33,577 results match your criteria bleeding rates


Increased mortality with REBOA only mitigated by strong unmeasured confounding: an expanded analysis using the National Trauma Data Bank.

J Trauma Acute Care Surg 2021 May 5. Epub 2021 May 5.

Department of Surgery, Yale School of Medicine Applied Mathematics Program, Department of Mathematics, Yale University Department of Statistics and Data Science, Yale University.

REBOA is being increasingly adopted to manage non-compressible torso hemorrhage, but a recent analysis of the 2015-2016 Trauma Quality Improvement Project (TQIP) dataset showed that placement of REBOA was associated with higher rates of death, lower extremity amputation, and acute kidney injury (AKI). We expand this analysis by including the 2017 dataset, quantifying the potential role of residual confounding, and distinguishing between traumatic and ischemic lower extremity amputation.

Methods: This retrospective study used the 2015-2017 TQIP database and included patients older than 18 years old, with signs of life on arrival, no aortic injury, and were not transferred. Read More

View Article and Full-Text PDF

Clinical performance of implant crowns with customized zirconia abutments. A prospective cohort study with a 4.5- to 8.8-year follow-up.

Clin Oral Implants Res 2021 May 4. Epub 2021 May 4.

Professor emeritus, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Switzerland.

Objective: To assess the clinical and esthetic outcomes and patient satisfaction of screw-retained one-piece implant crowns fabricated with zirconia abutments after a 4.5- to 8.8-years follow-up. Read More

View Article and Full-Text PDF

Prevalence of Frailty and Associations with Oral Anticoagulant Prescribing in Atrial Fibrillation.

J Gen Intern Med 2021 May 4. Epub 2021 May 4.

Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA.

Background: Frailty is often cited as a factor influencing oral anticoagulation (OAC) prescription in patients with non-valvular atrial fibrillation (NVAF). We sought to determine the prevalence of frailty and its association with OAC prescription in older veterans with NVAF.

Methods: We used ICD-9 codes in Veterans Affairs (VA) records and Medicare claims data to identify patients with NVAF and CHADSVASC ≥2 receiving care between February 2010 and September 2015. Read More

View Article and Full-Text PDF

Insulin Dependence Increases the Risk of 30-Day Postoperative Complications Following Ankle Fracture Surgery in Patients With Diabetes Mellitus.

J Foot Ankle Surg 2021 Mar 20. Epub 2021 Mar 20.

Associate Professor, Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX. Electronic address:

Patients with diabetes mellitus that undergo ankle fracture surgery have higher rates of postoperative complications compared to patients without diabetes mellitus. We evaluated the rate of complications in insulin-dependent diabetes mellitus patients, non-insulin-dependent diabetes mellitus patients, and patients without diabetes in the 30-day postoperative period following ankle fracture surgery. We also analyzed hospital length of stay, unplanned readmission, unplanned reoperation, and death. Read More

View Article and Full-Text PDF

Validation of anaemia, haemorrhage and blood disorder reporting in hospital data in New South Wales, Australia.

BMC Res Notes 2021 May 4;14(1):167. Epub 2021 May 4.

The University of Sydney Northern Clinical School, Women and Babies Research, C/O University Department of O&G, Level 5, Douglas Building, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia.

Objective: Hospital data are a useful resource for studying pregnancy complications, including bleeding-related conditions, however, the reliability of these data is unclear. This study aims to examine reliability of reporting of bleeding-related conditions, including anaemia, obstetric haemorrhage and blood disorders, and procedures, such as blood transfusion and hysterectomy, in coded hospital records compared with obstetric data from two large tertiary hospitals in New South Wales.

Results: There were 36,051 births between 2011 and 2015 included in the analysis. Read More

View Article and Full-Text PDF

A Feasibility Study of a Novel Delayed Cord Clamping Cart.

Children (Basel) 2021 Apr 29;8(5). Epub 2021 Apr 29.

Department of Pediatrics, Stanford University, Stanford, CA 94305, USA.

Delaying umbilical cord clamping (DCC) for 1 min or longer following a neonate's birth has now been recommended for preterm and term newborns by multiple professional organizations. DCC has been shown to decrease rates of iron deficiency anemia, intraventricular hemorrhage (IVH), necrotizing enterocolitis (NEC), and blood transfusion. Despite these benefits, clinicians typically cut the umbilical cord without delay in neonates requiring resuscitation and move them to a radiant warmer for further care; this effectively prevents these patients from receiving any benefits from DCC. Read More

View Article and Full-Text PDF

Application of Spinal Robotic Navigation Technology to Minimally Invasive Percutaneous Treatment of Spinal Fractures: A Clinical, Non-Randomized, Controlled Study.

Orthop Surg 2021 May 4. Epub 2021 May 4.

Department of Orthopedics, Chinese PLA General Hospital, Beijing, China.

Objective: To introduce a new robotic navigation system that assists pedicle screw implantation and verify the accuracy and stability of the system.

Methods: Pedicle screw placements were performed on the thoracic vertebrae (T)9-Lumbar vertebrae (L)5 thoracolumbar vertebrae of cadavers using robotic guidance. The operative duration, puncture success, correction, and correction time were assessed. Read More

View Article and Full-Text PDF

Perioperative Factor Concentrate Use is Associated With More Beneficial Outcomes and Reduced Complication Rates Compared With a Pure Blood Product-Based Strategy in Patients Undergoing Elective Cardiac Surgery: A Propensity Score-Matched Cohort Study.

J Cardiothorac Vasc Anesth 2021 Mar 27. Epub 2021 Mar 27.

Department of Anaesthesiology and Intensive Therapy, Semmelweis University, Budapest, Hungary.

Objective: The goal of this study was to compare factor concentrate (FC)-based and blood product-based hemostasis management of coagulopathy in cardiac surgical patients in terms of postoperative bleeding, required blood products, and outcome.

Design: Retrospective, propensity score-matched analysis.

Setting: Single, tertiary, academic medical center. Read More

View Article and Full-Text PDF

Considering Criteria for Active Phase Labor Management of Nulliparous Women: A Cost-Effectiveness Analysis.

Am J Perinatol 2021 May 3. Epub 2021 May 3.

Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon.

Objective:  The aim of the study is to evaluate differences in maternal and neonatal outcomes based on updated criteria for defining active labor at 6 cm of cervical dilation and to determine if these recommendations are cost-effective.

Study Design:  A decision-analytic model was built using TreeAge Pro 2020 software. We included maternal outcomes of mode of delivery, endometritis, postpartum hemorrhage requiring transfusion, and death. Read More

View Article and Full-Text PDF

OPEN VERSUS ENDOVASCULAR REPAIR FOR EXTRACRANIAL CAROTID ANEURYSMS.

J Vasc Surg 2021 Apr 30. Epub 2021 Apr 30.

Vascular Surgery Unit, First Department of Propedeutic Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece.

Introduction: ExtraCranial Carotid artery Aneurysms (ECCAs) are rare, although they are associated with a high stroke and mortality risk if untreated. This review aims to compare major outcomes between open and endovascular repair of ECCAs.

Methods: We systematically searched PubMed, Embase, Scopus, and the Cochrane Library for clinical studies published online up to September 2020 that evaluated major outcomes after both open and endovascular repair of ECCAs. Read More

View Article and Full-Text PDF

Effect of Lymphatic Filariasis and Hookworm Infection on Pregnancy Course and Outcome in Women Living in the Democratic Republic of the Congo.

Am J Trop Med Hyg 2021 May 3. Epub 2021 May 3.

1UMI 233, Institut de Recherche pour le Développement (IRD), INSERM Unité 1175 and University of Montpellier, Montpellier, France.

Little is known about the effect of helminth infections on the natural gynecological and pregnancy course. Our goal was to assess the relationship between Wuchereria bancrofti and hookworm (HW) infections with pregnancy course and outcome in a group of 82 women living in a rural area of the Democratic Republic of the Congo. Demographics and information on gynecological and obstetrical histories were collected retrospectively with standardized questionnaires. Read More

View Article and Full-Text PDF

Real-world outcomes with recombinant factor IX Fc fusion protein (rFIXFc) prophylaxis: Longitudinal follow-up in a national adult cohort.

Haemophilia 2021 May 3. Epub 2021 May 3.

St James's Hospital, National Coagulation Centre, Dublin, Ireland.

Introduction: In 2017, all people with severe haemophilia B (PWSHB) in Ireland switched from standard half-life (SHL) recombinant FIX (rFIX) to rFIX Fc fusion protein (rFIXFc) prophylaxis.

Aims: To evaluate prophylaxis regimens, bleeding rates and factor usage for two years of rFIXFc prophylaxis in a real-world setting.

Methods: Data collected retrospectively from electronic diaries and medical records of PWSHB for a two-year period on rFIXFc prophylaxis were compared with paired baseline data on SHL rFIX treatment. Read More

View Article and Full-Text PDF

Impacts of Gastrojejunal Anastomotic Technique on Rates of Marginal Ulcer Formation and Anastomotic Bleeding Following Roux-en-Y Gastric Bypass.

Obes Surg 2021 May 3. Epub 2021 May 3.

Atrium Health Weight Management, Section of Bariatric and Metabolic Surgery, Department of Surgery, Atrium Health, 2630 E 7th St Suite 100, Charlotte, NC, 28204, USA.

Background: Marginal ulceration (MU) and bleeding are possible complications following laparoscopic Roux-en-Y gastric bypass (RYGB). Our institution utilizes three techniques for performing the gastrojejunal anastomosis (GJA), providing a means to compare postoperative MU and bleeding as it relates to GJA technique.

Objectives: We sought to analyze the incidence of MU and bleeding between the 25-mm end-to-end anastomosis (EEA) stapler, linear stapler (LS), and robotic hand-sewn (RHS) GJA techniques. Read More

View Article and Full-Text PDF

The assessment of the relationship between the vascularity of FIGO Type 4-7 leiomyomas and abnormal uterine bleeding.

J Obstet Gynaecol 2021 May 3:1-5. Epub 2021 May 3.

Department of Obstetrics and Gynecology, Faculty of Medicine, Ufuk University, Ankara, Turkey.

The current study aimed to analyse and compare the vascularity of FIGO Type 4-7 leiomyoma specimens obtained from women with or without abnormal uterine bleeding (AUB). The records of 31 women who underwent myomectomy for FIGO Type 4-7 leiomyomas in a university hospital setting were analysed. Group I ( = 16) was composed of women that were symptomatic for AUB and group II ( = 15) consisted of asymptomatic cases. Read More

View Article and Full-Text PDF

Expedited surgery in geriatric hip fracture patients taking direct oral anticoagulants is not associated with increased short-term complications or mortality rates.

OTA Int 2020 Sep 21;3(3):e089. Epub 2020 Aug 21.

Department of Orthopaedics, University of Rochester School of Medicine and Dentistry, Rochester, New York.

Objectives: The purpose of this study was to evaluate potential differences in time to surgery, bleeding risk, wound complications, length of stay, transfusion rate, and 30-day mortality between patients anticoagulated with direct oral anticoagulants (DOACs) and those not anticoagulated at the time of evaluation for an acute hip fracture.

Design: Retrospective chart review Level III Study.

Setting: One university-based hospital in Rochester, NY. Read More

View Article and Full-Text PDF
September 2020

Compartment syndrome following use of tissue plasminogen activator for frostbite in the setting of concomitant diaphyseal tibia fracture.

OTA Int 2020 Jun 22;3(2):e079. Epub 2020 May 22.

Department of Orthpaedic Surgery, MetroHealth Medical Center, Cleveland, OH.

Background: Tissue plasminogen activator (tPA) is a thrombolytic agent increasingly being employed for the treatment of acute frostbite. Although tPA has been shown with success to increase digit salvage rates, data on potential complications, including risk of hemorrhage, is limited. As a result, acute trauma is considered a contraindication to use in many institution-based protocols. Read More

View Article and Full-Text PDF

Risk Factors for Late Rebleeding of Colonic Diverticular Bleeding in Elderly Individuals.

J Anus Rectum Colon 2021 28;5(2):148-157. Epub 2021 Apr 28.

Division of Gastroenterology and Hepatology, Department of Internal Medicine, St Marianna University School of Medicine, Kanagawa, Japan.

Objectives: This study aimed to examine the clinical characteristics of colonic diverticular bleeding (CDB) in elderly individuals.

Methods: This retrospective case-control study was conducted at a single tertiary center. A total of 519 patients (356 men and 163 women; mean age of 73. Read More

View Article and Full-Text PDF

Use of fully covered self-expanding metal biliary stents for managing endoscopic biliary sphincterotomy related bleeding.

Endosc Int Open 2021 May 22;9(5):E667-E673. Epub 2021 Apr 22.

Center for Advanced Endoscopy, Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.

Endoscopic biliary sphincterotomy (EBS) related-bleeding is a common adverse event related to endoscopic retrograde cholangiopancreatography (ERCP). Traditionally, endoscopic modalities such as epinephrine injection, cauterization, and balloon tamponade have been used for management. Recently, use of a fully covered self-expandable metal stent (FCSEMS) to manage EBS-related bleeding has gained popularity. Read More

View Article and Full-Text PDF

Endoscopic resection using an over-the-scope clip for duodenal neuroendocrine tumors.

Endosc Int Open 2021 May 22;9(5):E659-E666. Epub 2021 Apr 22.

Department of Pathology, Saitama Medical University International Medical Center, Saitama, Japan.

Endoscopic resection of duodenal neuroendocrine tumors (DNETs) remains controversial, and its indications are still unclear. This study aimed to evaluate short-term outcomes of a newly developed endoscopic muscularis resection (EMR) method that utilizes an over-the-scope clip (OTSC), termed EMRO, for treating DNETs. In total, 13 consecutive patients with 14 small (≤ 10 mm) DNETs who underwent EMRO from September 2017 to March 2020 were retrospectively enrolled. Read More

View Article and Full-Text PDF

Successful Management of a Patient with Intraoperative Bleeding of More than 80,000 mL and Usefulness of QTc Monitoring for Calcium Correction.

Case Rep Anesthesiol 2021 15;2021:6635696. Epub 2021 Apr 15.

Department of Anesthesiology and Resuscitology, Shinshu University School of Medicine, Matsumoto, Japan.

Intraoperative massive bleeding is associated with high rates of mortality and anesthetic management of massive bleeding is challenging because it is necessary to achieve volume resuscitation and electrolyte correction simultaneously during massive transfusion. We report a case of life-threatening bleeding of more than 80,000 mL during liver transplantation in which real-time QTc monitoring was useful for an extremely large amount of calcium administration for treatment of hypocalcemia. A 47-year-old female with a giant liver due to polycystic liver disease was scheduled to undergo liver transplantation. Read More

View Article and Full-Text PDF

Chromosomal Aneuploidy Associated With Clinical Characteristics of Pregnancy Loss.

Front Genet 2021 15;12:667697. Epub 2021 Apr 15.

Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.

Objective: Embryonic aneuploidy is found in about half of sporadic pregnancy losses and the associations between the chromosomal aneuploidy and clinical characteristics of pregnancy loss remain unclear. The aims of this study were to evaluate the associations between chromosomal aneuploidy of products of conception (POC) and clinical features of pregnancy loss.

Methods: We conducted a retrospective cohort study including 1,102 women experienced singleton pregnancy loss and underwent chromosomal microarray analysis (CMA) detection of POC in our hospital. Read More

View Article and Full-Text PDF

Multivessel Versus Culprit-Vessel Percutaneous Coronary Intervention in Patients With Non-ST-Segment Elevation Myocardial Infarction and Cardiogenic Shock.

JACC Cardiovasc Interv 2021 Apr 21. Epub 2021 Apr 21.

Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City, Kansas City, Missouri, USA.

Objectives: The aim of this study was to compare in-hospital outcomes and long-term mortality of multivessel versus culprit vessel-only percutaneous coronary intervention (PCI) in patients with non-ST-segment elevation myocardial infarction (NSTEMI), multivessel disease (MVD) and cardiogenic shock.

Background: The clinical benefits of complete revascularization in patients with NSTEMI, MVD, and cardiogenic shock remain uncertain.

Methods: Among 25,324 patients included in the National Cardiovascular Data Registry CathPCI Registry from July 2009 to March 2018, the rates of in-hospital procedural outcomes were compared between those undergoing multivessel PCI and those undergoing culprit vessel-only PCI after 1:1 propensity score matching. Read More

View Article and Full-Text PDF

The obesity paradox: Underweight patients are at the greatest risk of mortality after cholecystectomy.

Surgery 2021 Apr 28. Epub 2021 Apr 28.

Cardiovascular Outcomes Research Laboratories, David Geffen School of Medicine, University of California, Los Angeles, CA. Electronic address:

Background: Elevated body mass index is a risk factor for gallstone disease and cholecystectomy, but outcomes for low body mass index patients remain uncharacterized. We examined the association of body mass index with morbidity, mortality, and resource use after cholecystectomy.

Methods: The 2005 to 2016 American College of Surgeons National Surgical Quality Improvement Program was retrospectively analyzed for adult patients undergoing laparoscopic and open cholecystectomy. Read More

View Article and Full-Text PDF

Randomized clinical trial of zirconia and polyetheretherketone implant abutments for single-tooth implant restorations: A 5-year evaluation.

J Prosthet Dent 2021 Apr 28. Epub 2021 Apr 28.

Assistant Professor, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia.

Statement Of Problem: Titanium-supported polyetheretherketone (PEEK) abutments provide an economic alternative to zirconia abutments in esthetically important areas. Research comparing the performance regarding esthetics, longevity, and biologic parameters of PEEK abutments is lacking.

Purpose: The purpose of this clinical study was to determine whether PEEK implant abutments provide similar esthetic and biologic parameters and survival rates as zirconia implant abutments. Read More

View Article and Full-Text PDF

Negatively charged nanoparticles of multiple materials inhibit shear-induced platelet accumulation.

Nanomedicine 2021 Apr 28:102405. Epub 2021 Apr 28.

GW Woodruff School of Mechanical Engineering, Georgia, Institute of Technology, Atlanta, GA; Parker H Petit Institute for Bioengineering and Biosciences, Georgia, Institute of Technology, Atlanta, GA. Electronic address:

Platelet accumulation by VWF under high shear rates at the site of atherosclerotic plaque rupture leads to myocardial infarction and stroke. Current anti-platelet therapies remain ineffective for a large percentage of the population, while presenting significant risks for bleeding. We explore a novel way to inhibit arterial thrombus formation. Read More

View Article and Full-Text PDF

Impact of Readmission for Variceal Upper Gastrointestinal Bleeding: A Nationwide Analysis.

Dig Dis Sci 2021 May 1. Epub 2021 May 1.

Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.

Background: Variceal upper gastrointestinal bleeding (VUGIB) is a common and potentially lethal complication of cirrhosis. Population-based data regarding hospital readmission and other outcomes in VUGIB are limited.

Aim: In a large United States database of patients with VUGIB, we evaluated readmission rates, mortality rates, healthcare resource consumption, and identified predictors of readmission. Read More

View Article and Full-Text PDF

Hepatic artery resection without reconstruction in pancreatoduodenectomy.

Langenbecks Arch Surg 2021 May 1. Epub 2021 May 1.

Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.

Purpose: It has been reported that there are left and right hepatic arterial arcades via the blood vessels around the hilar bile duct; therefore, when the hilar bile duct is preserved, hepatic artery reconstruction may not be necessary. We compared the short-term and long-term outcomes in patients with distal cholangiocarcinoma who underwent pancreatoduodenectomy (PD) with right hepatic artery resection without right hepatic artery reconstruction (RHAR group) with those patients who underwent conventional PD.

Methods: All data were retrospectively collected from patient records. Read More

View Article and Full-Text PDF

Use of direct oral anticoagulants does not significantly increase delayed bleeding after endoscopic submucosal dissection for early gastric neoplasms.

Sci Rep 2021 Apr 30;11(1):9399. Epub 2021 Apr 30.

Division of Gastroenterology, Department of Internal Medicine and Liver Research Institute, Seoul National University Hospital, 101, Daehak-ro Jongno-gu, Seoul, 03080, Korea.

Direct oral anticoagulants (DOACs) are widely prescribed for the prevention of stroke in elderly patients with atrial fibrillation and approved indication for DOAC has been expanded. We aimed to evaluate the risk of delayed bleeding in patients who had taken DOAC and underwent endoscopic submucosal dissection (ESD) for gastric neoplasms. We included consecutive patients who underwent ESD between January 2016 and July 2019 in Seoul National University Hospital. Read More

View Article and Full-Text PDF

Adjunctive Intraarterial Thrombolysis in Endovascular Thrombectomy: A Systematic Review and Meta-analysis.

Neurology 2021 Apr 30. Epub 2021 Apr 30.

Department of Medicine, University of Auckland, Auckland, New Zealand;

Objective: To evaluate the safety and efficacy of intra-arterial thrombolysis (IAT) as an adjunct to endovascular thrombectomy (EVT) in ischemic stroke, we performed a systematic review and meta-analysis of the literature.

Methods: Searches were performed using Medline, Embase, and Cochrane databases for studies that compared EVT to EVT with adjunctive IAT (EVT+IAT). Safety outcomes included symptomatic intracerebral hemorrhage (sICH) and mortality at three months. Read More

View Article and Full-Text PDF

Substantial Within-Country Variation in the Incidence of Subarachnoid Hemorrhage: A Nationwide Finnish Study.

Neurology 2021 Apr 30. Epub 2021 Apr 30.

Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

Objective: To study whether the incidence of subarachnoid hemorrhage (SAH) varies between geographical regions of Finland.

Methods: By utilizing the nationwide Causes of Death and Hospital Discharge Registers, we identified all first-ever, hospitalized and sudden-death (dying before hospitalization) SAH events in Finland between 1998 and 2017. Based on the SAH patients' home residence, we divided SAHs into five geographical regions: 1) Southern, 2) Central, 3) Western, 4) Eastern, and 5) Northern Finland. Read More

View Article and Full-Text PDF