Surgery mortality after

Monk TG et al Anesthetic management and one-year mortality after noncardiac surgery. Anesth Analg 2005 100 4. [PMID 15616043]... 

Rubinstein, D., Mclnnes, L, Dudley, F. Morbidity and mortality after peritoneovenous shunt surgery for refractory ascites. Gut 1985 26 1070-1073... 

Overall, the data we examined present a mixed picture. While there are some difficulties of interpretation, there is reasonable evidence for a reduction in overall hospital mortality and in mortality after certain types of surgery. There is also good evidence for a fall in rates of MRSA, and possibly also... 

Jamieson WRE, Janusz MT, Miyagishima RT, et al. Influence of ischemic heart disease on early and late mortality after surgery for peripheral occlusive vascular disease. Circulation 1982 66 192-197. 

Hoeks SE, Scholte op Reimer WJ, van UH, Jorning PJ, Boersma E, Simoons ML, Bax JJ, Poldermans D. Increase of 1-year mortality after perioperative beta-blocker withdrawal in endovascular and vascular surgery patients. Eur J Vase Endovasc Surg 2007 33(1) 13-9. 

Dixon B, Santamaria JD, Reid D, CoUins M, Rechnitzer T, Newcomb AE, et al. The association of blood transfusion with mortality after cardiac surgery cause or confounding (CME). Transfusion 2013 53(l) 19-27. 

Epoetin Alfa [Erythropoietin/ EPO] (Epogen/ Procrit) [Recombinant Human Erythropoietin] WARNING Use lowest dose possible may be associated w/1 CV, thromboembolic events /or mortality D/C if Hgb >12 g/dL Uses CRF associated anemia zidovudine Rx in HIV-infected pts, CA chemo -1- transfusions associated w/ surgery Action Induces ery-thropoiesis Dose Adul Peds. 50-150 Units/kg IV/SQ 3x/wk adjust dose q4-6wk PRN Surgery 300 Units/kg/d x 10 d before to 4 d after -I dose if Hct 36% or Hgb, T > 12 g/dL or Hgb t >1 g/dL in 2-wk pmod hold dose if Hgb >12 g/dL Caution [C, +] Contra Uncontrolled HTN Disp Inj SE HTN, HA, fatigue, fever, tach, NA Interactions None noted EMS Monitor ECG for hypokalemia (peaked T waves) t risk of CV thrombotic events OD May cause HA, dizziness, SOB and polycythemia symptomatic and supportive... 

Clinical outcomes measures can include morbidity and mortality, event rates, and symptom resolution (Ovretveit, 2001). These measures are a direct measure of quality but may be difficult to assess, especially in pharmacy, where their onset could be years following a treatment or intervention (Chassin and Galvin, 1998 Shane and Gouveia, 2000). In these cases, indicators or markers can be used to assess outcomes. These indicators can be condition-specific (e.g., HgAlc) or procedure-specific (e.g., rate of postoperative infection after hip surgery) or address an important issue of patient care. For example, blood pressure may be used as a marker to assess susceptibility to stroke because it is not practical, safe, or ethical to wait and measure the occurrence of stroke. 

Contrast-induced nephropathy (CIN) is the most serious complication associated with the use of CM and can negatively affect long-term patient morbidity and mortality (4-10). CIN is usually defined as an acute decline in renal function characterized by an absolute rise of 0.5mg/dl (44jumol/l) in serum creatinine (SCr) or a 25% increase from baseline, occurring after the systemic administration of CM in the absence of other risk factors such as atheroembolic disease, hypotension and lew blood volume, surgery, or nephrotoxins (1,2,6,7,10-13). 

Index functional status 30 d after stroke. The results showed that only the severity of neurological deficit predicted greater 30-d mortality in these patients. Patients with hyperthermia on the first day of hospitalization had increased mortality and worse functional status at 30 d, but increased temperature was not an independent predictor of mortality 30 d after PICH. In a study to assess typical early onset complications following ischemic stroke, Weimar et al. (5) looked at a cohort of 3866 patients from 14 neurology departments with an acute stroke unit. In the first week following admission, increased intracranial pressure (ICP) and recurrent cerebral ischemia were the most frequent complications, along with fever, severe hypertension, and pneumonia. Similar concerns are also found in cardiac surgery patients in whom perioperative stroke occurred (6). 

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