes were the mean difference in QoL, and clinically important improvement in QoL, as defined in the original study, respectively. We conducted subgroup analyses based on ejection fraction category, SGLT2i agent, and timing of QoL measurement.</p></div><div><h3>Results</h3><p>From 1477 identified reports, we included 14 RCTs (n = 23,361). The mean age was 68 years, and 34% were female. All included RCTs reported QoL using the Kansas City Cardiomyopathy Questionnaire (KCCQ). SGLT2i use improved KCCQ-overall summary score, compared with placebo (mean difference 2.0, 95% confidence interval 1.6-2.5; high certainty). More patients receiving an SGLT2i achieved a clinically important QoL improvement (risk ratio 1.14, 95% confidence interval 1.02-1.28; moderate certainty). Similar improvements were observed in the KCCQ clinical summary and total symptom subscores, and across all subgroups and timeframes.</p></div><div><h3>Conclusions</h3><p>Use of an SGLT2i consistently provides a clinically important improvement in QoL among patients with HF, regardless of ejection fraction, with noticeable improvements seen as early as week 2.</p></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589790X23003487/pdfft?md5=f41538bda458b4bf5324741ebf78074b&pid=1-s2.0-S2589790X23003487-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138627642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-Reported Postoperative Neuropsychological Deterioration After Heart Valve Replacement and Coronary Artery Bypass Grafting","authors":"Marius Butz PhD, MSc ,&nbsp;Jasmin El-Shazly MSc ,&nbsp;Tibo Gerriets MD ,&nbsp;Rolf Meyer MSc ,&nbsp;Marlene Tschernatsch MD, MBA ,&nbsp;Tobias Braun MD ,&nbsp;Patrick Schramm MD, MSc ,&nbsp;Thorsten R. Doeppner MD, MSc, MHBA ,&nbsp;Stefan T. Gerner MD ,&nbsp;Andreas Boening MD ,&nbsp;Yeong-Hoon Choi MD ,&nbsp;Markus Schoenburg MD ,&nbsp;Martin Juenemann MD, MSc","doi":"10.1016/j.cjco.2023.11.007","DOIUrl":"10.1016/j.cjco.2023.11.007","url":null,"abstract":"<div><h3>Background</h3><p>Postoperative cognitive decline (POCD) after cardiosurgical interventions are well described through objective psychometric tests. However, a patient’s subjective perception is essential to clinical assessment and quality of life. This study systematically evaluated patient-reported POCD between subjects undergoing coronary artery bypass grafting and heart valve replacement.</p></div><div><h3>Methods</h3><p>This study was a multicentre, prospective questionnaire survey conducted at the cardiac surgery departments at the Kerckhoff Clinic in Bad Nauheim and the University Hospital in Giessen, Germany. We included patients undergoing elective coronary artery bypass grafting (CABG), aortic valve replacement (AVR), mitral valve replacement or reconstruction (MVR), and combined surgery (CABG + valve replacement [VR]) with extracorporeal circulation. The Hospital Anxiety and Depression Scale, the Cognitive Failures Questionnaire (CFQ) for Self-assessment (CFQ-S), and the external assessment (CFQ-foreign [F]) were completed preoperatively, as well as at 3 and 12 months postoperatively.</p></div><div><h3>Results</h3><p>A total of 491 patients were available for analyses (CABG = 182, AVR = 134, MVR = 93, CABG + VR = 82). POCD and postoperative depression increase (PODI) were observed for each surgical procedure. (At the 3-month follow-up: CFQ-S [CABG = 7.1%, AVR = 3.7%, MVR = 9.7%, CABG + VR = 9.8%]; CFQ-F [CABG = 9.9%, AVR = 9.7%, MVR = 9.7%, CABG + VR = 15.9%]; PODI [CABG = 7.7%, AVR = 9.7%, MVR = 6.5%, CABG + VR = 8.5%]. At the 12-month follow-up: CFQ-S [CABG = 6.6%, AVR = 7.5%, MVR = 15.1%, CABG + VR = 7.3%]; CFQ-F [CABG = 7.1%, AVR = 14.9%, MVR = 10.8%, CABG + VR = 9.8%]; PODI [CABG = 10.4%, AVR = 11.2%, MVR = 6.5%, CABG + VR = 4.9%]). No significant between-group effects were observed for the CFQ-S, CFQ-F, or the Hospital Anxiety and Depression Scale.</p></div><div><h3>Conclusions</h3><p>For clinicians, paying attention to patients' self-reported experiences of reduced cognitive function and symptoms of depression following cardiac surgery is important. Such reporting is an indication that interventions such as cognitive training or psychotherapy should be considered.</p></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589790X23003281/pdfft?md5=0169aaa1546282b8a156689b215bb700&pid=1-s2.0-S2589790X23003281-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139302533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcome of STEMI Patients With Reperfusion Delay of 120 Minutes or More Treated With the Pharmacoinvasive Approach vs PPCI: A Retrospective Study","authors":"Alexandre Angers-Goulet MD ,&nbsp;Olivier Bouchard ,&nbsp;Simon Bérubé MD ,&nbsp;Benoit Daneault MD","doi":"10.1016/j.cjco.2023.11.018","DOIUrl":"10.1016/j.cjco.2023.11.018","url":null,"abstract":"<div><h3>Background</h3><p>Primary percutaneous coronary intervention (PPCI) and fibrinolysis have proved to be major discoveries regarding treatment of ST-segment elevation myocardial infarction (STEMI). The threshold at which PPCI becomes less favourable than fibrinolysis remains unclear and controversial. Trials have studied the impact of delayed reperfusion in relation to symptom onset, but to our knowledge, none have focused on the outcome of patients past the expected 120-minute window regarding first medical contact (FMC) in the concomitant era of PPCI and fibrinolysis.</p></div><div><h3>Methods</h3><p>STEMI patients who presented to a single PPCI-capable hospital, in the period from 2016 to 2020, and were treated with PPCI within 120 -240 minutes after FMC, and those who received fibrinolysis, were included. Outcomes of patients treated with delayed PPCI were compared to those of patients treated with fibrinolysis. The primary endpoint was a net adverse clinical event composite of all-cause mortality, myocardial re-infarction, ischemia-driven target-vessel revascularization, disabling stroke, and major bleeding at discharge.</p></div><div><h3>Results</h3><p>Inclusion criteria were met for 536 STEMI patients, 429 treated with PPCI and 107 treated with fibrinolysis. The primary endpoint (net adverse clinical events) was not significantly different between the 2 groups (2.8% vs 3.7%, <em>P</em> = 0.61). However, intracranial hemorrhage (0% vs 2.8%, <em>P</em> = 0.008) and bleeding (BARC 3 or 5) (0.9% vs 3.7%, <em>P</em> = 0.048) significantly favoured the PPCI group.</p></div><div><h3>Conclusions</h3><p>This retrospective study suggests that delayed PPCI may be a safer approach than fibrinolysis in patients with an FMC-to-balloon time of &gt; 120 minutes, owing to reduction in the risk of intracranial and severe bleeding. These retrospective observations should be validated in larger randomized trials.</p></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589790X23003396/pdfft?md5=e3c902b22697e0dfd1a7063f22dab4e5&pid=1-s2.0-S2589790X23003396-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139298907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leadless Pacemaker Implantation in Patients With a Prior Conventional Pacing System","authors":"Julius Jelisejevas MD ,&nbsp;François Regoli MD ,&nbsp;Daniel Hofer MD ,&nbsp;Giulio Conte MD ,&nbsp;Tardu Oezkartal MD ,&nbsp;Ardan M. Saguner MD ,&nbsp;Maria Luce Caputo MD ,&nbsp;Lorenzo Grazioli MD ,&nbsp;Jan Steffel MD ,&nbsp;Angelo Auricchio MD ,&nbsp;Alexander Breitenstein MD","doi":"10.1016/j.cjco.2023.12.008","DOIUrl":"10.1016/j.cjco.2023.12.008","url":null,"abstract":"<div><h3>Background</h3><p>Leadless pacing has been established as an alternative approach to transvenous devices for selected patients. Often, leadless pacemaker (LP) implantation is a de novo procedure, but in an increasing number of patients, an LP is used after previous implantation of a conventional pacing system (CPS).</p></div><div><h3>Methods</h3><p>A retrospective analysis was conducted of the efficacy and safety of LP implantation in the context of a previously implanted CPS, from 2 large Swiss centres.</p></div><div><h3>Results</h3><p>A total of 257 consecutive patients undergoing LP implantation were included. They were divided into 2 groups: group 1 consisted of 233 patients who did not have a previous CPS, and group 2 consisted of 24 patients with an in situ CPS. In group 2, a total of 20 patients (83%) required transvenous lead extraction due to infection, malfunction, or other reasons. In 3 patients with device-related infection, lead extraction and LP implantation was performed as a single procedure, whereas in the remaining 11 cases, a time window occurred between the 2 procedures (median: 11.5 days; range: 2-186 days). Electrical device parameters at implantation and during follow-up did not differ between the 2 groups (mean: 12.5 ± 9.3 months). Eight major periprocedural complications (3.1%) were encountered (4 pericardial effusions, 3 instances of femoral bleeding, and 1 instance of intra-abdominal bleeding) in the entire cohort within a 30-day period. No complications occurred in the group with a previous device. No infections were registered, even when complete extraction of an infected CPS was performed prior to LP implantation.</p></div><div><h3>Conclusions</h3><p>Implantation of an LP in patients with a prior CPS (with or without extraction of the previous system) was effective and safe in our population of patients.</p></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589790X23003761/pdfft?md5=37c2342807bf0ff6a30803e3048fa9b5&pid=1-s2.0-S2589790X23003761-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139025950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Marantic Endocarditis With Recurrent Thromboembolism Potentially Associated With COVID-19 and Delayed Onset of Malignancy","authors":"Christine Vu MD ,&nbsp;Aurélie Mourot MD ,&nbsp;E. Marc Jolicoeur MD, MSc ,&nbsp;Michèle Mahone MD ,&nbsp;Michael Benzazon MD ,&nbsp;Alexis Matteau MD, MSc","doi":"10.1016/j.cjco.2023.12.017","DOIUrl":"10.1016/j.cjco.2023.12.017","url":null,"abstract":"","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589790X23003852/pdfft?md5=c87d6eea2f7d7e003b61d8ddfa433757&pid=1-s2.0-S2589790X23003852-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139192850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Addictions Management Following Cardiac Surgery on People Who Inject Drugs and Have Infective Endocarditis","authors":"Alison Greene MD, MSC ,&nbsp;Navjot Sandila MSc ,&nbsp;Anthony Pryor BSc ,&nbsp;Gregory Hirsch MD, MSc","doi":"10.1016/j.cjco.2023.12.007","DOIUrl":"https://doi.org/10.1016/j.cjco.2023.12.007","url":null,"abstract":"<div><h3>Background</h3><p>Managing reinfection in patients who inject drugs and have undergone cardiac surgery could reduce mortality. A significant gap exists in the management of addiction in this population and it is rarely addressed during index hospitalization for surgical intervention. This study sought to determine if management of addiction changed rates of readmission for reinfection.</p></div><div><h3>Methods</h3><p>This study was a retrospective chart review and analysis. Patients who underwent cardiac surgery for infective endocarditis due to injection drug use underwent a full chart review to determine if they received management of their addiction (addictions medicine consultation, social work consultation, medication- and/or opioid-assisted treatment, and community follow-up) following their surgical intervention.</p></div><div><h3>Results</h3><p>A total of 41 patients were identified who met the inclusion criteria. For addictions management, 43.2% of patients received an addictions medicine consultation, 67.6% received a social work consultation, 40.5% received medication- and/or opioid-assisted treatment, and 56.8% received community follow-up. Overall mortality of these patients was 21.6%, and 56.8% of patients were readmitted with reinfection. Multivariate logistic regression showed that patients who received intervention were 1.6 times more likely to be readmitted with reinfection (odds ratio 1.65, 95% confidence interval 0.29-9.41, <em>P</em> = 0.5736). Female patients had a significantly higher odds of reinfection, when adjusted for gender (odds ratio 9.95, 95% confidence interval 1.42-69.72, <em>P</em> = 0.021).</p></div><div><h3>Conclusions</h3><p>We demonstrated a nonstandardized approach to consultation and varying approaches to management of addiction. Patients who received intervention for addiction were more likely to be readmitted for reinfection, but this difference was not significant. Future efforts can include promotion of formalized addictions consultation services for high-risk patients.</p></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589790X2300375X/pdfft?md5=4b9237ef90c52a303223928e27655401&pid=1-s2.0-S2589790X2300375X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140647142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}