Publications by authors named "Alfred Adiamah"
Article Synopsis
- Major trauma significantly impacts younger individuals, especially in areas with higher socioeconomic deprivation, highlighting a public health concern that needs more research.
- A study analyzed data from 14 studies involving nearly 879,000 trauma patients, finding that 28% of incidents occurred in the most deprived socioeconomic group, with these patients being younger and more likely to be male.
- Despite the difference in demographics and the environment of those affected, there were no significant variations in surgical intervention rates, hospital stay duration, or mortality between socioeconomic groups, suggesting a need for targeted public health strategies in deprived areas.
Background: N-Acetylcysteine (NAC) is a recognized antioxidative agent that facilitates the conjugation of toxic metabolites. In recent years, NAC has been routinely used to limit ischaemia-reperfusion injury in liver transplantation. There remains, however, contradictory evidence on its effectiveness in liver resection.
View Article and Find Full Text PDFIntroduction: The mortality risk after appendicectomy in patients with liver cirrhosis is predicted to be higher than in the general population given the associated risk of perioperative bleeding, infections and liver decompensation. This population-based cohort study aimed to determine the 90-day mortality risk following emergency appendicectomy in patients with cirrhosis.
Methods: Adult patients undergoing emergency appendicectomy in England between January 2001 and December 2018 were identified from two linked primary and secondary electronic healthcare databases, the clinical practice research datalink and hospital episode statistics data.
Background: Malnutrition is a risk-factor for adverse postoperative outcomes. This systematic review and meta-analysis evaluated the impact of post-discharge oral nutritional supplements (ONS) on outcomes in patients undergoing gastrointestinal surgery.
Methods: The Medline and Embase databases were searched for randomised clinical trials in patients undergoing gastrointestinal surgery who had received ONS for at least two weeks after discharge from hospital.
Article Synopsis
- A study analyzed surgical outcomes for patients with and without cirrhosis undergoing cholecystectomy between 2000 and 2017 using healthcare data from England.
- In the cohort of 69,141 patients, those with cirrhosis showed significantly longer hospital stays, higher rates of readmission, and increased 90-day mortality compared to those without cirrhosis.
- The results indicated that patients with cirrhosis had 3 to 4 times the odds of mortality after elective and emergency surgery, emphasizing the greater risk associated with emergency procedures.
Purpose: To compare patterns and mechanisms of injuries during and after the UK Nationwide lockdown during the COVID-19 pandemic.
Methods: This prospective cohort study included all major trauma admissions during the 10-week period of the nationwide lockdown (09/03/2020-18/05/2020), compared with admissions in the 10-weeks following the full lifting of lockdown restrictions (04/07/20-12/09/2020). Differences in the volume, spectrum and mechanism of injuries presenting during and post-lockdown were compared using Fisher's exact and Chi-squared tests as appropriate.
Introduction: With the global prevalence of liver cirrhosis rising, this systematic review aimed to define the perioperative risk of mortality in these patients following appendicectomy.
Methods: Systematic searches of Medline, EMBASE, Cochrane Library databases, ICTRP, and Clinical trials.gov were undertaken to identify studies including patients with cirrhosis undergoing appendicectomy, published since database inception to March 2021.
Article Synopsis
- Patients with cirrhosis face increased mortality risks following colectomy, especially with emergency procedures compared to elective ones.
- A study of data from England showed that among 36,380 colectomy patients, only 248 had cirrhosis, with 70% having compensated cirrhosis.
- The risk of death at 90 days was notably higher for emergency surgeries (41% in decompensated cirrhosis) versus elective ones (10% in decompensated cirrhosis), and this risk remained elevated even after one year.
Introduction: Perioperative bleeding poses a major risk during liver surgery, which can result in increased transfusion requirements, morbidity, and mortality. Tranexamic acid (TXA) effectively reduces perioperative bleeding and transfusion requirements in trauma patients. However, there remains a lack of evidence of its use in liver surgery.
View Article and Find Full Text PDFBackground: Surgeon burnout has implications for patient safety and workforce sustainability. The aim of this study was to establish the prevalence of burnout among surgeons in the UK during the COVID-19 pandemic.
Methods: This cross-sectional online survey was set in the UK National Health Service and involved 601 surgeons across the UK of all specialities and grades.
Background And Aim: This meta-analysis aimed to estimate the incidence of splanchnic vein thrombosis (SVT) in patients with acute pancreatitis and assess the effects of therapeutic anticoagulation.
Methods: Systematic searches of the Medline, Embase, and Cochrane databases were undertaken to identify studies reporting the incidence and outcomes associated with SVT in patients with acute pancreatitis. The pooled incidence, odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a random effects model.
Background & Aims: Immune modulating nutrition (IMN) has been shown to reduce postoperative infectious complications and length of stay in patients with gastrointestinal cancer. Two studies of IMN in patients undergoing surgery for head and neck cancer also suggested that this treatment might improve long-term survival and progression-free survival. In the present study, we analysed follow-up data from our previous randomised controlled trial of IMN, in patients undergoing surgery for oesophagogastric and pancreaticobiliary cancer, in order to evaluate the long-term impact on survival of postoperative IMN versus an isocaloric, isonitrogenous control feed.
View Article and Find Full Text PDFBackground: Presentation at academic conferences is an important marker of research productivity. However, not all accepted abstracts progress to full publication, and there is anecdotal evidence suggesting an imbalance in sex and ethnicity amongst presenters. There is a lack of data evaluating the outcome of prize presentation sessions at academic surgical conferences in the UK.
View Article and Find Full Text PDFBackground: The global pandemic caused by SARS-CoV-2 has impacted population health and care delivery worldwide. As information emerges regarding the impact of "lockdown measures" and changes to clinical practice worldwide; there is no comparative information emerging from the United Kingdom with regard to major trauma.
Methods: This observational study from a UK Major Trauma Centre matched a cohort of patients admitted during a 10-week period of the SARS-CoV-2-pandemic (09/03/2020-18/05/2020) to a historical cohort of patients admitted during a similar time period in 2019 (11/03/2019-20/05/2019).
Background: Colorectal cancer has the second highest mortality of any malignancy, and venous thromboembolism is a major postoperative complication.
Objective: This study aimed to determine the variation in incidence of venous thromboembolism after colorectal cancer resection.
Data Sources: Following PRISMA and MOOSE guidelines (PROSPERO, ID: CRD42019148828), Medline and Embase databases were searched from database inception to August 2019 including 3 other registered medical databases.
Aim: Remote follow-up (RFU) after colorectal cancer (CRC) surgery allows delivery of surveillance tests without the need for regular outpatient clinical appointments. However, little is known about health-related quality of life (HRQoL) in RFU patients. The main aim of this study was to quantify HRQoL in our RFU population to identify particular patient groups that may benefit from a more personalised approach to follow-up, including access to a survivorship clinic.
View Article and Find Full Text PDFBackground & Aims: International guidance advocates the avoidance of prolonged preoperative fasting due to its negative impact on perioperative hydration. This study aimed to assess the adherence to these guidelines for fasting in patients undergoing elective and emergency surgery in the East Midlands region of the UK.
Methods: This prospective audit was performed over a two-month period at five National Health Service (NHS) Trusts across the East Midlands region of the UK.
Background And Aims: Hypertriglyceridaemia is both a primary cause of acute pancreatitis and an epiphenomenon. This study aimed to define the associations between hypertriglyceridaemia and clinical outcomes in patients admitted with acute pancreatitis.
Methods: This single-centre prospective observational study included patients with a confirmed clinical, biochemical or radiological diagnosis of acute pancreatitis from August 2017 to September 2018.
Aims: This meta-analysis aimed to define the perioperative risk of mortality in patients with alcoholic liver disease (ALD) undergoing extrahepatic gastrointestinal surgery.
Methods: Systematic searches of Embase, Medline and CENTRAL were undertaken to identify studies reporting about patients with ALD undergoing extrahepatic gastrointestinal surgery published since database inception to January 2019. Studies were only considered if they reported on mortality as an outcome.