British journal of anaesthesia最新文献

Association of loneliness and social isolation with postoperative outcomes: a retrospective registry study. 孤独感和社会隔离与术后预后的关系：一项回顾性登记研究。

IF 9.8 1区医学

British journal of anaesthesia Pub Date : 2025-10-23 DOI: 10.1016/j.bja.2025.09.004

Kaylyssa Philip,Amber Jolly,Calvin Diep,Rachel D Savage,Duminda N Wijeysundera,Christopher Witiw,Karim S Ladha

{"title":"Association of loneliness and social isolation with postoperative outcomes: a retrospective registry study.","authors":"Kaylyssa Philip,Amber Jolly,Calvin Diep,Rachel D Savage,Duminda N Wijeysundera,Christopher Witiw,Karim S Ladha","doi":"10.1016/j.bja.2025.09.004","DOIUrl":"https://doi.org/10.1016/j.bja.2025.09.004","url":null,"abstract":"BACKGROUNDLoneliness and social isolation are highly prevalent public health concerns. However, their impacts in acute care settings such as the postoperative period are unclear. This study explored whether loneliness, social isolation, or both are associated with a primary composite outcome of 30-day major postoperative complication, 30-day postoperative emergency admission, and 90-day mortality.METHODSThis retrospective cohort study used the UK Biobank. Individuals with complete loneliness and social isolation data, an eligible surgery within 1 yr of baseline, and national health registry linkage were included. Loneliness and social isolation were defined with validated, self-reported measures. Participants were stratified into four groups by baseline loneliness and social isolation status. Logistic regression models assessed associations between loneliness-social isolation groups and postoperative outcomes with comprehensive covariate adjustment.RESULTSSome 27 905 UK Biobank participants met eligibility criteria. Individuals who were socially isolated but not lonely had increased odds of the primary outcome (adjusted odds ratio 1.36, 95% confidence interval 1.10-1.68, P=0.004), mainly driven by higher odds of 30-day major postoperative complication (odds ratio 1.35, 95% confidence interval 1.04-1.72, P=0.08). In a subgroup analysis, this association remained statistically significant in males but not females.CONCLUSIONSIndividuals, particularly males, who were socially isolated but not lonely had increased odds of postoperative complications. Our results are consistent with other reports that loneliness and social isolation are weakly correlated, and that social isolation is more consistently associated with adverse physical outcomes. These findings suggest that targeted, interventional programmes addressing social isolation in surgical patients might assist in mitigating postoperative risks.","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"70 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145357722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Temporal trends in postoperative outcomes after major abdominal surgery: a population-based cohort study. 腹部大手术术后预后的时间趋势：一项基于人群的队列研究。

IF 9.8 1区医学

British journal of anaesthesia Pub Date : 2025-10-23 DOI: 10.1016/j.bja.2025.08.030

Matthanja Bieze,Ryan McGinn,Marta Berrio-Valencia,Robert Talarico,Guillaume Martel,Stuart A McCluskey,Daniel I McIsaac

{"title":"Temporal trends in postoperative outcomes after major abdominal surgery: a population-based cohort study.","authors":"Matthanja Bieze,Ryan McGinn,Marta Berrio-Valencia,Robert Talarico,Guillaume Martel,Stuart A McCluskey,Daniel I McIsaac","doi":"10.1016/j.bja.2025.08.030","DOIUrl":"https://doi.org/10.1016/j.bja.2025.08.030","url":null,"abstract":"BACKGROUNDEnhanced recovery after surgery protocols and minimally invasive surgery are strategies to mitigate postoperative complications, therefore complication rate is expected to decrease over time. We estimated temporal trends and variation in clinical and health system outcomes.METHODSThis was a population-based cohort study in Ontario, Canada, using data from the Institute of Clinical Evaluative Science. Male and female adults who underwent major elective abdominal surgery (gastroesophagectomy, pancreaticoduodenectomy, partial hepatectomy, colorectal resection) during 2005-21 were included. The primary outcome was a composite of moderate-to-severe postoperative complications. Secondary outcomes were health system outcomes. The primary analyses estimated aggregate unadjusted, and case-mix adjusted, linear trends.RESULTSWe included 148 725 patients. The yearly rate of moderate-to-severe complications was similar (rate ratio [RR] 0.994, 95% confidence interval [CI] 0.985-1.002). Temporal improvements in length of stay (RR 0.968, 95% CI 0.959-0.977), ICU admission (RR 0.982, 95% CI 0.966-0.998), days alive and at home (RR 1.004, 95% CI 1.003-1.005), and total costs (RR 0.990, 95% CI 0.982-0.997) were estimated. Temporal improvements in complication rates were seen for colorectal resection (RR 0.988, 95% CI 0.980-0.997) and gastroesophagectomy (RR 0.985, 95% CI 0.974-0.996), whereas complication rates for partial hepatectomy (RR 1.012, 95% CI 1.003-1.022) and pancreaticoduodenectomy (RR 1.016, 95% CI 1.004-1.028) increased over time.CONCLUSIONSDespite advances in perioperative protocols and techniques, the overall adjusted rate of moderate-to-severe complications did not change over time. Contrasting trends were evident between different surgical procedures. OSF PROTOCOL REGISTRATION: https://doi.org/10.17605/OSF.IO/792BR.","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"19 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145357755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Gender distribution of anaesthesiology journal editorial boards and authorship by women: a bibliometric analysis. 麻醉学期刊编委会的性别分布与女性作者：文献计量学分析。

IF 9.8 1区医学

British journal of anaesthesia Pub Date : 2025-10-23 DOI: 10.1016/j.bja.2025.09.020

Aslihan Gulec Kilic,Selin Erel,Tuba Dulger,Mia Gisselbaek,Joana Berger-Estilita,Sarah Saxena

引用次数: 0

Changes in circulating extracellular vesicle cargo are associated with cognitive decline after major surgery. Comment on Br J Anaesth 2025; 134: 1683-95. 大手术后循环细胞外囊泡载货量的变化与认知能力下降有关。Br [J][研究][2025]；134: 1683 - 95。

IF 9.8 1区医学

British journal of anaesthesia Pub Date : 2025-10-21 DOI: 10.1016/j.bja.2025.09.022

Yoshiyasu Takefuji

引用次数: 0

Perioperative management of patients taking glucagon-like peptide-1 receptor agonists: a restrictive fasting regimen is not necessary. Comment on Br J Anaesth 2025; 135: 48-78. 胰高血糖素样肽-1受体激动剂患者的围手术期管理：限制性禁食方案是不必要的。Br [J][研究][2025]；135: 48 - 78。

IF 9.8 1区医学

British journal of anaesthesia Pub Date : 2025-10-21 DOI: 10.1016/j.bja.2025.09.027

Rafi Khandaker,Ali Bordbar Jahantighi,Jan Schwarz,Carina Himes,Shiroh Isono,Matthias Eikermann,Philipp Fassbender

引用次数: 0

Erector spinae plane block versus paravertebral block for major oncological breast surgery. Comment on Br J Anaesth 2025; 35: 772-8. 竖脊肌平面阻滞与椎旁阻滞在乳腺肿瘤大手术中的应用。Br [J][研究][2025]；35: 772 - 8。

IF 9.8 1区医学

British journal of anaesthesia Pub Date : 2025-10-21 DOI: 10.1016/j.bja.2025.09.023

Weijie Huang

引用次数: 0

Associate Editorial Board and cover image caption 副编辑委员会和封面图片说明

IF 9.2 1区医学

British journal of anaesthesia Pub Date : 2025-10-17 DOI: 10.1016/S0007-0912(25)00648-8

引用次数: 0

Retraction notice to “Ultrasound-guided erector spinae plane block improves analgesia after laparoscopic hepatectomy: a randomised controlled trial” [Br J Anaesth 129 (2022) 445–453] 超声引导下直立器脊柱平面阻滞对腹腔镜肝切除术后镇痛效果的影响[J].中华外科杂志，2011,31(2):445-453。

IF 9.2 1区医学

British journal of anaesthesia Pub Date : 2025-10-17 DOI: 10.1016/j.bja.2025.10.001

Xin Huang , Jiao Wang , Juntao Zhang , Yi Kang , Bhushan Sandeep , Jing Yang

引用次数: 0

The effects of balanced crystalloid versus plasma on endothelial injury, systemic inflammation, and coagulation in experimental endotoxaemia: a randomised human volunteer study. 平衡晶体与血浆对实验性内毒素血症中内皮损伤、全身炎症和凝血的影响：一项随机人类志愿者研究

IF 9.8 1区医学

British journal of anaesthesia Pub Date : 2025-10-17 DOI: 10.1016/j.bja.2025.08.060

Daan P van den Brink,Bashar N Hilderink,Derek J B Kleinveld,Robert B Klanderman,Inge Pareyn,Karen Vanhoorelbeke,Philip C Spinella,Nicole P Juffermans

{"title":"The effects of balanced crystalloid versus plasma on endothelial injury, systemic inflammation, and coagulation in experimental endotoxaemia: a randomised human volunteer study.","authors":"Daan P van den Brink,Bashar N Hilderink,Derek J B Kleinveld,Robert B Klanderman,Inge Pareyn,Karen Vanhoorelbeke,Philip C Spinella,Nicole P Juffermans","doi":"10.1016/j.bja.2025.08.060","DOIUrl":"https://doi.org/10.1016/j.bja.2025.08.060","url":null,"abstract":"BACKGROUNDDuring shock, neutrophil-mediated glycocalyx degradation can lead to exposure of the procoagulant endothelial surface and consequent organ injury. Resuscitation using crystalloid fluids may augment this endothelial damage, while resuscitation using plasma may preserve glycocalyx health. We hypothesised that resuscitation with plasma would preserve glycocalyx integrity by reducing inflammation, glycocalyx shedding, and dyscoagulation in a controlled model of systemic inflammation in human volunteers.METHODSTwelve healthy male volunteers were injected with 2 ng kg-1 lipopolysaccharide (LPS) to induce systemic inflammation. Thirty minutes after LPS administration, participants were randomised to receive 10 ml kg-1 of either balanced salt solution or solvent detergent plasma (SDP). Plasma syndecan-1, a marker of glycocalyx degradation, was the primary outcome. Additionally, plasma biomarkers of inflammation, neutrophil extracellular trap formation, glycocalyx degradation, endothelial injury, and coagulation were measured serially, by bead-based or enzyme-linked immunoassays.RESULTSLPS induced a systemic inflammatory response, accompanied by endothelial injury as indicated by increased levels of syndecan-1 (median increase: 2920-4430 pg ml-1, P<0.05). Participants receiving SDP had lower levels of neutrophils and plasma matrix metalloproteinase-9, compared with those receiving balanced salt solution. Neutrophil extracellular trap formation, inflammation, and glycocalyx degradation were not affected by fluid therapy. SDP reduced LPS-induced prolonged prothrombin time, but had no impact on other biomarkers of coagulation.CONCLUSIONSIn human endotoxaemia, plasma resuscitation reduced leucocyte and neutrophil levels but did not reduce glycocalyx degradation, when compared with equal volume resuscitation with a balanced crystalloid solution.","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"1 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The effect of patient resilience on perioperative outcomes: a scoping review. 患者恢复力对围手术期预后的影响：一项范围综述。

IF 9.8 1区医学

British journal of anaesthesia Pub Date : 2025-10-17 DOI: 10.1016/j.bja.2025.08.039

Leandra Amado,Jiwon Lee,Mona Khalid,Kaylyssa Philip,Premi Paul,Daniel I McIsaac,Karim S Ladha

{"title":"The effect of patient resilience on perioperative outcomes: a scoping review.","authors":"Leandra Amado,Jiwon Lee,Mona Khalid,Kaylyssa Philip,Premi Paul,Daniel I McIsaac,Karim S Ladha","doi":"10.1016/j.bja.2025.08.039","DOIUrl":"https://doi.org/10.1016/j.bja.2025.08.039","url":null,"abstract":"BACKGROUNDPsychological resilience, the capacity to recover from adversity, may represent a modifiable perioperative risk factor. This scoping review evaluated how resilience is measured and its association with postoperative outcomes in adults undergoing surgery.METHODSStructured searches of Ovid MEDLINE, Embase, and Joanna Briggs Institute Evidence-Based Practice (up to April 2024) identified studies assessing resilience in adult surgical patients. After duplicate review, studies were included if they reported preoperative resilience measurement and its association with postoperative outcomes. Narrative synthesis of outcomes followed; these were categorised according to the Institute for Healthcare Improvement Triple Aim framework.RESULTSA total of 74 studies (n=11; 710 patients) met inclusion criteria, using seven validated tools to measure resilience, most commonly the Brief Resilience Scale (n=31; 41.9%) and Connor-Davidson Resilience Scale (n=22; 29.7%). Resilience was assessed at a single timepoint in 54 studies and at multiple timepoints in 20 studies. Of 36 studies (n=6802) exploring associations between preoperative resilience and postoperative outcomes, 25 (69.4%) reported on the patient experience domain, 26 (72.2%) on health outcomes (72.2%), and three (8.3%) on cost. Higher resilience was frequently associated with improved patient experience (e.g. quality of life, satisfaction, mental health, and pain), and certain functional outcomes. Limitations included heterogeneous definitions of resilience, a preponderance of single-centre studies, and generally low-quality evidence driven by inconsistent results, bias, and limited adjustment for confounders.CONCLUSIONSResilience measurement and its association with perioperative outcomes are variable. Emerging evidence suggests potential protective effects, warranting standardised longitudinal assessment in more diverse surgical populations.SCOPING REVIEW PROTOCOLOpen Science Framework (https://osf.io/j4cqs).","PeriodicalId":9250,"journal":{"name":"British journal of anaesthesia","volume":"16 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0