China
Africa
Explore chapters and articles related to this topic
Cardiac surgery
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
EuroSCORE II is the system commonly used to predict risk for patients in the UK and can be an independent predictor of major adverse cardiac events (MACEs). Therefore, it can be used to determine the risk of revascularisation irrespective of, and even before, the selection of treatment strategy. However, it is important to acknowledge that no risk score can accurately predict events in an individual patient. Moreover, limitations exist with all databases used to build risk models, and differences in definitions and variable content can affect the performance of risk scores when they are applied across different populations. Ultimately risk stratification should be used as a guide, while clinical judgement and multidisciplinary discussion (Heart Team) remain essential.
Risk and the Harm Caused by Healthcare
Published in Bill Runciman, Alan Merry, Merrilyn Walton, Safety and Ethics in Healthcare, 2007
Bill Runciman, Alan Merry, Merrilyn Walton
The physical condition of the patient is very important in this context. In an Australian review of medical records, three-quarters of all preventable deaths occurred in patients over 65 years of age, and the chance of an adverse event resulting in death in this age group was 10 times greater than that for patients under 45.15 Patients may be given some idea of their individual risk for certain types of problems by reference to various risk indices or scoring systems. The risk of having a heart attack or stroke in association with a non-cardiac operation is increased by several factors, the relative importance of each of which has been encapsulated in one such index, shown in Table 2.3. The patient’s risk is directly related to the total number of points scored using this table. The Euroscore is another example, and allows the risk of cardiac surgery to be predicted for individual patients with reasonable accuracy.23
Patient risk assessment: Use of risk calculators
Published in John Edward Boland, David W. M. Muller, Interventional Cardiology and Cardiac Catheterisation, 2019
The EuroSCORE is the European System for Cardiac Operative Risk Evaluation, which again was deduced from a large (almost 20,000 patient) database.25 This database was contributed to by many European countries, the largest of which were Germany, UK, Spain, Finland, France and Italy. The EuroSCORE II risk factors and information can be seen in Table 12.9, and is possible to apply using mental arithmetic. There is a more detailed version, the Logistic EuroSCORE that can be more accurate in predicting risk for high-risk patients. This is shown in Table 12.9, and requires computed calculations. It is advised that using the online risk calculator is the most accurate and easiest way of calculating risk with the EuroScore II.
Neutrophil Gelatinase-Associated Lipocalin (NGAL) and cystatin C are early biomarkers of acute kidney injury associated with cardiac surgery
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2022
Anne Cecilie K. Larstorp, Cathrin Lytomt Salvador, Bjørn Andreas Svensvik, Olav Klingenberg, Sonia Distante
In this prospective observational study, we included patients ≥18 years old scheduled to undergo elective cardiac surgery (e.g. coronary artery bypass graft [CABG] surgery and/or valve replacement surgery, or heart transplantations) with the use of extracorporeal circulation at Oslo University Hospital Rikshospitalet, during a period of six months in 2014. Preoperatively, the patients were evaluated by using the EuroSCORE (European system for cardiac operative risk evaluation), a risk model for the prediction of mortality related to cardiac surgery [17]. Exclusion criteria were preoperative eGFR <30 mL/min/1.73m2, renal replacement therapy and/or sepsis [18]. The Regional Ethics Committee approved the study protocol, all patients signed a written informed consent form, and the study was conducted in accordance with the Helsinki declaration.
Validation for EuroSCORE II in the Indonesian cardiac surgical population: a retrospective, multicenter study
Published in Expert Review of Cardiovascular Therapy, 2022
Juni Kurniawaty, Budi Yuli Setianto, Yunita Widyastuti, Supomo Supomo, Cindy E Boom, Cornelia Ancilla
The EuroSCORE model is one of the most commonly used risk scoring systems in cardiac surgery. The original EuroSCORE was developed in 1999 and had the highest discriminatory power among risk models of its time and it worked well in predicting 30-day postoperative mortality of cardiac surgery patients in many European countries as well as in the United States [6–8]. The EuroSCORE II was developed as an improvement to the original model’s performance [9]. The application of the EuroSCORE system for populations outside Europeans should be used with caution. Although the physiological characteristics are similar among all cardiac surgery patients, there are different interactions and impacts of various risk factors on individuals in different populations. Interactions between risk factors and a patient’s genetic makeup may be varied between populations [10].
Negative pressure wound therapy in the treatment of deep sternal wound infections – a critical appraisal
Published in Scandinavian Cardiovascular Journal, 2021
Heidi-Mari Myllykangas, Leena T. Berg, Annastina Husso, Jari Halonen
The most notable result emerging from our study is the significantly higher mortality in the NPWT group. Uneven distribution of patient or operation-derived characteristics do not explain this result. In fact, EuroSCORE II values were slightly higher in the control group. EuroSCORE II is a risk model predicting mortality after cardiac surgery. The higher EuroSCORE II values would suggest higher mortality in the control group, in contrast to our findings. El Oakley classification, described in Table 2, shows comparable distributions in both groups. There were a slightly higher number of positive blood cultures in the NPWT group as well as somewhat higher C-reactive protein (CRP) levels at the time of the first debridement. These differences were not statistically significant. However, in the NPWT group, the CRP levels continued to rise after the debridement leading to significantly higher overall CRP levels. The flap reconstruction in the control group carried out 4.66 ± 12.1 days after diagnosis, led to a faster decline in the CRP levels.