The Assessment of Complications After Major Abdominal Surgery: A Comparison of Two Scales.

Background: An accurate and reproducible method for the evaluation of postoperative morbidity is essential for a valid assessment of the outcomes of surgery. However, there is still no consensus on reporting of complications. The Clavien-Dindo classification (CDC) of complications is a validated system which reports only the most severe complication.

Impact of intraoperative blood pressure, blood pressure fluctuation, and pulse pressure on postoperative delirium in elderly patients with hip fracture: A prospective cohort study.

Aim: Postoperative delirium (PD) is a frequent complication of hip fracture surgery, but its pathophysiology remains poorly understood. We investigated the impact of a single episode of intraoperative hyper/hypotension, blood pressure (BP) fluctuation (ΔMAP), and pulse pressure (PP) on hyper/hypoactive PD in elderly patients undergoing surgery for hip fracture. We also assessed the effect of PD on clinical outcomes.

High incidence of multiresistant bacterial isolates from bloodstream infections in trauma emergency department and intensive care unit in Serbia.

We investigated the incidence of bloodstream infections (BSIs) in trauma emergency department (ED) and intensive care unit (ICU), to assess ED- and ICU-related predictors of BSI and to describe the most common bacteria causing BSI and their antimicrobial resistance markers. A prospective study was conducted in two trauma ICUs of the ED of Clinical Center of Serbia. Overall, 62 BSIs were diagnosed in 406 patients, of which 13 were catheter-related BSI (3.

Bacterial bloodstream infections in level-I trauma intensive care unit in Serbia: incidence, causative agents and outcomes.

Introduction: We aimed to describe incidence, outcomes and antimicrobial resistance markers of causative agents of bacterial BSI in the intensive care unit (ICU) in a trauma center in Serbia.

Methodology: Prospective surveillance was conducted from November 2014 to April 2016 in two trauma-surgical ICUs of the Emergency Department of Clinical center of Serbia. Bloodstream infections were diagnosed using the definitions of Center for Disease Control and Prevention.

Agreement between CDC/NHSN surveillance definitions and ECDC criteria in diagnosis of healthcare-associated infections in Serbian trauma patients.

After three national point prevalence studies (PPS) of healthcare associated infections (HAI) conducted in Serbian acute care hospitals using US (CDC/NHSN) surveillance definitions, Serbia is about to switch to European (ECDC) criteria for the purpose of the fourth HAI PPS. The aim of this study was to compare the US and the European HAI definitions in Serbian trauma intensive care unit (ICU). Prospective surveillance was performed at two surgical-trauma ICUs of the Emergency department of Clinical Center of Serbia.

The association of early postoperative lactate levels with morbidity after elective major abdominal surgery.

Lactate levels are widely used as an indicator of outcome in critically ill patients. We investigated the prognostic value of postoperative lactate levels for postoperative complications (POCs), mortality and length of hospital stay after elective major abdominal surgery. A total of 195 patients were prospectively evaluated.

Noninvasive Ventilation of Patients with Acute Respiratory Distress Syndrome. Insights from the LUNG SAFE Study.

Rationale: Noninvasive ventilation (NIV) is increasingly used in patients with acute respiratory distress syndrome (ARDS). The evidence supporting NIV use in patients with ARDS remains relatively sparse.

Objectives: To determine whether, during NIV, the categorization of ARDS severity based on the Pa/Fi Berlin criteria is useful.

Twenty-Eight-Day Mortality of Blunt Traumatic Brain Injury and Co-Injuries Requiring Mechanical Ventilation.

Objective: This paper aims to assess the impact of co-injuries and consequent emergency surgical interventions and nosocomial pneumonia on the 28-day mortality of patients with severe traumatic brain injuries (TBIs).

Subjects And Methods: One hundred and seventy-seven patients with TBI admitted to the emergency trauma intensive care unit at the Clinical Center of Serbia for more than 48 h were studied over a 1-year period. On admission, the Glasgow Coma Scale (GCS), Injury Severity Score (ISS) and Acute Physiology and Chronic Health Evaluation II score (APACHE II) were calculated.

SELF-REPORTED DRUG ALLERGIES IN SURGICAL POPULATION IN SERBIA.

History of drug allergy is of major concern during perioperative period. Medical records usually lack documents confirming the stated allergy. This study aimed to investigate the prevalence of self-reported drug allergies and their characteristics in adult Serbian surgical population, and to analyze their influence on drug prescription during perioperative period.

Surgical management of AAST grades III-V hepatic trauma by Damage control surgery with perihepatic packing and Definitive hepatic repair-single centre experience.

Background: Severe liver injury in trauma patients still accounts for significant morbidity and mortality. Operative techniques in liver trauma are some of the most challenging. They include the broad and complex area, from damage control to liver resection.

Risk factors for ventilator-associated pneumonia in patients with severe traumatic brain injury in a Serbian trauma centre.

Introduction: The aims of this study were (1) to assess the incidence of ventilator-associated pneumonia (VAP) in patients with traumatic brain injury (TBI), (2) to identify risk factors for developing VAP, and (3) to assess the prevalence of the pathogens responsible.

Patients And Methods: The following data were collected prospectively from patients admitted to a 24-bed intensive care unit (ICU) during 2013/14: the mechanism of injury, trauma distribution by system, the Acute Physiology and Chronic Health Evaluation (APACHE) II score, the Abbreviated Injury Scale (AIS) score, the Injury Severity Score (ISS), underlying diseases, Glasgow Coma Scale (GCS) score, use of vasopressors, need for intubation or cardiopulmonary resuscitation upon admission, and presence of pulmonary contusions. All patients were managed with a standardized protocol if VAP was suspected.

Estimating the effect of incident delirium on short-term outcomes in aged hip fracture patients through propensity score analysis.

Aim: We aimed to evaluate the factors contributing to delirium after hip fracture and assess the effect of incident delirium on short-term clinical outcomes.

Methods: A total of 270 non-delirious, consecutive hip fracture patients 60 years and older were included in a prospective cohort study. The patients were assessed with respect to physical status according to the American Society of Anesthesiologists classification, medical comorbidities with the Charlson Comorbidity Index, cognitive function with the Portable Mental Status Questionnaire and depression with the Geriatric Depressive Scale.

Effect of the overlap syndrome of depressive symptoms and delirium on outcomes in elderly adults with hip fracture: a prospective cohort study.

Objectives: To analyze the incidence of the overlap syndrome of depressive symptoms and delirium, risk factors, and independent and dose-response effect of the overlap syndrome on outcomes in elderly adults with hip fracture.

Design: Prospective cohort study.

Setting: University hospital.

Predictors of severe pain in the immediate postoperative period in elderly patients following hip fracture surgery.

Introduction: The aim of this study was to identify risk factors for severe postoperative pain immediately after hip-fracture surgery.

Patients And Methods: Three hundred forty-four elderly patients with an acute hip fracture were admitted to the hospital during a 12-months period. All patients who entered the study answered a structured questionnaire to assess demographic characteristics, previous diseases, drug use, previous surgery, and level of education.

[Outcome among patients suffering from in-hospital cardiac arrest].

Introduction: In relation to pre-hospital treatment of patients with cardiac arrest (CA) in the field where resuscitation is often started by nonprofessionals, resuscitation in hospital is most commonly performed by well-trained personnel.

Objective: The aim was to define the factors associated with an improved outcome among patients suffering from the in-hospital CA (IHCA).

Methods: The prospective study included a total of 100 patients in the Emergency Center over two-year period.

Free vascularised fibular grafts in orthopaedics.

Bony defects caused by trauma, tumors, infection or congenital anomalies can present a significant surgical challenge. Free vascularised fibular bone grafts (FVFGs) have proven to be extremely effective in managing larger defects (longer than 6 cm) where other conventional grafts have failed. FVFGs also have a role in the treatment of avascular necrosis (AVN) of the femoral head, failed spinal fusions and complex arthrodeses.

Severe road traffic injuries and youth: a 4-year analysis for the city of Belgrade.

The objective of this study is to describe severe road traffic injuries (RTIs) in the population under 18 years in Belgrade, the capital of Serbia. We analysed both severe non-fatal and fatal RTIs in children and adolescents under 18 years old in the Belgrade area, during the period 2008-2011. Data sources were the official statistics of the Public Health Institute in Belgrade and forensic-medical records from two paediatric university hospitals and five university hospitals for adults.

Spontaneous rupture of giant liver hemangioma: case report.

Introduction: Hemangioma is the most frequent benign solid tumor of the liver. It is well known that a giant liver hemangioma carries the risk of spontaneous rupture, followed by hemoperitoneum and hemorrhagic shock with possible fatal outcome.

Case Outline: This is a case report of the spontaneous rupture of a giant cavernous hemangioma of the liver in an 85-year old patient.

Routine chest radiographs in the surgical intensive care unit: can we change clinical habits with no proven benefit?

Daily routine chest radiographs (CR) are commonly performed in surgical ICU. Unnecessary CR increase costs and expose the staff and the patients to radiation risk. The goal of our study was to estimate the value of daily routine CR in the ICU and to determine the correlation between CR and physical findings in surgical ICU patients.

Glissonean pedicle approach in major liver resections.

Background/aims: Liver resections are still one of the most challenging operations. The aim of this study was to analyze the efficiency and safety of the intrahepatic Glissonean pedicle approach vs. classical Hilar dissection in major hepatectomies.

[Psoas major abscess by heroin addictive patients--a case report].

Drug abuse is related to many medical complications, which depend on the drug type, dose injected, the method of delivery and site of injection. We report a case of psoas abscess in young heroin addict, HIV negative, who was admitted in Emergency Center of Clinical Center in Belgrade because of fever, anaemia, prostration and right groin pain. Clinical and radiological examination were performed.

Risk factors and distribution of symptomatic venous thromboembolism in total hip and knee replacements: prospective study.

Purpose: Venous thromboembolism (VTE) is a common complication of orthopaedic surgery in the industrialised world; though there may be variability between population groups. This study aims to define the incidence and risk factors for symptomatic VTE following primary elective total hip and knee arthoplasty surgery in a single centre in Eastern Europe.

Methods: This prospective study included 499 adult patients undergoing total hip and knee arthroplasty for symptomatic osteoarthritis over a two-year period at the Clinic of Orthopaedic Surgery and Traumatology, Belgrade.

Overlooked dislocation of C6/C7 vertebra with minimal neurologic deficit.

The beginning of 21 century was marked by an enormous increase in the number of traffic accidents, which led to an increasing number of multiple injured patients with associated injuries, especially injuries of cervical spine, because of its anatomical features. Even in the era of modern diagnostic procedures, cervical spine injuries are still often overlooked, especially in multiple injured patients and unconscious patients, and the consequences of undiagnosed injuries can be fatal. Very often there are ligamentous lesions, which can be detected only by using NMR, while the osteoarticular lesions can be diagnosed through careful clinical examination, X-rays and CT scan.

Impact of the injury pattern on the pedestrian fatalities in the city of Belgrade.

Introduction: In the city of Belgrade pedestrians are under the high risk to sustain injuries in the road traffic accidents, they are often with multiple injuries, with long-term treatment and significant consequences. Most of them are in the )senior or in the school age group.

Methods: We present the results of the epidemiological analysis of the mechanism of injury and treatment outcome of the pedestrians who sustained the lower limb injuries and additional, the injuries of the other organic systems.

Segment-oriented liver resections based on posterior intrahepatic glissonian approach.

Background: Segment-oriented liver resections can be performed effective by posterior intrahepatic approach. A significance of such resection - is that they are oncologically radical as well as parenchyma-sparing.

Methodology: Segmental liver resections were performed in 102 patients with liver tumors.