Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 5 de 5
Filtrar
1.
Adv Skin Wound Care ; 37(5): 238-242, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38648236

RESUMO

GENERAL PURPOSE: To present research investigating the incidence of and risk factors associated with intraoperative pressure injury in patients undergoing neurologic surgery at Xiangya Hospital, Central South University in China. TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and registered nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After participating in this educational activity, the participant will:1. Identify the incidence of intraoperative pressure injuries (PIs) in patients undergoing neurologic surgery at Xiangya Hospital, Central South University in China.2. Describe risk factors for intraoperative PI.3. Outline strategies to help mitigate intraoperative PI risk.


Intraoperative pressure injury (PI) development is an adverse event that impacts thousands of patients globally and is associated with extended hospital stays and increased risk of mortality. To investigate the incidence of intraoperative PI in patients undergoing neurologic surgery and identify associated risk factors. A total of 1,728 patients who underwent neurosurgery in Xiangya Hospital, Central South University between January 2021 and December 2022 were included in this retrospective study. The authors collected patients' demographic data and clinical characteristics and used univariate and multivariate regression to evaluate significant PI risk factors. Intraoperative PI was observed in 1.8% of all surgical cases (n = 31). Having a body mass index greater than 24 kg/m2 (odds ratio, 3.87; 95% CI, 1.62­9.23; P = .002), being in a lateral position (odds ratio, 2.53; 95% CI, 1.04­6.17; P = .042) or a prone position (odds ratio, 10.43; 95% CI, 3.37­32.23; P < .001), and having a longer operation time (cutoff point at 7.92 hours for increased risk of PI; odds ratio, 1.36; 95% CI, 1.21­1.53; P < .001) were significant risk factors for intraoperative PI. This study identified three independent risk factors for intraoperative PI development: body position, surgery duration, and high body mass index. These findings can help OR nurses identify patients who are vulnerable to intraoperative PI and provide appropriate preventive measures. For these patients, perioperative protection and frequent microrepositioning during surgery would be indispensable.


Assuntos
Úlcera por Pressão , Humanos , Úlcera por Pressão/prevenção & controle , Úlcera por Pressão/epidemiologia , Úlcera por Pressão/etiologia , Fatores de Risco , Adulto , China/epidemiologia , Masculino , Feminino , Incidência , Complicações Intraoperatórias/epidemiologia , Complicações Intraoperatórias/prevenção & controle , Complicações Intraoperatórias/etiologia , Pessoa de Meia-Idade , Procedimentos Neurocirúrgicos/efeitos adversos , Procedimentos Neurocirúrgicos/métodos
2.
Risk Manag Healthc Policy ; 13: 865-881, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32801962

RESUMO

BACKGROUND: Human errors during operations may seriously threaten patient recovery and safety and affect the doctor-patient relationship. Therefore, risk evaluation of the surgical process is critical. Risk evaluation by failure mode and effect analysis (FMEA) is a prospective technology that can identify and evaluate potential failure modes in the surgical process to ensure surgical quality and patient safety. In this study, a hybrid surgical risk-evaluation model was proposed using FMEA and multiobjective optimization on the basis of ratio analysis plus full multiplicative form (MULTIMOORA) method under a single-valued trapezoidal neutrosophic environment. This work aimed to determine the most critical risk points during the surgical process and analyze corresponding solutions. METHODS: A team for FMEA was established from domain experts from different departments in a hospital in Hunan Province. Single-valued trapezoidal neutrosophic numbers (SVTNNs) were used to evaluate potential risk factors in the surgical process. Cmprehensive weights combining subjective and objective weights were determined by the best-worst method and entropy method to differentiate the importance of risk factors. The SVTNN-MULTIMOORA method was utilized to calculate the risk-priority order of failure modes in a surgical process. RESULTS: The hybrid FMEA model under the SVTNN-MULTIMOORA method was used to calculate the ranking of severity of 21 failure modes in the surgical process. An unclear diagnosis is the most critical failure in the surgical process of a hospital in Hunan Province. CONCLUSION: The proposed model can identify and evaluate the most critical potential failure modes of the surgical process effectively. In addition, such a model can help hospitals to reduce surgical risk and improve the safety of surgery.

3.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 44(8): 945-950, 2019 Aug 28.
Artigo em Chinês | MEDLINE | ID: mdl-31570685

RESUMO

According to the literature and expert experience, a comprehensive index system of subjective and objective was established, including the patient's condition, the treatment information for the same kind of patients, technical level of the medical team, and the medical conditions. Secondly, in the light of the heterogeneous evaluation information, the comprehensive index weight was computed by combining subjective weight and objective entropy weight. Furthermore, the VIKOR method was applied to deal with heterogeneous evaluation information and obtain the priority of potential surgical treatments. Taking a rectal cancer patient in a general hospital in Hunan Province as an example, the optimal surgical treatment obtained by this method was consistent with the actual treatment. The reliability and effectiveness of the heterogeneous VIKOR method based on probabilistic linguistic term sets are verified by an experimental example of rectal cancer, and the method can be used to help doctors, patients and family members to select the surgical treatments for rectal cancer effectively.


Assuntos
Neoplasias Retais , Peso Corporal , Humanos , Neoplasias Retais/cirurgia , Reprodutibilidade dos Testes
4.
Vox Sang ; 114(7): 721-739, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31373018

RESUMO

BACKGROUND AND OBJECTIVES: A health industry standard recommending restrictive transfusion is to be in effect in China in April 2019. We aim to explore its potential economic and clinical impacts among surgical patients. MATERIALS AND METHODS: A decision tree model was applied to compare cost-effectiveness of current routine transfusion in China, a restrictive (transfusion at Hb < 8 g/dl or ischaemic symptoms) and a liberal (transfusion at Hb < 10 g/dl) strategy. Parameters were estimated from empirical data of 25 227 surgical inpatients aged ≥30 years in a multicenter study and supplemented by meta-analysis when necessary. Results are shown for cardio-cerebral-vascular (CCV) surgery and non-CCV (orthopaedics, general, thoracic) surgery separately. RESULTS: Per 10 000 patients in routine, restrictive, liberal transfusion scenarios, total spending (transfusion and length of stay related) was 7·67, 7·58 and 9·39 million CNY (1 CNY × 0.157 = 1 US dollar) for CCV surgery and 6·35, 6·70 and 8·09 million CNY for non-CCV surgery; infectious and severe complications numbered 354, 290, and 290 (CCV) and 315, 286, and 330 (non-CCV), respectively. Acceptability curves showed high probabilities for restrictive strategy to be cost-effective across a wide range of willingness-to-pay values. Such findings were mostly consistent in sensitivity and subgroup analyses except for patients with cardiac problems. CONCLUSION: We showed strong rationale, succeeding previous findings only in cardiac or joint procedures, to comply with the new standard as restrictive transfusion has high potential to save blood, secure safety, and is cost-effective for a wide spectrum of surgical patients. Experiences should be further summarized to pave the way towards individualized transfusion.


Assuntos
Transfusão de Sangue/economia , Análise Custo-Benefício , Adulto , Idoso , Transfusão de Sangue/métodos , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Centro Cirúrgico Hospitalar/economia , Centro Cirúrgico Hospitalar/estatística & dados numéricos
5.
J Cancer Res Ther ; 14(Supplement): S998-S1003, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30539836

RESUMO

OBJECTIVE: The objective of this paper was to identify the disrupted pathways associated with colon cancer at a network level based on protein-protein interaction (PPI) network and pathway analysis. MATERIALS AND METHODS: First of all, the Affymetrix microarray data of colon cancer, human PPIs relationships, and human pathways existed in the database were recruited and preprocessed. Second, differentially expressed genes (DEGs) between colon cancer and normal controls were identified. In the following, an objective PPI network was constructed using these DEGs. Ultimately, we calculated the disrupted pathways based on the intersection between pathway network and the objective network. Meanwhile, the topological centrality (degree) analysis was performed to explore the hub genes in the objective network. RESULTS: In our study, an objective network consisted of 2288 PPI pairs by 574 DEGs were constructed. In addition, ten disrupted pathways whose number of intersection was not <22 between objective network and each pathway, as well as P < 0.05, was selected. Furthermore, a total of 22 hub genes in the objective network were selected based on degree >30. Last, seven out of the above ten pathways were validated to involve in the intersections of pathway network and objective network. Moreover, cell cycle was the most significant disrupted pathway. CONCLUSIONS: We successfully identified several biologically disrupted pathways, and these pathways might be potential biomarkers in detection and treatment for colon cancer.


Assuntos
Biomarcadores Tumorais/metabolismo , Neoplasias do Colo/patologia , Regulação Neoplásica da Expressão Gênica , Redes Reguladoras de Genes , Mapas de Interação de Proteínas/genética , Biomarcadores Tumorais/genética , Neoplasias do Colo/diagnóstico , Neoplasias do Colo/genética , Biologia Computacional , Conjuntos de Dados como Assunto , Perfilação da Expressão Gênica , Humanos , Mapeamento de Interação de Proteínas , Transcriptoma/genética
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA