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Your search keyword '"Remco J.A. van Wensen"' showing total 3 results
Start Over Author "Remco J.A. van Wensen" Topic treatment outcome
3 results on '"Remco J.A. van Wensen"'

1. Delirium after emergency/elective open and endovascular aortoiliac surgery at a surgical ward with a high-standard delirium care protocol

Author

Koop Bosscha, Remco J.A. van Wensen, Olivier H.J. Koning, Paul L. J. Dautzenberg, and B. Koebrugge

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, behavioral disciplines and activities, Endovascular aneurysm repair, Iliac Artery, Risk Assessment, Clinical Protocols, Risk Factors, mental disorders, medicine, Odds Ratio, Humans, Radiology, Nuclear Medicine and imaging, Hospital Mortality, Prospective Studies, Elective surgery, Risk factor, Prospective cohort study, Emergency Treatment, Aorta, Aged, Netherlands, Chi-Square Distribution, business.industry, Incidence, Age Factors, Delirium, General Medicine, Odds ratio, Vascular surgery, nervous system diseases, Surgery, Logistic Models, Treatment Outcome, Elective Surgical Procedures, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Elective Surgical Procedure, Surgery Department, Hospital, Vascular Surgical Procedures
Abstract

Delirium is a common problem in elderly patients undergoing surgery. Standard delirium care is not available at all surgical wards. We determined the incidence, risk factors, and outcomes of postoperative delirium among patients undergoing elective/emergency aortoiliac surgery at a surgical ward with high-standard delirium care. A prospective descriptive survey in 107 patients was conducted. High-standard delirium care was given to patients above age 65, consisting of an extended focus on risk factors and intensive screening. The Delirium Observation Scale was used as a screening instrument for delirium. Patients were classified as having delirium if they met the DSM-IV criteria. The overall incidence of delirium was 23%. The incidence was 14% after elective surgery. Delirium occurred in 59% after emergency surgery and more often after open than after endovascular aneurysm repair ( p < .01). Delirium was associated with age ( p < .01) and emergency surgery ( p = .01) and is an important and frequent complication after aortoiliac surgery.

Published
2010

2. Pelvic sepsis after stapled hemorrhoidopexy

Author

Remco J.A. van Wensen, Koop Bosscha, and Maarten H van Leuken

Subjects
Adult, medicine.medical_specialty, medicine.medical_treatment, Case Report, Hemorrhoids, Severity of Illness Index, Age groups, Sepsis, Surgical Stapling, Pelvic sepsis, Medicine, Humans, business.industry, Ileostomy, Pelvic Infection, Gastroenterology, General Medicine, medicine.disease, Abscess, Surgery, Anti-Bacterial Agents, Treatment Outcome, Stapled hemorrhoidopexy, Practice Guidelines as Topic, Female, business, Tomography, X-Ray Computed, Colorectal surgeons
Abstract

Stapled hemorrhoidopexy is a surgical procedure used worldwide for the treatment of grade III and IV hemorrhoids in all age groups. However, life-threatening complications occur occasionally. The following case report describes the development of pelvic sepsis after stapled hemorrhoidopexy. A literature review of techniques used to manage major septic complications after stapled hemorrhoidopexy was performed. There is no standardized treatment currently available. Stapled hemorrhoidopexy is a safe, effective and time-efficient procedure in the hands of experienced colorectal surgeons.

Published
2008

3. Delirium after abdominal surgery at a surgical ward with a high standard of delirium care: incidence, risk factors and outcomes

Author

Huiberdina L. Koek, Remco J.A. van Wensen, B. Koebrugge, Paul L. J. Dautzenberg, and Koop Bosscha

Subjects
Male, medicine.medical_specialty, behavioral disciplines and activities, Risk Factors, mental disorders, Abdomen, medicine, Humans, Intensive care medicine, Digestive System Surgical Procedures, Aged, Aged, 80 and over, business.industry, Incidence (epidemiology), Incidence, Gastroenterology, Delirium, nervous system diseases, Treatment Outcome, Elective Surgical Procedures, Emergency medicine, behavior and behavior mechanisms, Surgery, Female, medicine.symptom, business, human activities, Hospital Units, Abdominal surgery
Abstract

Background: Although delirium is a common problem in elderly patients undergoing surgery, standard delirium care is not available in all wards. The object of this study was to determine the incidence, risk factors and outcomes of postoperative delirium among patients aged 65 and above undergoing elective abdominal surgery at a surgical ward with a high standard delirium care. Methods: Prospective descriptive survey in 71 patients. The Delirium Observation Scale was used to screen for delirium. Patients were classified as having a delirium if they met the DSM IV-criteria. Delirious and nondelirious patients were compared and associated risk factors were calculated using logistic regression analyses. Results: Incidence of postoperative delirium was 24%. Univariate analysis showed that age above 74 years, CST score, ASA score, length of ICU stay, length of hospital stay and number of complications were significant risk factors for delirium. Older age, however, was the only significant risk factor in multivariate analysis (OR 1.16; 95% CI 1.00–1.35; p = 0.05). Lastly, mortality was significantly higher in the delirium group (29.4 vs. 3.7%; p = 0.001). Conclusion: At a surgical ward with high standard delirium care, the incidence of delirium was 24% and mortality was higher in delirious patients undergoing elective abdominal surgery.

Published
2008

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