Background: The purpose of this study was to investigate the predictive value of the modified systemic inflammation score (mSIS) in postoperative unplanned admission to the intensive care unit (ICU) in patients with non-small-cell lung cancer (NSCLC).
Methods: The clinical data of 1,321 patients with NSCLC treated with thoracic surgery in our hospital from August 2019 to June 2021 were analyzed retrospectively. The preoperative mSIS, which takes into account the serum albumin (ALB) level and lymphocyte-to-monocyte ratio (LMR), was recorded as 0, 1 or 2 and then was used to identify high-risk patients with unplanned admission to the ICU. The independent risk factors for unplanned admission to the ICU in patients with NSCLC after surgery were identified by multivariate logistic regression analysis.
Results: A total of 1,321 patients, including 549 (41.6%) males and 772 (58.4%) females, were included. The median age was 57 years (range 16-95 years). The incidence of unplanned admission to the ICU in patients with mSIS = 2 was significantly higher than that in those with mSIS = 0 and mSIS = 1. The multivariate analysis showed that an mSIS of 2 (OR = 3.728; = 0.004; 95% CI, 1.520-9.143), an alcohol consumption history (OR = 2.791, = 0.011; 95% CI, 1.262-6.171), intraoperative infusion volume (OR = 1.001, = 0.021; 95% CI, 1.000-1.001) and preoperative underlying diseases (OR = 3. 57, = 0.004; 95% CI, 1.497-8.552) were independent risk factors for unplanned admission to the ICU after lung cancer surgery. In addition, the multivariate logistic regression model showed that the C-statistic value was 0.799 (95% CI: 0.726∼0.872, < 0.001).
Conclusions: The mSIS scoring system can be used as a simplified and effective predictive tool for unplanned ICU admission in patients with NSCLC.
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http://dx.doi.org/10.3389/fsurg.2022.893555 | DOI Listing |
J Clin Med
January 2025
Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University, Hat-Yai 90110, Thailand.
Frailty is increasingly being recognized as a risk factor for adverse outcomes in older surgical patients undergoing surgery. We investigated the association between frailty and intraoperative complications using multiple frailty assessment tools in older patients undergoing elective intermediate- to high-risk non-cardiac surgery. This retrospective cohort study included 637 older patients scheduled for elective non-cardiac surgery.
View Article and Find Full Text PDFWorld J Surg Oncol
January 2025
Canisius Wilhelmina Ziekenhuis, Nijmegen, Gelderland, Netherlands.
Background: Breast conserving surgery (BCS) with partial breast reconstruction (PBR) results in less morbidity, better cosmetic outcomes, and improved patient satisfaction compared to mastectomy. Perforator flap reconstruction can attenuate defects prone to breast deformity after BCS. Usually, postoperative drains and inpatient admission are part of this treatment.
View Article and Find Full Text PDFAnaesth Crit Care Pain Med
January 2025
City Cardiological Center, Almaty, Kazakhstan.
Acute Heart Failure (AHF) is a leading cause of death and represents the most frequent cause of unplanned hospital admission in patients older than 65 years. Since the past decade, several randomized clinical trials have highlighted the importance and pivotal role of certain therapeutics, including decongestion by the combination of loop diuretics, the need for rapid goal-directed medical therapies implementation before discharge, risk stratification, and early follow-up after discharge therapies. Cardiogenic shock, defined as sustained hypotension with tissue hypoperfusion due to low cardiac output and congestion, is the most severe form of AHF and mainly occurs after acute myocardial infarction, which can progress to multiple organ failure.
View Article and Find Full Text PDFAnn Emerg Med
January 2025
Division of Pediatrics, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel. Electronic address:
Study Objective: To cover pediatric emergency physicians' off-hours, third-year pediatric residents in Israel are trained for unsupervised administration of emergency department (ED) dissociative and deep sedation. We assessed the frequency of critical sedation events associated with resident-performed sedations.
Methods: We conducted a retrospective chart review on all patients receiving intravenous sedation across 10 pediatric EDs between January 2018 and September 2022.
Health Serv Insights
January 2025
Spacelabs Healthcare, Snoqualmie, WA, USA.
Background: Quality improvement initiatives in the acute care setting often target reduction of mortality and length of stay (LOS). Unplanned care escalations are associated with increased mortality risk and prolonged LOS, but may be precipitated by different factors, including appropriate triage, bed availability, and post-admission deterioration.
Objectives: This work evaluates different transfer timeframes to quantify the impact of deterioration-associated unplanned transfers to intensive care (ICU) on mortality and LOS, informing evidence-based interventions to improve patient care.
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