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Last Updated: 15 May 2022

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In-hospital complication–related risk factors for discharge and 90-day outcomes in patients with aneurysmal subarachnoid hemorrhage after surgical clipping and endovascular coiling: a propensity score–matched analysis

OBJECTIVE VIEW More than ten years have passed since two of the best-known clinical trials of ruptured aneurysms found that endovascular coiling was superior to surgical clipping. The growth of surgical techniques has greatly improved in recent years, but it is also important to reanalyze the effects of the differences in treatment methods on patients with aneurysmal subarachnoid hemorrhage. To determine each independent predictor's prediction ability within treatment groups, each independent predictor's prediction ability was used. In comparison to 329 patients who underwent EC, PSM's control for sex, aneurysm location, Hunt and Hess grade, updated Fisher Scale score, and current smoking and alcohol use were reduced. In the SC and EC groups, a positive correlation was found between the number of in-hospital events and total hospital charges.

Source link: https://doi.org/10.3171/2021.10.jns211484


Association of Uric Acid and C-reactive Protein with the Severity of Coronary Artery Disease Using SYNTAX Score and Clinical SYNTAX Score

SXscore's use in longer-term risk has been further enhanced by clinical factors, enhancing the SXscore's usefulness to longer-term risk. Atherosclerosis and CAD are both related to serum uric acid. However, serum uric acid mixed with CRP may be able to determine the SXscore and CSS. Methods: In this research, a total of 208 patients with chest pain were included. SXs and CSS showed a positive correlation with age and CRP. SXscore and CSS were correlated with DM and fasting glucose, respectively. Both maximum and high CSS predictive accuracy were measured using receiver operator characteristic curves at 0. 205 mg/dL and 0. 145 mg/dL respectively. Conclusion: Serum CRP is closely related to SXscore and CSS, although serum UA is unrelated with CSS. CRP forecasts high CSS at a lower level than CRP forecasts SXscore, but not at a lower price than predicted SXscore. SXscore and CSS can be predicted using serum CRP and serum UA.

Source link: https://doi.org/10.1532/hsf.2397


Impact of Controlling Nutritional Status Score (CONUT) and Prognostic Nutritional Index (PIN) on Patients Undergoing Coronary Artery Bypass Graft Surgery

Background: The aim of this study is to determine the adverse effects of hunger in patients with coronary artery disease undergoing coronary artery bypass graft surgery. Methods: We analyzed 149 patients who underwent coronary artery bypass surgery in this research, determining how they differed. The patients' nutritional status was determined using a controllable nutritional status score and a prognostic nutritional status. After coronary artery bypass graft surgery, there are obvious correlations between the severe controlling nutritional status score and prognostic nutritional index groups, as well as morbidity and mortality.

Source link: https://doi.org/10.1532/hsf.2493


Correlation Between Vasoactive-Inotropic Score and Postoperative Acute Kidney Injury after Cardiovascular Surgery

This review was designed to find the connection between Vasoactive-Inotropic Score and postoperative acute kidney injury in adult patients with cardiovascular disease. Additionally, studies of the relationship of VIS-max to postoperative AKI were calculated by calculating the net reclassification and discrimination improvement with the addition of the VIS-max to a baseline model of the Society of Thoracic Surgeons score for investigating the correlation of VIS-max and postoperative AKI. In 291 patients with AKI, 3 patients with AKI class 1, 12 patients with AKI class 2, 12 students with AKI class 2, and 15 patients with AKI class 3 required RRT. According to a multivariate logistic regression study, VIS-max was correlated with postoperative AKI and the need for RRT in AKI patients. VIS-max's combined STS score for predicting postoperative AKI and the requirement of RRT were significantly higher than the AUC's VIS-max, STS score, and EuroSCORE.

Source link: https://doi.org/10.1532/hsf.3537


A new grading system focusing on neurological outcomes for brain metastases treated with stereotactic radiosurgery: the modified Basic Score for Brain Metastases

Object The Basic Score for Brain Metastases Lattencion and colleagues developed by Lorenzoni and colleagues is one of the most useful grading methods for forecasting survival times after stereotactic radiosurgery of brain metastases. Methods The authors analyzed key brain variables for both preservation of neurological function and prevention of neurological disease as 0 or 10 = 1, respectively. Patients were divided into two subgroups: Subgroup A with a total NPS of 3 or 4 and Subgroup B with an NPS of 0, 1, or 2. According to the original BSBM groups' NPS subgroup classification, the authors characterized the modified BSBM according to the NPS subgroup classification that was not applicable to the initial BSBM groups. SRS-related brain metastases treated with SRS in 2838 consecutive patients with brain metastases were confirmed. 2089 patients and Subgroup B 749 at Subgroup A had 2089 patients and Subgroup B 749 had 749. In BSBM 0, 5. 7 in BSBM 1, 11. 4 in BSBM 2 and 21. 7 in BSBM 3, and pairwise differences between the two BSBM groups were statistically significant, with pairwise comparisons between the BSBM groups being 2. 6 months, 5. 7 in BSBM 0, 11. 4 in BSBM 2 and 21. 7 in BSBM 3, and 21. 7 in BSBM 2 and 21. 7 in BSBM 3 BSBM 1 BSBM 1 BSBM 1 BSBM 1 BSBM 1 BSBM 2 BSBM 2 BSBM 3 BSBM 3 BSBM 3 BSBM 2 BSBM 3 BSBM 3 3. 6 in BSBM 2 BSBM 2 BSBM 11. 4 in BSBM 12. 4 in BSBM 22. 4 in BSBM 22. 1 BSBM 21. 7 in BSBM 21. 6 in BSBM 3 BSBM 3 BSBM 21. 7 in BSBM 3 2. 6 in BSBM 3 2. 6, 21. 7 in BSBM 3 2. 6, 21. 8 in both subgroups A and B, statistically significant differences in both qualitative and neurological survival were found in both qualitative and neurological survivals.

Source link: https://doi.org/10.3171/2014.7.gks14980


Impact of Glasgow Coma Scale score and pupil parameters on mortality rate and outcome in pediatric and adult severe traumatic brain injury: a retrospective, multicenter cohort study

OBJECTIVE PREDICTION of death and function is crucial in determining treatment plans and allocation of funds for patients with severe traumatic brain injury. Patients with severe TBI who are 15 years old have a reduced mortality risk and improved outcomes than adults with severe TBI, according to this research, who use pupillary status and Glasgow Coma Scale score. METHODS A retrospective cohort review of patients suffering from severe TBI who were registered in the German Society for Trauma Surgery's Trauma Registry between 2002 and 2013 was carried out. The Severe TBI was defined as an Abbreviated Injury Scale of the head score of 3 and an AIS score for any other area of the body that does not meet the AIS head record. The adult mortality risk and mortality rate for patients with a GCS of 3 and bilaterally fixed and dilated pupils was higher than that of the pediatric patients, although pediatric resuscitation rates were significantly higher in pediatric patients. CONCLUSIONS This analysis found that severe TBI in children aged 15 years is correlated with a reduced mortality risk and improved functional outcomes than in adults. Also, children who are missing motor response or fixed, bilaterally dilated pupils, as well as adults with the same initial presentation have a lower mortality risk and improved functional outcome.

Source link: https://doi.org/10.3171/2016.1.jns152385


A propensity score analysis of the impact of surgical intervention on unexpected 30-day readmission following admission for subdural hematoma

OBJECTIVE Subdural hematoma is a common disorder that is increasingly being treated nonoperatively. This research seeks to investigate the incidence of unexpected 30-day readmission in a cohort of patients admitted to an academic neurosurgical center. METHODS This is an observational review of 200 consecutive adult patients with SDH admitted to an academic medical center's neurosurgical ICU. Surgery administration was not directly related to the likelihood of a positive outcome at hospital discharge, according to a logistic regression model weighted by the inverse probability of diagnosis and including probable confounders, but it did have a significant reduction in the likelihood of unexpected readmissions. CONCLUSION Over 25% of SDH patients admitted to an academic neurosurgical ICU were unexpectedly readmitted within 30 days. Even adjusting for the likelihood of treatment by propensity score weighed logistic regression, clinical outcomes did not influence outcome at hospital discharge, but it is highly associated with readmission.

Source link: https://doi.org/10.3171/2017.6.jns17188


Validation of the unruptured intracranial aneurysm treatment score: comparison with real-world cerebrovascular practice

OBJECTIVE The aim of this report was to compare the initial aneurysm treatment score recommendations in a quaternary academic medical center with a high number of patients with unruptured intracranial aneurysms. METHODS The METHODS were used to evaluate patients with UIAs during a 3-year follow-up period. RESULTS: The following summarized the findings: A total of 221 consecutive patients with UIAs met the inclusion criteria: 69 patients underwent hospitalization and 152 did not. Patients aged between 0 and 2, which does not provide a treatment recommendation, left 162 patients with a UIATS treatment plan. The UIATS did not offer hospitalization to 51% of patients for whom care would be advised by the UIATS did not participate in the real-world cohort, and 20% of patients for whom conservative management was not suggested by UIATS had intervention. 0. 646 square kilometers were covered by the ROC curve.

Source link: https://doi.org/10.3171/2017.4.jns17548


Inverse national trends of laser interstitial thermal therapy and open surgical procedures for refractory epilepsy: a Nationwide Inpatient Sample–based propensity score matching analysis

Despite its effectiveness, OBJECTIVE Surgery for medically refractory epilepsy is underutilized treatment strategy. Patients with a primary diagnosis of RE with a primary diagnosis of RE were included in either open surgeries or LITT. RESULTS A cohort of 128,525 in-hospital patients with RE was included, and 5. 5% of these patients underwent either open surgical procedures or LITT. For the open cohort, the median LOS was 1 day for the LITT cohort and 4 days for the open cohort. LITT was associated with reduced median LOS, high risk of discharge home, and lower median index hospitalization charges compared to new procedures for PSM analysis. LITT is a safe treatment modality in carefully selected patients with RE, and it provides the opportunity to increase the use of surgical procedures in patients who may be unable to open surgery or have contraindications that prohibit open surgery.

Source link: https://doi.org/10.3171/2020.1.focus19935


Multivariate risk factor analysis and literature review of postoperative deterioration in Karnofsky Performance Scale score in elderly patients with skull base meningioma

OBJECTIVE Following surgery, elderly patients are particularly vulnerable to severe morbidity following surgery. Meningioma surgery's key risk factors, age, and skull base location are among the various risk factors. This research sought to identify risk factors in elderly patients with skull base meningioma. METHODS The authors' institute and affiliate hospitals treated a total of 265 elderly patients with meningioma surgically treated between 2000 and 2016, and the findings were reviewed. 57 patients with skull base meningioma were evaluated among them. The authors also reviewed 11 surgical studies of elderly patients 60 years old with meningioma. At the maximum diameter, the mean size of meningitis was 36. 6 14. 8 mm, and the mean follow-up period was 31. 1 31. 5 months. Location, preoperative KPS score, BMI level 2, and serum albumin levels were all found to be negative prognostic factors, according to a Univariate analysis. According to multivariate research, location and BMI were risk factors for KPS score decline right after surgery. According to the 11 papers reviewed, the median prevalence of skull base-related location was 45. 5 percent; for asymptomatic status, the mean was 24 percent; and for mortality at 3 months and 1 year were 6. 3% and 8. 8 respectively; CONCLUSION The preoperative assessment based on the frailty model was vital to ensure better results in elderly patients with skull base meningioma. BMI is a determinant that measures frailty, especially in elderly people with skull base meningioma.

Source link: https://doi.org/10.3171/2018.1.focus17730

* Please keep in mind that all text is summarized by machine, we do not bear any responsibility, and you should always check original source before taking any actions

* Please keep in mind that all text is summarized by machine, we do not bear any responsibility, and you should always check original source before taking any actions