Whole blood (wb) resuscitation shows significant benefits in trauma patients, leading to lower odds of mortality at 4-hour, 24-hour, and 30-day intervals compared to component-only transfusions. Data from 12,275 patients indicate that higher wb to total transfusion volume (wb:ttv) ratios further decrease mortality, with each 10% increase correlating to a 13% reduction in 4-hour mortality […]
Category: Appendix, Gallbladder and Surgical Emergencies
Early surgeon consultation increases cholecystectomy success rates.
In a study of 376 patients with symptomatic cholelithiasis, early surgical consultation significantly improved treatment outcomes. Only 23.7% received successful management, while 76.3% experienced failure. The success rate rose to 67.4% among those who received surgery consultations during hospital admission. Conversely, only 28.5% had outpatient consulting within 30 days post-visit. Factors such as age, sex, […]
Trans-cystic stenting reduces hospital stay and improves ERCP efficiency
Implementing trans-cystic biliary stenting during acute cholecystectomy significantly reduced the median total hospital stay from six to five days for patients needing both endoscopic retrograde cholangiopancreatography (ERCP) and cholecystectomy. The stenting process was efficient, with 22 out of 23 attempts successful and a median insertion time of 14 minutes. Post-stenting, outpatient ERCP cases increased dramatically, […]
Extended wait times for CVP measurements increase mortality risk
Delays in obtaining central venous pressure (CVP) measurements significantly raise the risk of 28-day mortality in critically ill patients with acute pancreatitis. An analysis of data from 233 patients revealed that those who experienced longer wait times for CVP assessments had more than double the risk of early death compared to those monitored within 12 […]
New Risk Assessment Score Predicts Mortality in Abdominal Emergencies
A novel risk evaluation score, the NDAR score, was developed through a national audit in Senegal to predict mortality in patients with abdominal surgical emergencies. Analyzing 1,114 patient records, researchers identified several key factors influencing outcomes, including age, ASA status, positive QSIRS scores, and specific diagnoses. The NDAR score demonstrates high predictive capacity (AUC of […]
Surgery shows superior treatment success for acute appendicitis
A network meta-analysis of 13 randomized controlled trials evaluated various antibiotic treatments against surgical options for acute appendicitis. Results indicated that surgical intervention had the highest initial treatment success (66.5% SUCRA) and was superior at 1-year follow-up compared to selected antibiotic regimens. However, no significant differences were identified for treatment-related complications among interventions. Overall, while […]
Three methods found safe for appendix stump closure
In a comparative study of appendectomy techniques, endoloop, Hem-o-Lok clip, and endostapler were evaluated for safety and effectiveness. Of 150 cases analyzed, only 4% experienced complications, which included intra-abdominal abscesses and wound infections. Endoloop emerged as the most utilized and economical option, while endostapler, despite its higher costs, is recommended for challenging cases only. Overall, […]
Mural nodules and intraluminal air predict neuroendocrine tumors.
Mural nodules protruding into the lumen and intraluminal air serve as significant predictors of neuroendocrine tumors in patients with acute appendicitis. In a study involving 1,150 patients, those with neuroendocrine tumors exhibited a mural nodule prevalence of 53.3% sensitivity and 95.8% specificity, while intraluminal air showed 53.3% sensitivity and 76.7% specificity. Incorporating these imaging indicators […]
Alcohol saliva test strips effectively identify trauma patients’ consumption.
In a study involving 805 trauma patients in Malawi, researchers found that 18.3% reported alcohol use. The alcohol saliva test (AST) showed a 95.5% agreement with breathalyzer results, with a kappa coefficient of 0.83. The AST’s sensitivity was 78.5% and specificity was 99.3%, demonstrating excellent discrimination capacity (AUC 0.88). The findings underscore the feasibility of […]
Most patients achieve critical view of safety in surgery
In a review of 309 laparoscopic cholecystectomies, researchers found that an adequate critical view of safety (CVS) was achieved in 79.9% of cases, significantly reducing surgical complications. Notably, factors such as acute cholecystitis, male sex, and previous surgeries correlated with challenges in attaining CVS. Despite these factors, no surgical complications were reported in the successful […]