AI Article Synopsis
- Prolonged pleural effusion/chylothorax (PPE/C) is a complication in pediatric cardiac surgery that has not been thoroughly studied, prompting this investigation into its incidence, risk factors, and impact on outcomes.
- A multicentre study collected data on multiple post-operative complications across 5 UK hospitals, finding that PPE/C occurred in 6.5% of patients, typically 6 days after surgery, and increased mortality primarily in patients with multiple other complications.
- The study concludes that while PPE/C is associated with increased mortality, it does not significantly extend hospital length of stay in cases with multiple complications, highlighting the need for effective prevention and management strategies for PPE/C in complex post-operative care.
Article Abstract
Objectives: Prolonged pleural effusion/chylothorax (PPE/C) is a less investigated complication following paediatric cardiac surgery, and its true incidence, risk factors and impact on postoperative outcomes are not well described. We aim to address these gaps in knowledge using data from a prospective, multicentre study.
Methods: Data on 9 post-operative morbidities (unplanned reinterventions, extracorporeal life support, necrotising enterocolitis, PPE/C, renal replacement therapy, major adverse events, acute neurological events, feeding issues and postsurgical infection) were prospectively collected at 5 UK centres between 2015 and 2017, following paediatric cardiac surgery. Incidence of PPE/C, associations with procedure types, and risk factors were described. Mortality (30-day and 6-month) and hospital length of stay (HLoS) were compared between those with isolated PPE/C, single non-PPE/C morbidity, no morbidity, multimorbidity PPE/C and non-PPE/C multimorbidity.
Results: A total of 3090 procedures (2861 patients) were included (median age, 228 days). There were 202 PPE/C (incidence of 6.5%), occurring at a median of 6 days postoperatively (interquartile range: 3-10). PPE/C was associated with excess early mortality only when complicating scenarios where at least 2 other post-operative morbidities occurred. On average PPE/C is associated with 8 more HLoS days, but the relative impact is greatest when comparing isolated PPE/C with no morbidity (P < 0.001), whereas in multimorbidity scenarios, PPE/C does not significantly contribute to an increase of HLoS.
Conclusions: Addition of PPE/C increases mortality but not HLoS in multimorbidity and HLoS only in single morbidity scenarios. This reinforces the important role of prevention, early detection and management of PPE/C in complex situations.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522863 | PMC |
| http://dx.doi.org/10.1093/ejcts/ezae363 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Association of Albumin-To-Creatinine Ratio With Diabetic Retinopathy Among US Adults (NHANES 2009-2016).
Endocrinol Diabetes Metab
January 2025
Department of Endocrinology and Metabolism, Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Objective: This study investigates the relationship between the albumin-to-creatinine ratio and diabetic retinopathy (DR) in US adults using NHANES data from 2009 to 2016. This study assesses the predictive efficacy of the urinary serum albumin-to-creatinine ratio (UACR/SACR Ratio) against traditional biomarkers such as the serum albumin-to-creatinine ratio (SACR) and urinary albumin-to-creatinine ratio (UACR) for evaluating DR risk. Additionally, the study explores the potential of these biomarkers, both individually and in combination with HbA1c, for early detection and risk stratification of DR.
View Article and Find Full Text PDFSevere obesity, a susceptibility factor for developing inflammatory bowel disease. Results of a population-based study.
J Crohns Colitis
January 2025
Servei d'Aparell Digestiu, Hospital Universitari Germans Trias i Pujol (Badalona, Catalonia, Spain).
Background And Aims: Inflammatory bowel disease (IBD) develops in genetically susceptible individuals exposed to certain environmental factors, of which only a few have been established. We aimed to assess whether bariatric surgery (BS) and severe obesity are associated with an increased risk of developing IBD.
Methods: Adults diagnosed with obesity or severe obesity between 2005 and 2020 were identified from the Catalan Health Surveillance System; those diagnosed with IBD prior to the diagnosis of obesity or severe obesity were excluded.
Retinal detachment after acute retinal necrosis: a retrospective analysis of hospitalized patients.
Jpn J Ophthalmol
January 2025
Department of Visual Science and Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Purpose: To review hospitalized patients with Acute Retinal Necrosis (ARN) and investigate factors associated with subsequent retinal detachment (RD).
Study Design: Retrospective.
Methods: The study included 40 patients (42 eyes), categorized into non-RD (23 eyes) and RD (19 eyes) groups.
Pharmacologic Management of Heart Failure with Preserved Ejection Fraction (HFpEF) in Older Adults.
Drugs Aging
January 2025
Program for the Care and Study of the Aging Heart, Department of Medicine, Weill Cornell Medicine, 420 East 70th St, New York, NY, LH-36510063, USA.
There are several pharmacologic agents that have been touted as guideline-directed medical therapy for heart failure with preserved ejection fraction (HFpEF). However, it is important to recognize that older adults with HFpEF also contend with an increased risk for adverse effects from medications due to age-related changes in pharmacokinetics and pharmacodynamics of medications, as well as the concurrence of geriatric conditions such as polypharmacy and frailty. With this review, we discuss the underlying evidence for the benefits of various treatments in HFpEF and incorporate key considerations for older adults, a subpopulation that may be at higher risk for adverse drug events.
View Article and Find Full Text PDFAssessing early therapeutic drug monitoring of adalimumab as a predictor of treatment efficacy and immunogenicity in rheumatic diseases: "early therapeutic drug monitoring of adalimumab".
Clin Rheumatol
January 2025
Department of Public Health, University of Murcia, Campus de Ciencias de la Salud, Murcia, 30120, Spain.
Introduction: Therapeutic drug monitoring (TDM) in inflammatory rheumatic diseases (RMDs) is gaining interest. However, there are unresolved questions about the best practices for implementing TDM effectively in clinical settings.
Objective: The primary objective of this study was to evaluate whether early TDM of adalimumab predicts drug survival at 52 weeks in patients with RMDs.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!