Database : MEDLINE
Search on : Sepsis [Words]
References found : 92227 [refine]
Displaying: 1 .. 10   in format [Detailed]

page 1 of 9223 go to page                         

  1 / 92227 MEDLINE  
              next record last record
select
to print
Photocopy
Full text

[PMID]: 26101326
[Au] Autor:Wynn JL; Scumpia PO; Stocks BT; Romano-Keeler J; Alrifai MW; Liu JH; Kim AS; Alford CE; Matta P; Weitkamp JH; Moore DJ
[Ad] Address:Division of Neonatology, Department of Pediatrics, Vanderbilt University, Nashville, TN 37232; james.wynn@peds.ufl.edu....
[Ti] Title:Neonatal CD71+ Erythroid Cells Do Not Modify Murine Sepsis Mortality.
[So] Source:J Immunol;195(3):1064-70, 2015 Aug 1.
[Is] ISSN:1550-6606
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Sepsis is a major cause of neonatal mortality and morbidity worldwide. A recent report suggested that murine neonatal host defense against infection could be compromised by immunosuppressive CD71(+) erythroid splenocytes. We examined the impact of CD71(+) erythroid splenocytes on murine neonatal mortality to endotoxin challenge or polymicrobial sepsis and characterized circulating CD71(+) erythroid (CD235a(+)) cells in human neonates. Adoptive transfer or an Ab-mediated reduction in neonatal CD71(+) erythroid splenocytes did not alter murine neonatal survival to endotoxin challenge or polymicrobial sepsis challenge. Ex vivo immunosuppression of stimulated adult CD11b(+) cells was not limited to neonatal splenocytes; it also occurred with adult and neonatal bone marrow. Animals treated with anti-CD71 Ab showed reduced splenic bacterial load following bacterial challenge compared with isotype-treated mice. However, adoptive transfer of enriched CD71(+) erythroid splenocytes to CD71(+)-reduced animals did not reduce bacterial clearance. Human CD71(+)CD235a(+) cells were common among cord blood mononuclear cells and were shown to be reticulocytes. In summary, a lack of effect on murine survival to polymicrobial sepsis following adoptive transfer or diminution of CD71(+) erythroid splenocytes under these experimental conditions suggests that the impact of these cells on neonatal infection risk and progression may be limited. An unanticipated immune priming effect of anti-CD71 Ab treatment, rather than a reduction in immunosuppressive CD71(+) erythroid splenocytes, was likely responsible for the reported enhanced bacterial clearance. In humans, the well-described rapid decrease in circulating reticulocytes after birth suggests that they may have a limited role in reducing inflammation secondary to microbial colonization.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1507
[Cu] Class update date: 150718
[Lr] Last revision date:150718
[Js] Journal subset:AIM; IM
[St] Status:In-Data-Review
[do] DOI:10.4049/jimmunol.1500771

  2 / 92227 MEDLINE  
              first record previous record next record last record
select
to print
Photocopy
Full text

[PMID]: 25962083
[Au] Autor:Wong HR; Cvijanovich NZ; Anas N; Allen GL; Thomas NJ; Bigham MT; Weiss SL; Fitzgerald J; Checchia PA; Meyer K; Shanley TP; Quasney M; Hall M; Gedeit R; Freishtat RJ; Nowak J; Raj SS; Gertz S; Dawson E; Howard K; Harmon K; Lahni P; Frank E; Hart KW; Lindsell CJ
[Ad] Address:1Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center and Cincinnati Children's Research Foundation, Cincinnati, OH. 2Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH. 3Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland, Oakland, CA. 4Division of Critical Care Medicine, Children's Hospital of Orange County, Orange, CA. 5Division of Critical Care Medicine, Children's Mercy Hospital, Kansas City, MO. 6Division of Critical Care Medicine, Penn State Hershey Children's Hospital, Hershey, PA. 7Division of Critical Care Medicine, Akron Children's Hospital, Akron, OH. 8Division of Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA. 9Division of Critical Care Medicine, Texas Children's Hospital, Houston, TX. 10Division of Critical Care Medicine, Miami Children's Hospital, Miami, FL. 11Division of Critical Care Medicine, CS Mott Children's Hospital at the University of Michigan, Ann Arbor, MI. 12Division of Critical Care Medicine, Nationwide Children's Hospital, Columbus, OH. 13Division of Critical Care Medicine, Children's Hospital of Wisconsin, Milwaukee, WI. 14Division of Critical Care Medicine, Children's National Medical Center, Washington, DC. 15Division of Critical Care Medicine, Children's Hospital and Clinics of Minnesota, Minneapolis, MN. 16Division of Critical Care Medicine, Riley Hospital for Children, Indianapolis, IN. 17Division of Critical Care Medicine, Hackensack University Medical Center, Joseph M. Sanzari Children's Hospital, Hackensack, NJ. 18Division of Critical Care Medicine, The University of Chicago Comer Children's Hospital, Chicago, IL. 19Department of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, OH.
[Ti] Title:A Multibiomarker-Based Model for Estimating the Risk of Septic Acute Kidney Injury.
[So] Source:Crit Care Med;43(8):1646-53, 2015 Aug.
[Is] ISSN:1530-0293
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE: The development of acute kidney injury in patients with sepsis is associated with worse outcomes. Identifying those at risk for septic acute kidney injury could help to inform clinical decision making. We derived and tested a multibiomarker-based model to estimate the risk of septic acute kidney injury in children with septic shock. DESIGN: Candidate serum protein septic acute kidney injury biomarkers were identified from previous transcriptomic studies. Model derivation involved measuring these biomarkers in serum samples from 241 subjects with septic shock obtained during the first 24 hours of admission and then using a Classification and Regression Tree approach to estimate the probability of septic acute kidney injury 3 days after the onset of septic shock, defined as at least two-fold increase from baseline serum creatinine. The model was then tested in a separate cohort of 200 subjects. SETTING: Multiple PICUs in the United States. INTERVENTIONS: None other than standard care. MEASUREMENTS AND MAIN RESULTS: The decision tree included a first-level decision node based on day 1 septic acute kidney injury status and five subsequent biomarker-based decision nodes. The area under the curve for the tree was 0.95 (CI95, 0.91-0.99), with a sensitivity of 93% and a specificity of 88%. The tree was superior to day 1 septic acute kidney injury status alone for estimating day 3 septic acute kidney injury risk. In the test cohort, the tree had an area under the curve of 0.83 (0.72-0.95), with a sensitivity of 85% and a specificity of 77% and was also superior to day 1 septic acute kidney injury status alone for estimating day 3 septic acute kidney injury risk. CONCLUSIONS: We have derived and tested a model to estimate the risk of septic acute kidney injury on day 3 of septic shock using a novel panel of biomarkers. The model had very good performance in a test cohort and has test characteristics supporting clinical utility and further prospective evaluation.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1507
[Cu] Class update date: 150718
[Lr] Last revision date:150718
[Js] Journal subset:AIM; IM
[St] Status:In-Data-Review
[do] DOI:10.1097/CCM.0000000000001079

  3 / 92227 MEDLINE  
              first record previous record next record last record
select
to print
Photocopy
Full text

[PMID]: 25962082
[Au] Autor:Rhee C; Murphy MV; Li L; Platt R; Klompas M; Centers for Disease Control and Prevention Prevention Epicenters Program
[Ad] Address:1Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA. 2Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA.
[Ti] Title:Lactate Testing in Suspected Sepsis: Trends and Predictors of Failure to Measure Levels.
[So] Source:Crit Care Med;43(8):1669-76, 2015 Aug.
[Is] ISSN:1530-0293
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVES: Serum lactate monitoring is central to risk stratification and management of sepsis and is now part of a potential quality measure. We examined 11-year trends in lactate testing and predictors of failure to measure lactates in patients with severe sepsis. DESIGN: Retrospective cohort study. SETTING: Two U.S. academic hospitals. PATIENTS: Adult patients admitted from 2003 to 2013. INTERVENTIONS: Annual rates of lactate measurement were assessed in patients who had blood cultures ordered and patients with severe sepsis, as defined by concomitant International Classification of Diseases, Ninth Revision codes for infection and organ dysfunction. The approximate time of suspected sepsis was determined by the first blood culture order with concurrent antibiotic initiation. Multivariate analysis was performed to identify predictors of failure to measure lactates in severe sepsis cases in 2013. MEASUREMENTS AND MAIN RESULTS: Among hospitalizations with blood culture orders, rates of lactate measurement increased from 11% in 2003 to 48% in 2013 (p < 0.001 for linear trend). Rates of repeat lactate measurement within 6 hours after lactate levels greater than or equal to 4.0 mmol/L increased from 23% to 69% (p < 0.001). Patients were progressively less likely to be on vasopressors at the time of first lactate measurement (49% in 2003 vs 21% in 2013; p < 0.001). Despite these trends, lactates were measured at the time of suspected sepsis in only 65% of patients with severe sepsis in 2013. On multivariate analysis, hospital-onset sepsis and hospitalization on a nonmedical service were significant predictors of failure to measure lactates (adjusted odds ratio, 7.56; 95% CI, 6.31-9.06 and adjusted odds ratio, 2.08; 95% CI, 1.76-2.24, respectively). CONCLUSIONS: Lactate testing has increased dramatically over time and is being extended to patients without overt shock. However, rates of serial lactate testing are still suboptimal, and lactates are not being measured in many patients with severe sepsis. Hospital-onset sepsis and nonmedical units may be high-yield targets for quality improvement initiatives.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1507
[Cu] Class update date: 150718
[Lr] Last revision date:150718
[Js] Journal subset:AIM; IM
[St] Status:In-Data-Review
[do] DOI:10.1097/CCM.0000000000001087

  4 / 92227 MEDLINE  
              first record previous record next record last record
select
to print
Photocopy
Full text

[PMID]: 25867906
[Au] Autor:Semler MW; Weavind L; Hooper MH; Rice TW; Gowda SS; Nadas A; Song Y; Martin JB; Bernard GR; Wheeler AP
[Ad] Address:1Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University School of Medicine, Nashville, TN. 2Division of Anesthesiology Critical Care Medicine, Vanderbilt University, Nashville, TN. 3Department of Internal Medicine, Eastern Virginia Medical School, Norfolk, VA. 4Division of Critical Care, Christian Medical College Hospital, Vellore, Tamil Nadu, India. 5Institute for Software Integrated Systems, Vanderbilt University School of Engineering, Nashville, TN. 6Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN. 7Department of Internal Medicine, Meharry Medical College, Nashville, TN.
[Ti] Title:An Electronic Tool for the Evaluation and Treatment of Sepsis in the ICU: A Randomized Controlled Trial.
[So] Source:Crit Care Med;43(8):1595-602, 2015 Aug.
[Is] ISSN:1530-0293
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVES: To determine whether addition of an electronic sepsis evaluation and management tool to electronic sepsis alerting improves compliance with treatment guidelines and clinical outcomes in septic ICU patients. DESIGN: A pragmatic randomized trial. SETTING: Medical and surgical ICUs of an academic, tertiary care medical center. PATIENTS: Four hundred and seven patients admitted during a 4-month period to the medical or surgical ICU with a diagnosis of sepsis established at the time of admission or in response to an electronic sepsis alert. INTERVENTIONS: Patients were randomized to usual care or the availability of an electronic tool capable of importing, synthesizing, and displaying sepsis-related data from the medical record, using logic rules to offer individualized evaluations of sepsis severity and response to therapy, informing users about evidence-based guidelines, and facilitating rapid order entry. MEASUREMENTS AND MAIN RESULTS: There was no difference between the electronic tool (218 patients) and usual care (189 patients) with regard to the primary outcome of time to completion of all indicated Surviving Sepsis Campaign 6-hour Sepsis Resuscitation Bundle elements (hazard ratio, 1.98; 95% CI, 0.75-5.20; p = 0.159) or time to completion of each element individually. ICU mortality, ICU-free days, and ventilator-free days did not differ between intervention and control. Providers used the tool to enter orders in only 28% of available cases. CONCLUSIONS: A comprehensive electronic sepsis evaluation and management tool is feasible and safe but did not influence guideline compliance or clinical outcomes, perhaps due to low utilization.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1507
[Cu] Class update date: 150718
[Lr] Last revision date:150718
[Js] Journal subset:AIM; IM
[St] Status:In-Data-Review
[do] DOI:10.1097/CCM.0000000000001020

  5 / 92227 MEDLINE  
              first record previous record next record last record
select
to print
Photocopy
PubMed Central Full text
Full text

[PMID]: 25993608
[Au] Autor:Yu JY; Zhang B; Peng L; Wu CH; Cao H; Zhong JF; Hoffman J; Huang SH
[Ad] Address:Department of Microbiology, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou 510515, China; Saban Research Institute of Children's Hospital Los Angeles, Department of Pediatrics, Keck School of Med...
[Ti] Title:Repositioning of Memantine as a Potential Novel Therapeutic Agent against Meningitic E. coli-Induced Pathogenicities through Disease-Associated Alpha7 Cholinergic Pathway and RNA Sequencing-Based Transcriptome Analysis of Host Inflammatory Responses.
[So] Source:PLoS One;10(5):e0121911, 2015.
[Is] ISSN:1932-6203
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Neonatal sepsis and meningitis (NSM) remains a leading cause worldwide of mortality and morbidity in newborn infants despite the availability of antibiotics over the last several decades. E. coli is the most common gram-negative pathogen causing NSM. Our previous studies show that α7 nicotinic receptor (α7 nAChR), an essential regulator of inflammation, plays a detrimental role in the host defense against NSM. Despite notable successes, there still exists an unmet need for new effective therapeutic approaches to treat this disease. Using the in vitro/in vivo models of the blood-brain barrier (BBB) and RNA-seq, we undertook a drug repositioning study to identify unknown antimicrobial activities for known drugs. We have demonstrated for the first time that memantine (MEM), a FDA-approved drug for treatment of Alzheimer's disease, could very efficiently block E. coli-caused bacteremia and meningitis in a mouse model of NSM in a manner dependent on α7 nAChR. MEM was able to synergistically enhance the antibacterial activity of ampicillin in HBMEC infected with E. coli K1 (E44) and in neonatal mice with E44-caused bacteremia and meningitis. Differential gene expression analysis of RNA-Seq data from mouse BMEC infected with E. coli K1 showed that several E44-increased inflammatory factors, including IL33, IL18rap, MMP10 and Irs1, were significantly reduced by MEM compared to the infected cells without drug treatment. MEM could also significantly up-regulate anti-inflammatory factors, including Tnfaip3, CISH, Ptgds and Zfp36. Most interestingly, these factors may positively and negatively contribute to regulation of NF-κB, which is a hallmark feature of bacterial meningitis. Furthermore, we have demonstrated that circulating BMEC (cBMEC) are the potential novel biomarkers for NSM. MEM could significantly reduce E44-increased blood level of cBMEC in mice. Taken together, our data suggest that memantine can efficiently block host inflammatory responses to bacterial infection through modulation of both inflammatory and anti-inflammatory pathways.
[Pt] Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Entry month:1505
[Cu] Class update date: 150530
[Lr] Last revision date:150530
[Js] Journal subset:IM
[St] Status:In-Process
[do] DOI:10.1371/journal.pone.0121911

  6 / 92227 MEDLINE  
              first record previous record next record last record
select
to print
Photocopy
Full text

[PMID]: 25927681
[Au] Autor:Rodriguez BF; Mascaraque LR; Fraile LR; Perez IC; Kuder K
[Ad] Address:Medical Doctor (M.D.) Pediatrics/Neonatology, Department of Neonatology, Santa Elena Medical Center , Madrid , Spain.
[Ti] Title:Streptococcus pneumoniae: the forgotten microorganism in neonatal sepsis.
[So] Source:Fetal Pediatr Pathol;34(3):202-5, 2015 Jun.
[Is] ISSN:1551-3823
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:UNLABELLED: Streptococcus pneumoniae is a rarely cause of neonatal sepsis. Its prevalence is low but with a mortality of 50%. Measures to prevent Streptococcus agalactiae transmission could help to increase Invasive Pneumococcal Disease (IPD) in newborns. Transmission could be from mother intrapartum; or in those cases of late onset sepsis, the community carriers. Systematic vaccination with PCV-7 and PCV-13 has reduced IPD rates. We present a case of a newborn with no perinatal risk factors for infection. In the first 24 hours after surgery of an ovarian cyst, the patient started with bad general condition with fever and regular perfusion. Empiric antibiotic treatment was started. Streptococcus pneumoniae was isolated in blood culture. CONCLUSION: In neonatal sepsis, we always think in Streptococcus agalactiae. Streptococcus pneumoniae is rare but with a high morbidity and mortality. Systematic vaccination is a measure that has demonstrated a reduction in the incidence of Invasive pneumococcal disease.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1505
[Js] Journal subset:IM
[St] Status:In-Process
[do] DOI:10.3109/15513815.2015.1033073

  7 / 92227 MEDLINE  
              first record previous record next record last record
select
to print
Photocopy
Full text

[PMID]: 26085680
[Au] Autor:Bergstrm B; Aune MH; Awuh JA; Kojen JF; Blix KJ; Ryan L; Flo TH; Mollnes TE; Espevik T; Stenvik J
[Ad] Address:Centre of Molecular Inflammation Research, Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim N-7491, Norway;...
[Ti] Title:TLR8 Senses Staphylococcus aureus RNA in Human Primary Monocytes and Macrophages and Induces IFN- Production via a TAK1-IKK-IRF5 Signaling Pathway.
[So] Source:J Immunol;195(3):1100-11, 2015 Aug 1.
[Is] ISSN:1550-6606
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Staphylococcus aureus may cause serious infections and is one of the most lethal and common causes of sepsis. TLR2 has been described as the main pattern recognition receptor that senses S. aureus and elicits production of proinflammatory cytokines via MyD88 -: NF-κB signaling. S. aureus can also induce the production of IFN-, a cytokine that requires IFN regulatory factors (IRFs) for its transcription, but the signaling mechanism for IFN- induction by S. aureus are unclear. Surprisingly, we demonstrate that activation of TLR2 by lipoproteins does not contribute to IFN- production but instead can suppress the induction of IFN- in human primary monocytes and monocyte-derived macrophages. The production of IFN- was induced by TLR8-mediated sensing of S. aureus RNA, which triggered IRF5 nuclear accumulation, and this could be antagonized by concomitant TLR2 signaling. The TLR8-mediated activation of IRF5 was dependent on TAK1 and IκB kinase (IKK), which thus reveals a physiological role of the recently described IRF5-activating function of IKK. TLR8 -: IRF5 signaling was necessary for induction of IFN- and IL-12 by S. aureus, and it also contributed to the induction of TNF. In conclusion, our study demonstrates a physiological role of TLR8 in the sensing of entire S. aureus in human primary phagocytes, including the induction of IFN- and IL-12 production via a TAK1 -: IKK -: IRF5 pathway that can be inhibited by TLR2 signaling.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1507
[Js] Journal subset:AIM; IM
[St] Status:In-Data-Review
[do] DOI:10.4049/jimmunol.1403176

  8 / 92227 MEDLINE  
              first record previous record next record last record
select
to print
Photocopy
Full text

[PMID]: 26092539
[Au] Autor:Maeda K; Kanaoka Y; Ohki T; Sumi M; Toya N; Fujita T
[Ad] Address:Division of Vascular Surgery, Department of Surgery, Jikei University School of Medicine, Tokyo, Japan koji-m@jikei.ac.jp....
[Ti] Title:Better Clinical Practice Could Overcome Patient-Related Risk Factors of Vascular Surgical Site Infections.
[So] Source:J Endovasc Ther;22(4):640-6, 2015 Aug.
[Is] ISSN:1545-1550
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: To clarify the current status of surgical site infection (SSI) during endovascular aortic repair and to define risk factors for SSI among the patients who underwent thoracic or abdominal stent-graft repair through a groin incision. METHODS: Between 2006 and 2013, data were collected from 1604 patients (mean age 75.29.5 years; 1282 men) with 2799 groin incisions for transfemoral access during aortic stent-graft procedures. SSIs were classified as superficial or deep (both occurring within 30 days) or organ/space infections (occurring within 1 year after surgery) according to the Centers for Disease Control and Prevention guidelines. Strategies in place for minimizing SSIs were (1) employing oblique groin incisions, (2) covering the incision with saline-soaked gauze, (3) irrigating the incision thoroughly with saline per layer, and (4) using absorbable sutures. RESULTS: Overall incidence of SSI was 0.4% (6 patients). The majority of SSIs were late-onset prosthetic graft infections (5, 0.3%). Five of the 6 were successfully treated with conservative therapy; one patient died of sepsis. Univariate analysis showed additional therapy (eg, coil embolization) with a stent-graft procedure was a risk factor for SSI. CONCLUSION: Appropriate antibiotic administration, oblique groin incision, meticulous operative technique, protection against airborne infection during the operation, and closed dressings may avert vascular wound SSIs.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1507
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1177/1526602815591553

  9 / 92227 MEDLINE  
              first record previous record next record last record
select
to print
Photocopy
Full text

[PMID]: 26185876
[Au] Autor:Tanaka R; Kosugi S; Sato D; Hirukawa H; Tada T; Ichikawa H; Hanyu T; Ishikawa T; Kobayashi T; Wakai T
[Ad] Address:Division of Digestive Surgery, Tachikawa Medical Center, Niigata, Japan, tanakaryo1001@med.niigata-u.ac.jp.
[Ti] Title:Conservative treatment of esophageal perforation related to a peptic ulcer with pyloric stenosis.
[So] Source:Clin J Gastroenterol;7(4):295-8, 2014 Aug.
[Is] ISSN:1865-7265
[Cp] Country of publication:Japan
[La] Language:eng
[Ab] Abstract:We report a case of esophageal perforation (Boerhaave syndrome) caused by vomiting related to a duodenal ulcer with pyloric stenosis. A 45-year-old male presented with left chest pain and dyspnea after forceful vomiting. Chest radiography and computed tomography (CT) revealed a massive left pleural effusion and left tension pneumothorax. Abdominal CT revealed pyloric stenosis with a remarkably dilated stomach. Tube thoracostomy and nasogastric suction were immediately performed and we selected conservative treatment based on the following factors-a stable general condition without sepsis, early diagnosis, and good drainage. Esophagogastroduodenoscopy on hospital day 9 demonstrated a healing ulcer in the lower esophagus and pyloric stenosis. We performed distal gastrectomy as elective surgery for pyloric stenosis due to a duodenal ulcer on hospital day 30. In summary, an esophageal perforation with contamination spreading to the thoracic cavity was successfully treated with conservative treatment.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1507
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1007/s12328-014-0493-3

  10 / 92227 MEDLINE  
              first record previous record
select
to print
Photocopy
Full text

[PMID]: 26072111
[Au] Autor:Matulewicz RS; Sharma V; McGuire BB; Oberlin DT; Perry KT; Nadler RB
[Ad] Address:Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL. Electronic address: richard.matulewicz@northwestern.edu....
[Ti] Title:The effect of surgical duration of transurethral resection of bladder tumors on postoperative complications: An analysis of ACS NSQIP data.
[So] Source:Urol Oncol;33(8):338.e19-24, 2015 Aug.
[Is] ISSN:1873-2496
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Transurethral resection of bladder tumor (TURBT) is a common procedure used in the diagnosis and treatment of bladder cancer. Despite how often it is performed, not much is known about the risk factors for complications. Traditional surgery has an increase in morbidity and mortality with increasing operative duration. We assess the effect of operative duration on TURBT complications. METHODS: The years 2006 to 2012 of the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) were queried for patients undergoing TURBT. We separated patients into 4 groups based on operative time: 0 to 30 minutes, 30.1 to 60 minutes, 60.1 to 90 minutes, and greater than 90 minutes. Standard statistical analysis including multivariate regression was performed to determine predictors of complications. RESULTS: A total of 10,599 TURBTs were included in our analysis. The overall complication rate for TURBT was 5.8% and there was an increase in the rate of complications seen as operative duration increased, which remained after controlling for age, comorbidities, tumor size, and American Society of Anesthesiology classification. Increased operative duration was associated with a greater risk of postoperative urinary tract infection, sepsis or septic shock, pulmonary embolism/deep venous thrombosis, reintubation or failure to wean, myocardial infarction, and death. Larger tumors were related to an increased odds of requiring blood transfusions. CONCLUSIONS: Using a contemporary multicenter cohort of TURBTs from the ACS NSQIP database, we demonstrate that increased operative duration is associated with serious postoperative complications. This association was found to persist even after adjusting for patient age, comorbidities, tumor size, and functional status.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1507
[Js] Journal subset:IM
[St] Status:In-Data-Review


page 1 of 9223 go to page                         
   


Refine the search
  Database : MEDLINE Advanced form   

    Search in field  
1  
2
3
 
           



Search engine: iAH v2.6 powered by WWWISIS

BIREME/PAHO/WHO - Latin American and Caribbean Center on Health Sciences Information