Living alone predicts non-home discharge post elective hip arthroplasty: A matched-pair cohort study.

The impact of home support and interaction with family members on recovery and perioperative outcomes remains unclear. We determined whether living alone was predictive of discharge disposition following total hip arthroplasty (THA). Data were from American College of Surgeons National Surgical Quality Improvement Program participating hospitals in 2021.

Comprehensive Dynamic 3-Dimensional Analysis of the Tricuspid Valve in Functional Tricuspid Regurgitation: Implications for Prophylactic Tricuspid Valve Intervention.

Objectives: To track and measure changes in the tricuspid annulus (TA) using 3-dimensional (3D) echocardiography during a complete cardiac cycle in patients with functional tricuspid regurgitation (TR) compared to patients without TR, and to compare tricuspid annular plane systolic excursion (TAPSE) derived from 2-dimensional (2D) and 3D coordinates as a measure of right ventricular (RV) function to the standard method of 2D fractional area change (FAC).

Design: Intraoperative 3D echocardiography data were collected prospectively, followed by postprocessing software analysis to track and reconstruct changes throughout the cardiac cycle.

Setting: Data were collected from 108 patients undergoing left-sided heart surgery at 2 large academic centers-Beth Israel Deaconess Medical Center in Boston, MA and Rhode Island Hospital, Providence, RI-between November 2018 and April 2020.

The impact of social vulnerability index on survival following autologous stem cell transplant for multiple myeloma.

Autologous hematopoietic stem cell transplantation (ASCT) is the standard of care for eligible patients with multiple myeloma (MM) to prolong progression-free survival (PFS). While several factors affect survival following ASCT, the impact of social determinants of health such as the CDC Social Vulnerability Index (SVI) is not well documented. This single-center retrospective analysis evaluated the impact of SVI on PFS following ASCT in MM patients.

Impact of functional status on 30-day resource utilization and organ system complications following index bariatric surgery: a cohort study.

Background: Bariatric surgical procedures carry an appreciable risk profile despite their elective nature. Identified risk factors for procedural complications are often limited to medical comorbidities. This study assesses the impact of functional status on resource utilization and organ system complications following bariatric surgery.

Undiagnosed Factor VII Deficiency in Cardiac Surgery Complicated by Bleeding: A Case Report.

Rare bleeding disorders in the perioperative period call for targeted resuscitation strategies. Factor VII deficiency, for instance, is often corrected with exogenous administration of recombinant factor VIIa. This activated clotting factor, initially designed for patients with hemophilia A or B with factor inhibitors, is gaining popularity as a salvage therapy for severe and persistent traumatic and surgical bleeding.

Effect of regional versus general anesthesia on thirty-day outcomes following carotid endarterectomy: a cohort study.

Background: The effect of regional versus general anesthesia on carotid endarterectomy outcomes is debated. This study assesses the effect of anesthetic technique on major morbidity and mortality and additional secondary endpoints following carotid endarterectomy.

Materials And Methods: This was a retrospective propensity-matched-cohort analysis investigating elective carotid endarterectomy patients in the 2015-2019 American College of Surgeons National Surgical Quality Improvement Program ( n =37 204).

Effect of spinal versus general anesthesia on thirty-day outcomes following total hip arthroplasty: A matched-pair cohort analysis.

Study Objective: It has not yet been established whether total hip arthroplasty complications are associated with anesthetic technique (spinal versus general). This study assessed the effect of spinal versus general anesthesia on health care resource utilization and secondary endpoints following total hip arthroplasty.

Design: Propensity-matched cohort analysis.

Late surgical start time is associated with increased blood transfusion following gastric bypass surgery.

Background: Surgical start time (SST) has demonstrated conflicting effects on perioperative outcomes due to confounding factors, such as increased acuity in later SST cases. This study investigated the effect of SST on blood transfusion after gastric bypass surgery, a complication-prone elective surgical procedure.

Methods: This retrospective cohort study included all patients undergoing gastric bypass surgery at a single academic medical center from 2016 through 2021 (n = 299).

Positive SARS-CoV-2 detection on intraoperative nasopharyngeal viral testing is not associated with worse outcomes for asymptomatic elective surgical patients.

Background: It has been demonstrated that surgical patients with COVID-19 are at increased risk for postoperative complications. However, this association has not been tested in asymptomatic elective surgical patients.

Methods: A retrospective cohort study among elective gynecological and spine surgery patients at a single tertiary medical center from July 2020 through April 2022 ( = 1,130) was performed.

A systemic congestive index (systemic pulse pressure to central venous pressure ratio) predicts adverse outcomes in patients undergoing valvular heart surgery.

Background And Aims: Invasive hemodynamics may provide a more nuanced assessment of cardiac function and risk phenotyping in patients undergoing cardiac surgery. The systemic pulse pressure (SPP) to central venous pressure (CVP) ratio represents an integrated index of right and left ventricular function and thus may demonstrate an association with valvular heart surgery outcomes. This study hypothesized that a low SPP/CVP ratio would be associated with mortality in valvular surgery patients.

The Effect of State-Level Prescription Opioid Legislation on Patient Outcomes After Lumbar Tubular Microdecompression.

Background: In the United States, a statewide legislation titled the Strengthen Opioid Misuse Prevention (STOP) Act was enacted in 2017 to limit prescription opioid use and reduce dependence. The impact of state legislation curbing opioid prescription on outcomes after spine surgery is unknown.

Study Design: Case series.

A Novel Hemodynamic Index of Post-operative Right Heart Dysfunction Predicts Mortality in Cardiac Surgical Patients.

Introduction: This study aimed to investigate whether mortality following cardiac surgery was associated with the pulmonary artery pulsatility index (PAPi): pulmonary artery pulse pressure divided by central venous pressure (CVP), and a novel index: mean pulmonary artery pressure (mPAP) minus CVP.

Methods: This retrospective analysis investigated all cardiac surgery patients in the Society of Thoracic Surgeons registry at a single academic medical center from January 2017 through March 2020 (n = 1510). The primary and secondary outcomes were mortality at 1 year and serum creatinine increase during index surgical admission, respectively.

Effect of enhanced recovery after surgery for elective cesarean deliveries on neonatal outcomes.

Objective: To evaluate the impact of initiation of an enhanced recovery after cesarean delivery (ERAC) protocol for elective cesarean delivery (CD) on neonatal outcomes.

Study Design: We performed a retrospective analysis of elective CD at ≥39 weeks gestational age between September 2014 and August 2018 at a single institution before and after ERAC protocol implementation. Our primary outcome was composite neonatal complication rate and secondary outcome was rate of breastfeeding.

Preclinical Proficiency-Based Model of Ultrasound Training.

Background: Graduate medical education is being transformed from a time-based training model to a competency-based training model. While the application of ultrasound in the perioperative arena has become an expected skill set for anesthesiologists, clinical exposure during training is intermittent and nongraduated without a structured program. We developed a formal structured perioperative ultrasound program to efficiently train first-year clinical anesthesia (CA-1) residents and evaluated its effectiveness quantitatively in the form of a proficiency index.

The effect of smoking on achieving meaningful clinical outcomes one year after lumbar tubular microdecompression: a matched-pair cohort analysis.

Background Context: There has been a shift in the spine literature in reporting meaningful outcomes, including meaningful clinically important difference (MCID), after surgery. The evidence on the effect of tobacco smoking at the time of lumbar tubular microdecompression (LTMD) on meaningful outcomes is limited.

Purpose: To compare differences in 1-year functional outcomes and rates of achieving MCID between current smokers and non-smokers who underwent LTMD for lumbar spinal stenosis (LSS).

Defining a Minimum Clinically Important Difference in Patient-Reported Outcome Measures in Lumbar Tubular Microdecompression Patients.

Background: Patient-reported outcome measures (PROMs) are critical tools used in the assessment and reporting of surgical outcomes. However, significant differences in PROM scores have not been shown to consistently correlate with clinical improvement from the physician or patient perspective. Defining a minimum clinically important difference (MCID) for PROMs offers interpretation of surgical outcomes with an emphasis on patient-centered feedback.

Cost and Complications of Single-Level Lumbar Decompression in Those Over and Under 75: A Matched Comparison.

Study Design: Retrospective database analysis.

Objective: This study aimed to compare costs and complication rates following single-level lumbar decompression in patients under age 75 versus patients aged 75 and older.

Summary Of Background Data: Lumbar decompression is a common surgical treatment for lumbar pathology; however, its effectiveness can be debated in elderly patients because complication rates and costs by age group are not well-defined.

Accurate prediction of lumbar microdecompression level with an automated MRI grading system.

Objective: Lumbar spine MRI interpretations have high variability reducing utility for surgical planning. This study evaluated a convolutional neural network (CNN) framework that generates automated MRI grading for its ability to predict the level that was surgically decompressed.

Materials And Methods: Patients who had single-level decompression were retrospectively evaluated.

Heated Air Delivery by Micro-Sauna: An Experimental Treatment Prototype Concept for Coronavirus Disease 2019.

Coronavirus disease 2019 (COVID-19) has gained international attention as it poses a significant threat to global health. Currently, medical researchers are working to exhaust all strategies that may prove beneficial in combating this disease. Heat has been shown to destabilize other coronavirus strains in testing environments, and it has been hypothesized that heated air may destabilize viral pathogens in vivo as well.

Lumbar microdecompression in elderly versus general adult patients: Comparable outcomes and costs despite group differences.

This study investigated differences between patients <65 and ≥65 years of age following lumbar microdecompression. Differences between age groups were investigated with univariate analyses. A linear mixed effects model was fit to the study outcomes.

Should the EuroQol-Five Dimensions Replace the Oswestry Disability Index When Tracking Lumbar Tubular Microdecompression Outcomes?

Objective: Patient-reported outcomes measures (PROMs) are critical in evaluating the effectiveness of surgical spine interventions. The Oswestry Disability Index (ODI) is commonly used but tedious to administer routinely. The EuroQol-5 Dimensions (EQ-5D) questionnaire is easier to administer but not traditionally used to measure spine surgical results.

Far Lateral Tubular Decompression: A Case Series Studying One and Two Year Outcomes with Predictors of Failure.

Introduction The optimal surgical treatment of isolated lumbar foraminal stenosis has not been defined. Minimally invasive decompression of the foramen from a far lateral tubular decompression (FLTD) approach has been shown to not only have minimal morbidity but also highly variable success rates at short-term follow-up. It is important to quantify improvement and define the demographic and radiographic parameters that predict failure in this promising, minimally invasive surgical technique.

Unilateral Laminotomy with Bilateral Decompression: A Case Series Studying One- and Two-Year Outcomes with Predictors of Minimal Clinical Improvement.

Objective: To assess factors that may predict failure to improve at 12 and 24 months after unilateral laminotomy with bilateral decompression (ULBD) for the management of lumbar spinal stenosis.

Methods: A database of 255 patients who underwent microdecompression surgery by a single orthopedic spine surgeon between 2014 and 2018 was queried. Patients who underwent primary single-level ULBD of the lumbar spine were included.

Evaluation of the quality of transesophageal echocardiography images and verification of proficiency.

Various metrics have been used in curriculum-based transesophageal echocardiography (TEE) training programs to evaluate acquisition of proficiency. However, the quality of task completion, that is the final image quality, was subjectively evaluated in these studies. Ideally, the endpoint metric should be an objective comparison of the trainee-acquired image with a reference ideal image.