3 results on '"Reinisch-Liese, A"'
Search Results
2. DIALAPP: a prospective validation of a new diagnostic algorithm for acute appendicitis.
- Author
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Malkomes, Patrizia, Edmaier, Franziska, Liese, Juliane, Reinisch-Liese, Alexander, El Youzouri, Hanan, Schreckenbach, Teresa, Bucher, Andreas M., Bechstein, Wolf Otto, and Schnitzbauer, Andreas A.
- Subjects
APPENDICITIS ,COMPUTED tomography ,INTEREST rates ,ALGORITHMS - Abstract
Purpose: The management of patients with suspected appendicitis remains a challenge in daily clinical practice, and the optimal management algorithm is still being debated. Negative appendectomy rates (NAR) continue to range between 10 and 15%. This prospective study evaluated the accuracy of a diagnostic pathway in acute appendicitis using clinical risk stratification (Alvarado score), routine ultrasonography, gynecology consult for females, and selected CT after clinical reassessment. Methods: Patients presenting with suspected appendicitis between November 2015 and September 2017 from age 18 years and above were included. Decision-making followed a clear management pathway. Patients were followed up for 6 months after discharge. The hypothesis was that the algorithm can reduce the NAR to a value of under 10%. Results: A total of 183 patients were included. In 65 of 69 appendectomies, acute appendicitis was confirmed by histopathology, corresponding to a NAR of 5.8%. Notably, all 4 NAR appendectomies had other pathologies of the appendix. The perforation rate was 24.6%. Only 36 patients (19.7%) received a CT scan. The follow-up rate after 30 days achieved 69%, including no patients with missed appendicitis. The sensitivity and specificity of the diagnostic pathway was 100% and 96.6%, respectively. The potential saving in costs can be as much as 19.8 million €/100,000 cases presenting with the suspicion of appendicitis. Conclusion: The risk-stratified diagnostic algorithm yields a high diagnostic accuracy for patients with suspicion of appendicitis. Its implementation can safely reduce the NAR, simultaneously minimizing the use of CT scans and optimizing healthcare-related costs in the treatment of acute appendicitis. Trial registration: ClinicalTrials.gov Identifier: NCT02627781 (December 2015) [ABSTRACT FROM AUTHOR] more...
- Published
- 2021
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3. Impact of the SARS-CoV-2 pandemic on emergency surgery services—a multi-national survey among WSES members.
- Author
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Reichert, Martin, Sartelli, Massimo, Weigand, Markus A., Doppstadt, Christoph, Hecker, Matthias, Reinisch-Liese, Alexander, Bender, Fabienne, Askevold, Ingolf, Padberg, Winfried, Coccolini, Federico, Catena, Fausto, Hecker, Andreas, The WSES COVID-19 emergency surgery survey collaboration group, Abdullaev, Abakar, Camacho-Ortiz, Adrian, Toro, Adriana, Chichom-Mefire, Alain, Martínez-Pérez, Aleix, Kavalakat, Alfie J., and Mohamedahmed, Ali Yasen Y. more...
- Subjects
SURGERY & psychology ,APPENDICITIS ,CHOLECYSTITIS ,HOSPITAL emergency services ,MEDICAL care ,MEDICAL needs assessment ,PATIENTS ,SEPSIS ,SURGEONS ,OPERATIVE surgery ,MEDICAL triage ,WORLD Wide Web ,SEVERITY of illness index ,DESCRIPTIVE statistics ,TREATMENT delay (Medicine) ,COVID-19 pandemic - Abstract
Background: The SARS-CoV-2 pandemic is a major challenge for health care services worldwide. It's impact on oncologic therapies and elective surgery has been described recently, and the literature provides guidelines regarding appropriate elective patient treatment during the pandemic. However, the impact of SARS-CoV-2 pandemic on emergency surgery services has been poorly investigated up to now. Methods: A 17-item web survey had been distributed to emergency surgeons in June 2020 around the world, investigating the impact of SARS-CoV-2 pandemic on patients and septic diseases both requiring emergency surgery and the time-to-intervention in emergency surgery routine, as well as experiences with surgery in COVID-19 patients. Results: Ninety-eight collaborators from 31 countries responded to the survey. The majority (65.3%) estimated the impact of the SARS-CoV-2 pandemic on emergency surgical patient care as being strong or very strong. Due to the pandemic, 87.8% reported a decrease in the total number of patients undergoing emergency surgery and approximately 25% estimated a delay of more than 2 h in the time-to-diagnosis and another 2 h in the time-to-intervention. Fifty percent make structural problems with in-hospital logistics (e.g. transport of patients, closed normal wards etc.) mainly responsible for delayed emergency surgery and the frequent need (56.1%) for a triage of emergency surgical patients. 56.1% of the collaborators observed more severe septic abdominal diseases during the pandemic, especially for perforated appendicitis and severe septic cholecystitis (41.8% and 40.2%, respectively). 62.2% had experiences with surgery in COVID-19-infected patients. Conclusions: The results of The WSES COVID-19 emergency surgery survey are alarming. The combination of an estimated decrease in numbers of emergency surgical patients and an observed increase in more severe septic diseases may be a result of the fear of patients from infection with COVID-19 and a consecutive delayed hospital admission and diagnosis. A critical delay in time-to-diagnosis and time-to-intervention may be a result of changes in in-hospital logistics and operating room as well as intensive care capacities. Both reflect the potentially harmful impact of SARS-CoV-2 pandemic on emergency surgery services. [ABSTRACT FROM AUTHOR] more...
- Published
- 2020
- Full Text
- View/download PDF
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