7 research outputs found
Epithelial splenic cysts and life-threatening splenic rupture
No full textRezumat Chisturile epiteliale splenice aei ruptura splenicã care pune viaåa în pericol Premize/Scopul lucrãrii: Chisturile primitive splenice sunt relativ rare aei sunt de cele mai multe ori clasificate drept chisturi epiteliale, acestea fiind mai frecvente la tineri. În majoritata cazurilor sunt asimptomatice fiind descoperite incidental la examenele imagistice sau în timpul laparotomiei. Raportãm douã cazuri rare de pacienåi cu chisturi epiteliale splenice descoperite incidental în timpul laparotomiei de urgenåã pentru rupturã splenicã. Material aei Metodã: Primul pacient este un bãrbat de 70 ani care s-a prezentat cu simptome de abdomen acut dupã un acces de tuse în timpul unui episod de astm. Laparotomia de urgenåã a descoperit rupturã de splinã aei hemoragie intraperitonealã. S-a practicat splenectomie iar examenul histopatologic a evidenåiat rupturã splenicã cu un chist epitelial. Al doilea pacient este un bãrbat de 19 ani care a fost transferat în Departamentul de Urgenåã în aeoc hipovolemic datorat hemoragiei intraperitoneale dupã un traumatism abdominal închis. În cursul laparotomiei s-a descoperit rupturã splenicã aei un chist epitelial. Concluzie: chisturile epiteliale splenice sunt entitãåi rare aei pot fi descoperite incidental în timpul tratamentului chirurgical al rupturii splenice aei a hemoperitoneului. Aceste chisturi pot fi factori predispozanåi ai rupturii splenice în caz de presiune intraabdominalã crescutã sau traumatisme abdominale închise. Cuvinte cheie: chist epitelial splenic, rupturã splenicã, descoperire incidentalã, laparotomie Abstract Background/Aim: Primary splenic cysts are relatively uncommon and in the majority of cases are classified as epithelial cysts which are more frequent in young patients. Most of them are asymptomatic, and they are found incidentally during imaging techniques or laparotomy. We report two rare cases of patients with epithelial splenic cysts as an incidental finding during emergency laparotomy for splenic rupture. Materials and Method: The first patient was a 70-year-old man who presented with symptoms of acute abdomen after intensive cough during an episode of asthma. Emergency laparotomy findings were splenic rupture and intraperitoneal haemorrhage. A splenectomy was performed and the histological examination showed a ruptured spleen with an epithelial cyst. The second patient was a 19-year-old man who was transferred to the Emergency Department in hypovolemic shock due to intraperitoneal bleeding after a blunt abdominal injury. During laparotomy a splenic rupture was found, and an epithelial cyst. Conclusion: Epithelial splenic cysts are a rare entity and they can be an incidental finding during the surgical treatment of a spleen rupture and haemoperitoneum. These cysts may b
Prospective observational cohort study on grading the severity of postoperative complications in global surgery research
No full textNestle Health Sciences
The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis
No full textThe ISOS study was funded through an unrestricted research
grant from Nestle Health Sciences. T.E.F.A. is supported by a
Medical Research Council/British Journal of Anaesthesia clinical
research training fellowship. B.B. is funded by a National
Research Foundation rating grant and an MRC (SA) selfinitiated
research grant. M.G. is a Chief Scientist Office (Scotland)
NHS Research Scheme Clinician. R.P. is a UK National
Institute for Health Research Professor
Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries The International Surgical Outcomes Study group
No full textFunded by Nestle Health Sciences through an unrestricted research grant, by a
National Institute for Health Research Professorship held by
R.P., and sponsored by Queen Mary University of London
Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries
No full textThis was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London
Use of failure-to-rescue to identify international variation in postoperative care in low-, middle- and high-income countries: A 7-day cohort study of elective surgery
No full textThe incidence and impact of postoperative complications are poorly described. Failure-to-rescue, the rate of death following complications, is an important quality measure for perioperative care but has not been investigated across multiple health care systems. Methods. We analysed data collected during the International Surgical Outcomes Study, an international 7-day cohort study of adults undergoing elective inpatient surgery. Hospitals were ranked by quintiles according to surgical procedural volume (Q1 lowest to Q5 highest). For each quintile we assessed in-hospital complications rates, mortality, and failure-to-rescue. We repeated this analysis ranking hospitals by risk-adjusted complication rates (Q1 lowest to Q5 highest). Results. A total of 44 814 patients from 474 hospitals in 27 low-, middle-, and high-income countries were available for analysis. Of these, 7508 (17%) developed one or more postoperative complication, with 207 deaths in hospital (0.5%), giving an overall failure-to-rescue rate of 2.8%. When hospitals were ranked in quintiles by procedural volume, we identified a threefold variation in mortality (Q1: 0.6% vs Q5: 0.2%) and a two-fold variation in failure-to-rescue (Q1: 3.6% vs Q5: 1.7%). Ranking hospitals in quintiles by risk-adjusted complication rate further confirmed the presence of important variations in failureto- rescue, indicating differences between hospitals in the risk of death among patients after they develop complications. Conclusions. Comparison of failure-to-rescue rates across health care systems suggests the presence of preventable postoperative deaths. Using such metrics, developing nations could benefit from a data-driven approach to quality improvement, which has proved effective in high-income countries
