200 results on '"Kunst G"'
Search Results
2. Peri‐operative cardiac arrest in the older frail patient as reported to the 7th National Audit Project of the Royal College of Anaesthetists.
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Moppett, I. K., Kane, A. D., Armstrong, R. A., Kursumovic, E., Soar, J., Cook, T. M., Bouch, D. C., Agarwal, S., Cordingley, J., Cortes, L., Davies, M. T., Dorey, J., Finney, S. J., Kendall, S.W, Kunst, G., Lourtie, J., Lucas, D. N., Mouton, R., Nickols, G., and Nolan, J. P.
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CARDIAC arrest ,OLDER patients ,HIP fractures ,ANESTHESIOLOGISTS ,TERMINALLY ill ,SURGICAL emergencies ,UROLOGICAL surgery ,POSITIVE pressure ventilation - Abstract
Summary: Frailty increases peri‐operative risk, but details of its burden, clinical features and the risk of, and outcomes following, peri‐operative cardiac arrest are lacking. As a preplanned analysis of the 7th National Audit Project of the Royal College of Anaesthetists, we described the characteristics of older patients living with frailty undergoing anaesthesia and surgery, and those reported to the peri‐operative cardiac arrest case registry. In the activity survey, 1676 (26%) of 6466 patients aged > 65 y were reported as frail (Clinical Frailty Scale score ≥ 5). Increasing age and frailty were both associated with increasing comorbidities and the proportion of surgery undertaken as an emergency. Except in patients who were terminally ill (Clinical Frailty Scale score 9), increasing frailty was associated with an increased proportion of complex or major surgery. The rate of use of invasive arterial blood pressure monitoring was associated with frailty only until Clinical Frailty Scale score 5, and then plateaued or fell. Of 881 cardiac arrests reported to the 7th National Audit Project, 156 (18%) were in patients aged > 65 y and living with frailty, with an estimated incidence of 1 in 1204 (95%CI 1 in 1027–1412) and a mortality rate of 1 in 2020 (95%CI 1 in 1642–2488), approximately 2.6‐fold higher than in adults who were not frail. Hip fracture, emergency laparotomy, emergency vascular surgery and urological surgery were the most common surgical procedures in older patients living with frailty who had a cardiac arrest. We report a high burden of frailty within the surgical population, requiring complex, urgent surgery, and the extent of poorer outcomes of peri‐operative cardiac arrest compared with patients of the same age not living with frailty. [ABSTRACT FROM AUTHOR]
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- 2024
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3. Cardiac arrest in vascular surgical patients receiving anaesthetic care: an analysis from the 7th National Audit Project (NAP7) of the Royal College of Anaesthetists
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Armstrong, R. A., primary, Cook, T. M., additional, Kunst, G., additional, Kane, A. D., additional, Kursumovic, E., additional, Lucas, D.N., additional, Nickols, G., additional, Soar, J., additional, and Mouton, R., additional
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- 2024
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4. Tranexamic acid in coronary artery surgery: One-year results of the Aspirin and Tranexamic Acid for Coronary Artery Surgery (ATACAS) trial
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Myles, Paul, Smith, Julian, Cooper, D. James, Silbert, Brendan, McNeil, John, Marasco, Silvana, Esmore, Donald, Krum, Henry, Tonkin, A., Buxton, B., Heritier, S., Merry, A., Liew, D., McNeil, J., Forbes, A., Cooper, D.J., Wallace, S., Meehan, A., Myles, P., Galagher, W., Farrington, C., Ditoro, A., Wutzlhofer, L., Story, D., Peyton, P., Baulch, S., Sidiropoulos, S., Potgieter, D., Baker, R.A., Pesudovs, B., O'Loughlin J Wells, E., Coutts, P., Bolsin, S., Osborne, C., Ives, K., Smith, J., Hulley, A., Christie-Taylor, G., Painter, T., Lang, S., Mackay, H., Cokis, C., March, S., Bannon, P.G., Wong, C., Turner, L., Scott, D., Silbert, B., Said, S., Corcoran, P., de Prinse, L., Bussières, J.S., Gagné, N., Lamy, A., Semelhago, L., Chan, M.T.V., Underwood, M., Choi, G.S.Y., Fung, B., Landoni, G., Lembo, R., Monaco, F., Simeone, F., Marianello, D., Alvaro, G., De Vuono, G., van Dijk, D., Dieleman, J., Numan, S., McGuinness, S., Parke, R., Raudkivi, P., Gilder, E., Byrne, K., Dunning, J., Termaat, J., Mans, G., Jayarajah, M., Alderton, J., Waugh, D., Platt, M.J., Pai, A., Sevillano, A., Lal, A., Sinclair, C., Kunst, G., Knighton, A., Cubas, G.M., Saravanan, P., Millner, R., Vasudevan, V., Patteril, M., Lopez, E., Basu, R., Lu, J., Myles, Paul S., Smith, Julian A., Kasza, Jessica, Jayarajah, Mohandas, Painter, Thomas, Bussières, Jean S., McGuinness, Shay, Byrne, Kelly, Chan, Matthew T.V., Landoni, Giovanni, Wallace, Sophie, and Forbes, Andrew
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- 2019
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5. Optimising pain management protocols following cardiac surgery: A protocol for a national quality improvement study
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Jayakumar, S., Borrelli, M., Milan, Z., Kunst, G., and Whitaker, D.
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- 2019
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6. Peri‐operative cardiac arrest: epidemiology and clinical features of patients analysed in the 7th National Audit Project of the Royal College of Anaesthetists.
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Armstrong, R. A., Soar, J., Kane, A. D., Kursumovic, E., Nolan, J. P., Oglesby, F. C., Cortes, L., Taylor, C., Moppett, I. K., Agarwal, S., Cordingley, J., Davies, M. T., Dorey, J., Finney, S. J., Kendall, S., Kunst, G., Lucas, D. N., Mouton, R., Nickols, G., and Pappachan, V. J.
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CARDIAC arrest ,CLINICAL epidemiology ,ANESTHESIOLOGISTS ,GASTROINTESTINAL surgery ,VASCULAR surgery - Abstract
Summary: The 7th National Audit Project of the Royal College of Anaesthetists studied peri‐operative cardiac arrest in the UK, a topic of importance to patients, anaesthetists and surgeons. Here we report the results of the 12‐month registry, from 16 June 2021 to 15 June 2022, focusing on epidemiology and clinical features. We reviewed 881 cases of peri‐operative cardiac arrest, giving an incidence of 3 in 10,000 anaesthetics (95%CI 3.0–3.5 per 10,000). Incidence varied with patient and surgical factors. Compared with denominator survey activity, patients with cardiac arrest: included more males (56% vs. 42%); were older (median (IQR) age 60.5 (40.5–80.5) vs. 50.5 (30.5–70.5) y), although the age distribution was bimodal, with infants and patients aged > 66 y overrepresented; and were notably more comorbid (73% ASA physical status 3–5 vs. 27% ASA physical status 1–2). The surgical case‐mix included more weekend (14% vs. 11%), out‐of‐hours (19% vs. 10%), non‐elective (65% vs. 30%) and major/complex cases (60% vs. 28%). Cardiac arrest was most prevalent in orthopaedic trauma (12%), lower gastrointestinal surgery (10%), cardiac surgery (9%), vascular surgery (8%) and interventional cardiology (6%). Specialities with the highest proportion of cases relative to denominator activity were: cardiac surgery (9% vs. 1%); cardiology (8% vs. 1%); and vascular surgery (8% vs. 2%). The most common causes of cardiac arrest were: major haemorrhage (17%); bradyarrhythmia (9%); and cardiac ischaemia (7%). Patient factors were judged a key cause of cardiac arrest in 82% of cases, anaesthesia in 40% and surgery in 35%. [ABSTRACT FROM AUTHOR]
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- 2024
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7. Peri‐operative cardiac arrest: management and outcomes of patients analysed in the 7th National Audit Project of the Royal College of Anaesthetists.
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Armstrong, R. A., Cook, T. M., Kane, A. D., Kursumovic, E., Nolan, J. P., Oglesby, F. C., Cortes, L., Taylor, C., Moppett, I. K., Agarwal, S., Cordingley, J., Davies, M. T., Dorey, J., Finney, S. J., Kendall, S., Kunst, G., Lucas, D. N., Mouton, R., Nickols, G., and Pappachan, V. J.
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CARDIAC arrest ,PULMONARY embolism ,ANESTHESIOLOGISTS ,SEPTIC shock ,HOSPITAL admission & discharge ,BONE cements - Abstract
Summary: The 7th National Audit Project of the Royal College of Anaesthetists studied peri‐operative cardiac arrest in the UK, a topic of importance to patients, anaesthetists and surgeons. We report the results of the 12‐month registry phase, from 16 June 2021 to 15 June 2022, focusing on management and outcomes. Among 881 cases of peri‐operative cardiac arrest, the initial rhythm was non‐shockable in 723 (82%) cases, most commonly pulseless electrical activity. There were 665 (75%) patients who survived the initial event and 384 (52%) who survived to hospital discharge. A favourable functional outcome (based on modified Rankin Scale score) was reported for 249 (88%) survivors. Outcomes varied according to arrest rhythm. The highest rates of survival were seen for bradycardic cardiac arrests with 111 (86%) patients surviving the initial event and 77 (60%) patients surviving the hospital episode. The lowest survival rates were seen for patients with pulseless electrical activity, with 312 (68%) surviving the initial episode and 156 (34%) surviving to hospital discharge. Survival to hospital discharge was worse in patients at the extremes of age with 76 (40%) patients aged > 75 y and 9 (45%) neonates surviving. Hospital survival was also associated with surgical priority, with 175 (88%) elective patients and 176 (37%) non‐elective patients surviving to discharge. Outcomes varied with the cause of cardiac arrest, with lower initial survival rates for pulmonary embolism (5, 31%) and bone cement implantation syndrome (9, 45%), and hospital survival of < 25% for pulmonary embolism (0), septic shock (13, 24%) and significant hyperkalaemia (1, 20%). Overall care was rated good in 464 (53%) cases, and 18 (2%) cases had overall care rated as poor. Poor care elements were present in a further 245 (28%) cases. Care before cardiac arrest was the phase most frequently rated as poor (92, 11%) with elements of poor care identified in another 186 (21%) cases. These results describe the management and outcomes of peri‐operative cardiac arrest in UK practice for the first time. [ABSTRACT FROM AUTHOR]
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- 2024
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8. The incidence of potentially serious complications during non‐obstetric anaesthetic practice in the United Kingdom: an analysis from the 7th National Audit Project (NAP7) activity survey.
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Kane, A. D., Cook, T. M., Armstrong, R. A., Kursumovic, E., Davies, M. T., Agarwal, S., Nolan, J. P., Smith, J. H., Moppett, I. K., Oglesby, F. C., Cortes, L., Taylor, C., Cordingley, J., Dorey, J., Finney, S. J., Kunst, G., Lucas, D. N., Nickols, G., Mouton, R., and Patel, B.
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ANESTHETICS ,SEPTIC shock ,SURGICAL emergencies ,CARDIAC arrest ,INFORMED consent (Medical law) ,ARRHYTHMIA ,UNIVARIATE analysis ,ELECTIVE surgery - Abstract
Summary: Complications and critical incidents arising during anaesthesia due to patient, surgical or anaesthetic factors, may cause harm themselves or progress to more severe events, including cardiac arrest or death. As part of the 7th National Audit Project of the Royal College of Anaesthetists, we studied a prospective national cohort of unselected patients. Anaesthetists recorded anonymous details of all cases undertaken over 4 days at their site through an online survey. Of 416 hospital sites invited to participate, 352 (85%) completed the survey. Among 24,172 cases, 1922 discrete potentially serious complications were reported during 1337 (6%) cases. Obstetric cases had a high reported major haemorrhage rate and were excluded from further analysis. Of 20,996 non‐obstetric cases, 1705 complications were reported during 1150 (5%) cases. Circulatory events accounted for most complications (616, 36%), followed by airway (418, 25%), metabolic (264, 15%), breathing (259, 15%), and neurological (41, 2%) events. A single complication was reported in 851 (4%) cases, two complications in 166 (1%) cases and three or more complications in 133 (1%) cases. In non‐obstetric elective surgery, all complications were 'uncommon' (10–100 per 10,000 cases). Emergency (urgent and immediate priority) surgery accounted for 3454 (16%) of non‐obstetric cases but 714 (42%) of complications with severe hypotension, major haemorrhage, severe arrhythmias, septic shock, significant acidosis and electrolyte disturbances all being 'common' (100–1000 per 10,000 cases). Based on univariate analysis, complications were associated with: younger age; higher ASA physical status; male sex; increased frailty; urgency and extent of surgery; day of the week; and time of day. These data represent the rates of potentially serious complications during routine anaesthesia care and may be valuable for risk assessment and patient consent. [ABSTRACT FROM AUTHOR]
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- 2024
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9. Peri‐operative tobacco cessation interventions: a systematic review and meta‐analysis
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Harrogate, S., primary, Barnes, J., additional, Thomas, K., additional, Isted, A., additional, Kunst, G., additional, Gupta, S., additional, Rudd, S., additional, Banerjee, T., additional, Hinchliffe, R., additional, and Mouton, R., additional
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- 2023
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10. Fitter, better, sooner: prehabilitation and clinical outcomes in cardiac surgery.
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Kunst, G. and Agarwal, S.
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CARDIAC surgery , *PREHABILITATION , *TREATMENT effectiveness , *CLUSTER randomized controlled trials , *PREOPERATIVE period , *SURGICAL complications , *ELECTIVE surgery - Abstract
The staff who were supervising patients exercising, who had expressed fears about exercise in this patient group, reported that they were surprised at the amount of exercise the patients could do. Patients, their carers and healthcare professionals recently identified prehabilitation as one of 10 research priorities in adult cardiac surgery in the UK [[1]]. The cardiac surgery patient population was perceived to be at high risk of exercise-induced adverse events [[15]] and there has been an understandable reticence on the part of both clinicians and patients to test the theory that it could be beneficial. A disadvantage can be that prehabilitation, which normally lasts for several weeks before surgery, is incompatible with urgent or emergency surgery, and yet patients undergoing this have higher risks of postoperative complications compared with elective patient cohorts. [Extracted from the article]
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- 2023
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11. Organisation of UK hospitals and anaesthetic departments in the treatment of peri‐operative cardiac arrest: an analysis from the 7th National Audit Project (NAP7) local co‐ordinator baseline survey.
- Author
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Kursumovic, E., Soar, J., Nolan, J. P., Plaat, F., Kane, A. D., Armstrong, R. A., Davies, M. T., Oglesby, F. C., Cortes, L., Taylor, C., Moppett, I. K., Agarwal, S., Cordingley, J., Dorey, J., Finney, S. J., Kunst, G., Lucas, D. N., Nickols, G., Mouton, R., and Patel, B.
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CRITICALLY ill children ,CRITICALLY ill patient care ,CARDIAC arrest ,HOSPITAL care of children ,ANESTHETICS ,PEDIATRIC intensive care ,OPERATING rooms - Abstract
Summary: We report the results of the Royal College of Anaesthetists' 7th National Audit Project organisational baseline survey sent to every NHS anaesthetic department in the UK to assess preparedness for treating peri‐operative cardiac arrest. We received 199 responses from 277 UK anaesthetic departments, representing a 72% response rate. Adult and paediatric anaesthetic care was provided by 188 (95%) and 165 (84%) hospitals, respectively. There was no paediatric intensive care unit on‐site in 144 (87%) hospitals caring for children, meaning transfer of critically ill children is required. Remote site anaesthesia is provided in 182 (92%) departments. There was a departmental resuscitation lead in 113 (58%) departments, wellbeing lead in 106 (54%) and departmental staff wellbeing policy in 81 (42%). A defibrillator was present in every operating theatre suite and in all paediatric anaesthesia locations in 193 (99%) and 149 (97%) departments, respectively. Advanced airway equipment was not available in: every theatre suite in 13 (7%) departments; all remote locations in 103 (57%) departments; and all paediatric anaesthesia locations in 23 (15%) departments. Anaesthetic rooms were the default location for induction of anaesthesia in adults and children in 148 (79%) and 121 (79%) departments, respectively. Annual updates in chest compressions and in defibrillation were available in 149 (76%) and 130 (67%) departments, respectively. Following a peri‐operative cardiac arrest, debriefing and peer support programmes were available in 154 (79%) and 57 (29%) departments, respectively. While it is likely many UK hospitals are very well prepared to treat anaesthetic emergencies including cardiac arrest, the survey suggests this is not universal. [ABSTRACT FROM AUTHOR]
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- 2023
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12. The 7th National Audit Project (NAP7) baseline survey of individual anaesthetists: preparedness for and experiences of peri‐operative cardiac arrest.
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Kursumovic, E., Cook, T. M., Lucas, D. N., Davies, M. T., Martin, S., Kane, A. D., Armstrong, R. A., Oglesby, F. C., Cortes, L., Taylor, C., Moppett, I. K., Agarwal, S., Beecham, E., Cordingley, J., Dorey, J., Finney, S. J., Kunst, G., Nickols, G., Mouton, R., and Nolan, J. P.
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CARDIAC arrest ,ANESTHESIOLOGISTS ,PREPAREDNESS ,PSYCHOLOGICAL factors ,WELL-being - Abstract
Summary: The Royal College of Anaesthetists' 7th National Audit Project baseline survey assessed knowledge, attitudes, practices and experiences of peri‐operative cardiac arrests among UK anaesthetists and Anaesthesia Associates. We received 10,746 responses, representing a 71% response rate. In‐date training in adult and paediatric advanced life support was reported by 9646 (90%) and 7125 (66%) anaesthetists, respectively. There were 8994 (84%) respondents who were confident in leading a peri‐operative cardiac arrest, with males more confident than females, but only 5985 (56%) were confident in leading a debrief and 7340 (68%) communicating with next of kin. In the previous two years, 4806 (46%) respondents had managed at least one peri‐operative cardiac arrest, of which 321 (7%) and 189 (4%) of these events involved a child or an obstetric patient, respectively. Respondents estimated the most common causes of peri‐operative cardiac arrest to be hypovolaemia, hypoxaemia and cardiac ischaemia, with haemorrhage coming fifth. However, the most common reported causes for the most recently attended peri‐operative cardiac arrest were haemorrhage; (927, 20%); anaphylaxis (474, 10%); and cardiac ischaemia (397, 9%). Operating lists or shifts were paused or stopped after 1330 (39%) cardiac arrests and 1693 (38%) respondents attended a debrief, with 'hot' debriefs most common. Informal wellbeing support was relatively common (2458, 56%) and formal support was uncommon (472, 11%). An impact on future care delivery was reported by 196 (4%) anaesthetists, most commonly a negative psychological impact. Management of a peri‐operative cardiac arrest during their career was reported by 8654 (85%) respondents. The overall impact on professional life was more often judged positive (2630, 30%) than negative (1961, 23%), but impact on personal life was more often negative. [ABSTRACT FROM AUTHOR]
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- 2023
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13. Post Reperfusion Syndrome in Liver Transplant after Normothermic Perfusion
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Loughnan, A., primary, Jabri, Y., additional, Dancy, L., additional, Pereira, L. Beltrão, additional, Schwartz, F., additional, Jassem, W., additional, Bezerra Pereira, J.F. Holanda, additional, Kunst, G., additional, and Milan, Z., additional
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- 2023
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14. Implication of Major Adverse Postoperative Events and Myocardial Injury on Disability and Survival: A Planned Subanalysis of the ENIGMA-II Trial
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Beattie, W. Scott, Wijeysundera, Duminda N., Chan, Matthew T. V., Peyton, Philip J., Leslie, Kate, Paech, Michael J., Sessler, Daniel I., Wallace, Sophie, Myles, Paul S., Galagher, W., Farrington, C., Ditoro, A., Baulch, S., Sidiropoulos, S., Bulach, R., Bryant, D., O’Loughlin, E., Mitteregger, V., Bolsin, S., Osborne, C., McRae, R., Backstrom, M., Cotter, R., March, S., Silbert, B., Said, S., Halliwell, R., Cope, J., Fahlbusch, D., Crump, D., Thompson, G., Jefferies, A., Reeves, M., Buckley, N., Tidy, T., Schricker, T., Lattermann, R., Iannuzzi, D., Carroll, J., Jacka, M., Bryden, C., Badner, N., Tsang, M. W. Y., Cheng, B. C. P., Fong, A. C. M., Chu, L. C. Y., Koo, E. G. Y., Mohd, N., Ming, L. E., Campbell, D., McAllister, D., Walker, S., Olliff, S., Kennedy, R., Eldawlatly, A., Alzahrani, T., Chua, N., Sneyd, R., McMillan, H., Parkinson, I., Brennan, A., Balaji, P., Nightingale, J., Kunst, G., Dickinson, M., Subramaniam, B., Banner-Godspeed, V., Liu, J., Kurz, A., Hesler, B., Fu, A. Y., Egan, C., Fiffick, A. N., Hutcherson, M. T., Turan, A., Naylor, A., Obal, D., and Cooke, E.
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- 2018
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15. THE ACCEPTABILITY, FEASIBILITY & APPROPRIATENESS OF A NOVEL BIOMARKER-GUIDED QUALITY IMPROVEMENT TREATMENT BUNDLE FOR PATIENTS WITH SUBCLINICAL ACUTE KIDNEY INJURY AFTER CARDIAC SURGERY
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Milne, B., primary, Gilbey, T., additional, Helyar, S., additional, Meeks, D., additional, Pellowe, C., additional, D''Andrea, E., additional, Lees, N., additional, Ostermann, M., additional, and Kunst, G., additional
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- 2022
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16. Methods of the 7 th National Audit Project ( NAP7 ) of the Royal College of Anaesthetists: peri‐operative cardiac arrest
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Kane, A. D., primary, Armstrong, R. A., additional, Kursumovic, E., additional, Cook, T. M., additional, Oglesby, F. C., additional, Cortes, L., additional, Moppett, I. K., additional, Moonesinghe, S. R., additional, Agarwal, S., additional, Bouch, D. C., additional, Cordingley, J., additional, Davies, M. T., additional, Dorey, J., additional, Finney, S. J., additional, Kunst, G., additional, Lucas, D. N., additional, Nickols, G., additional, Mouton, R., additional, Nolan, J. P., additional, Patel, B., additional, Pappachan, V. J., additional, Plaat, F., additional, Samuel, K., additional, Scholefield, B. R., additional, Smith, J. H., additional, Varney, L., additional, Vindrola‐Padros, C., additional, Martin, S., additional, Wain, E. C., additional, Kendall, S. W., additional, Ward, S., additional, Drake, S., additional, Lourtie, J., additional, Taylor, C., additional, and Soar, J., additional
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- 2022
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17. Cerebral oximetry: another blow to non‐invasive monitoring?
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Kunst, G. and Milan, Z.
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- 2017
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18. Intraoperative permissive oliguria – how much is too much?
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Kunst, G and Ostermann, M
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- 2017
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19. Patient characteristics, anaesthetic workload and techniques in the UK: an analysis from the 7th National Audit Project (NAP7) activity survey.
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Kane, A. D., Soar, J., Armstrong, R. A., Kursumovic, E., Davies, M. T., Oglesby, F. C., Cortes, L., Taylor, C., Moppett, I. K., Agarwal, S., Cordingley, J., Dorey, J., Finney, S. J., Kunst, G., Lucas, D. N., Nickols, G., Mouton, R., Nolan, J. P., Patel, B., and Pappachan, V. J.
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COVID-19 ,ANESTHETICS ,COVID-19 pandemic ,ANESTHESIOLOGISTS ,OPERATING room nursing ,ANESTHESIA - Abstract
Summary: Detailed contemporary knowledge of the characteristics of the surgical population, national anaesthetic workload, anaesthetic techniques and behaviours are essential to monitor productivity, inform policy and direct research themes. Every 3–4 years, the Royal College of Anaesthetists, as part of its National Audit Projects (NAP), performs a snapshot activity survey in all UK hospitals delivering anaesthesia, collecting patient‐level encounter data from all cases under the care of an anaesthetist. During November 2021, as part of NAP7, anaesthetists recorded details of all cases undertaken over 4 days at their site through an online survey capturing anonymous patient characteristics and anaesthetic details. Of 416 hospital sites invited to participate, 352 (85%) completed the activity survey. From these, 24,177 reports were returned, of which 24,172 (99%) were included in the final dataset. The work patterns by day of the week, time of day and surgical specialty were similar to previous NAP activity surveys. However, in non‐obstetric patients, between NAP5 (2013) and NAP7 (2021) activity surveys, the estimated median age of patients increased by 2.3 years from median (IQR) of 50.5 (28.4–69.1) to 52.8 (32.1–69.2) years. The median (IQR) BMI increased from 24.9 (21.5–29.5) to 26.7 (22.3–31.7) kg.m–2. The proportion of patients who scored as ASA physical status 1 decreased from 37% in NAP5 to 24% in NAP7. The use of total intravenous anaesthesia increased from 8% of general anaesthesia cases to 26% between NAP5 and NAP7. Some changes may reflect the impact of the COVID‐19 pandemic on the anaesthetic population, though patients with confirmed COVID‐19 accounted for only 149 (1%) cases. These data show a rising burden of age, obesity and comorbidity in patients requiring anaesthesia care, likely to impact UK peri‐operative services significantly. [ABSTRACT FROM AUTHOR]
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- 2023
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20. Intraoperative dexamethasone does not increase the risk of postoperative wound infection: a propensity score-matched post hoc analysis of the ENIGMA-II trial (EnDEX)
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Corcoran, T., Kasza, J., Short, T. G., O’Loughlin, E., Chan, M. T. V., Leslie, K., Forbes, A., Paech, M., Myles, P., Myles, P, Wallace, S, Galagher, W, Farrington, C, Ditoro, A, Peyton, P, Baulch, S, Sidiropoulos, S, Bulach, R, Bryant, D, O’Loughlin, E, Mitteregger, V, Bolsin, S, Osborne, C, McRae, R, Backstrom, M, Leslie, K, Cotter, R, Paech, M, March, S, Silbert, B, Said, S, Halliwell, R, Cope, J, Fahlbusch, D, Crump, D, Thompson, G, Jefferies, A, McCulloch, T, Reeves, M, Buckley, N, Tidyl, T, Schricker, T, Lattermann, R, Iannuzzi, D, Beattie, S, Carroll, J, Jacka, M, Bryden, C, Badner, N, Chan, MTV, (ANZCA Trials Group member), Tsang, MWY, Cheng, BCP, Fong, ACM, Chu, LCY, Koo, EGY, Mohd, N, Ming, L E, Yin Wang, C, Campbell, D, McAllister, D, Walker, S, Olliff, S, Kennedy, R, Eldawlatly, A, Alzahrani, T, Chua, N, Haller, G, Pichon, I, Sneyd, R, McMillan, H, Parkinson, I, Rousseau, G, Brennan, A, Balaji, P, Cupitt, J, Nightingale, J, Kunst, G, Dickinson, M, Saran, T, Subramaniam, B, Banner-Godspeed, V, Sessler, DI, Liu, J, Kurz, A, Hesler, B, Fu, AY, Egan, C, Fiffick, AN, Hutcherson, MT, Turan, A, Naylor, A, Obal, D, and Cooke, E
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- 2017
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21. Cerebral oximetry and its role in adult cardiac, non‐cardiac surgery and resuscitation from cardiac arrest
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Green, D. W. and Kunst, G.
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- 2017
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22. Krish Seetah, Humans, Animals, and the Craft of Slaughter in Archaeo-Historic Societies
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Kunst, G��nther Karl
- Abstract
Rezension zu: Krish Seetah, Humans, Animals, and the Craft of Slaughter in Archaeo-Historic Societies. Cambridge University Press, Cambridge 2018. ISBN 978-1-108-42880-4. doi: https://doi.org/10.1017/9781108553544. xix + 259 Seiten mit 45 Abbildungen und 8 Tabellen, Germania : Anzeiger der R��misch-Germanischen Kommission des Deutschen Arch��ologischen Instituts, Bd. 98 2020(2021)
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- 2021
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23. Methods of the 7th National Audit Project (NAP7) of the Royal College of Anaesthetists: peri‐operative cardiac arrest.
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Kane, A. D., Armstrong, R. A., Kursumovic, E., Cook, T. M., Oglesby, F. C., Cortes, L., Moppett, I. K., Moonesinghe, S. R., Agarwal, S., Bouch, D. C., Cordingley, J., Davies, M. T., Dorey, J., Finney, S. J., Kunst, G., Lucas, D. N., Nickols, G., Mouton, R., Nolan, J. P., and Patel, B.
- Abstract
Summary: Cardiac arrest in the peri‐operative period is rare but associated with significant morbidity and mortality. Current reporting systems do not capture many such events, so there is an incomplete understanding of incidence and outcomes. As peri‐operative cardiac arrest is rare, many hospitals may only see a small number of cases over long periods, and anaesthetists may not be involved in such cases for years. Therefore, a large‐scale prospective cohort is needed to gain a deep understanding of events leading up to cardiac arrest, management of the arrest itself and patient outcomes. Consequently, the Royal College of Anaesthetists chose peri‐operative cardiac arrest as the 7th National Audit Project topic. The study was open to all UK hospitals offering anaesthetic services and had a three‐part design. First, baseline surveys of all anaesthetic departments and anaesthetists in the UK, examining respondents' prior peri‐operative cardiac arrest experience, resuscitation training and local departmental preparedness. Second, an activity survey to record anonymised details of all anaesthetic activity in each site over 4 days, enabling national estimates of annual anaesthetic activity, complexity and complication rates. Third, a case registry of all instances of peri‐operative cardiac arrest in the UK, reported confidentially and anonymously, over 1 year starting 16 June 2021, followed by expert review using a structured process to minimise bias. The definition of peri‐operative cardiac arrest was the delivery of five or more chest compressions and/or defibrillation in a patient having a procedure under the care of an anaesthetist. The peri‐operative period began with the World Health Organization 'sign‐in' checklist or first hands‐on contact with the patient and ended either 24 h after the patient handover (e.g. to the recovery room or intensive care unit) or at discharge if this occured earlier than 24 h. These components described the epidemiology of peri‐operative cardiac arrest in the UK and provide a basis for developing guidelines and interventional studies. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
24. Homologous Radioimmunoassay for Human Parathyroid Hormone (Residues 44–68) with Tyrosylated Peptide as Tracer
- Author
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Schmidt-Gayk, H., Kunst, G., Schmidt-Gayk, Heinrich, editor, Armbruster, Franz Paul, editor, and Bouillon, Roger, editor
- Published
- 1990
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25. Peri-operative anaesthetic myocardial preconditioning and protection – cellular mechanisms and clinical relevance in cardiac anaesthesia
- Author
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Kunst, G. and Klein, A. A.
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- 2015
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26. Depth of anaesthesia optimisation and postoperative cognitive dysfunction
- Author
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Green, D., Ballard, C., and Kunst, G.
- Published
- 2015
- Full Text
- View/download PDF
27. Use of failure-to-rescue to identify international variation in postoperative care in low-, middle- and high-income countries
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Ahmad T., Bouwman R. A., Grigoras I., Aldecoa C., Hofer C., Hoeft A., Holt P., Buhre W., Pearse R. 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R., Stewart, K., Towse, K., Tregonning, J., Vahedi, A., Walker, A., Baines, D., Bilolikar, A., Chande, S., Copley, E., Dunk, N., Kulkarni, R., Kumar, P., Metodiev, Y., Ncomanzi, D., Raithatha, B., Raymode, P., Szafranski, J., Twohey, L., Watt, P., Weatherall, L., Weatherill, J., Whitman, Z., Wighton, E., Abayasinghe, C., Chan, A., Darwish, S., Gill, J., Glasgow, E., Hadfield, D., Harris, C., Hopkins, P., Kochhar, A., Kunst, G., Mellis, C., Pool, A., Riozzi, P., Selman, A., Smith, E. -J., Vele, L., Gercek, Y., Guy, K., Holden, D., Watson, N., Whysall, K., Andreou, P., Hales, D., Thompson, J., Bowrey, S., Mcdonald, S., Gilmore, J., Hills, V., Kelly, C., Kelly, S., Lloyd, G., Abbott, T., Gall, L., Torrance, H., Vivian, M., Berntsen, E., Nolan, T., Turner, A., Vohra, A., Brown, A., Clark, R., Coughlan, E., Daniel, C., Patvardhan, C., Pearson, R., Predeep, S., Saad, H., Shanmugam, M., Varley, S., Wylie, K., Cooper, L., Makowski, A., Misztal, B., Moldovan, E., Pegg, C., Donovan, A., Foot, J., Large, S., Claxton, A., Netke, B., Armstrong, R., Calderwood, C., Kwok, A., Mohr, O., Oyeniyi, P., Patnaik, L., Post, B., Ali, S., Arshad, H., Baker, G., Brenner, L., Brincat, M., Brunswicker, A., Cox, H., Cozar, O. I., Cheong, E., Durst, A., Fengas, L., Flatt, J., Glister, G., Narwani, V., Photi, E., Rankin, A., Rosbergen, M., Beaton, C., Horn, R., Hunt, J., Rousseau, G., Stancombe, L., Absar, M., Allsop, J., Drinkwater, Z., Hodgkiss, T., Smith, K., Alexander-Sefre, F., Campey, L., Dudgeon, L., Hall, K., Hitchcock, R., James, L., Winstone, U., Ahmad, N., Bauchmuller, K., Harrison, J., Jeffery, H., Miller, D., Pinder, A., Pothuneedi, S., Rosser, J., Sanghera, S., Swift, D., Walker, R., Bester, D., Cavanagh, S., Cripps, H., Daniel, H., Lynch, J., Pyke, S., Scholefield, J., Whitworth, H., Bottrill, F., Ramalingam, G., Webb, S., Akerman, N., Antill, P., Bourner, L., Buckley, S., Castle, G., Charles, R., Eggleston, C., Foster, R., Gill, S., Lindley, K., Lklouk, M., Lowery, T., Martin, O., Milne, D., O'Connor, P., Ratcliffe, A., Rose, A., Smith, A., Varma, S., Ward, J., Barcraft-Barnes, H., Camsooksai, J., Colvin, C., Reschreiter, H., Tbaily, L., Venner, N., Hamilton, C., Kelly, L., Toth-Tarsoly, P., Dodsworth, K., Foord, D., Gordon, P., Hawes, E., Lamb, N., Mouland, J., Nightingale, J., Rose, S., Schrieber, J., Al 'Amri, K., Aladin, H., Arshad, M. A., Barraclough, J., Bentley, C., Bergin, C., Carrera, R., Clarkson, A., Collins, M., Denham, S., Griffiths, E., Ip, P., Jeyanthan, S., Joory, K., Kaur, S., Marriott, P., Mitchell, N., Nagaiah, S., Nilsson, A., Parekh, N., Pope, M., Seager, J., Serag, H., Tameem, A., Thomas, A., Thunder, J., Torrance, A., Vohra, R., Whitehouse, A., Wong, T., Blunt, M., Wong, K., Giles, J., Reed, I., Weller, D., Bell, G., Birch, J., Damant, R., Maiden, J., Mewies, C., Prince, C., Radford, J., Reynolds, T., Balain, B., Banerjee, R., Barnett, A., Burston, B., Edwards, J., Evans, C., Ford, D., Gallacher, P., Hill, S., Jaffray, D., Karlakki, S., Kennedy, J., Kiely, N., Lewthwaite, S., Marquis, C., Ockendon, M., Phillips, S., Pickard, S., Richardson, J., Roach, R., Smith, T., Spencer-Jones, R., Steele, N., Steen, J., Van Liefland, M., White, S., Faulds, M., Harris, M., Nicol, S., Pearson, S. A., Chukkambotla, S., Andrew, A., Attrill, E., Campbell, G., Datson, A., Fouracres, A., Graterol, J., Graves, L., Hong, B., Ishimaru, A., Karthikeyan, A., King, H., Lawson, T., Lee, G., Lyons, S., Hall, A. M., Mathoulin, S., Mcintyre, E., Mclaughlin, D., Mulcahy, K., Paddle, J., Robbins, J., Sung, W., Tayo, A., Trembath, L., Venugopal, S., Wigmore, G., Boereboom, C., Downes, C., Humphries, R., Melbourne, S., Tou, S., Ullah, S., Batchelor, N., Boxall, L., Broomby, R., Deen, T., Hellewell, A., Helliwell, L., Hutchings, M., Hutchins, D., Keenan, S., Mackie, D., Potter, A., Smith, F., Stone, L., Thorpe, K., Wassall, R., Woodgate, A., Baillie, S., Campbell, T., James, S., King, C., De Araujo, D. M., Martin, D., Morkane, C., Neely, J., Rajendram, R., Burton, M., James, K., Keevil, E., Minik, O., Morgan, J., Musgrave, A., Rajanna, H., Roberts, T., Adamson, M., Jumbe, S., Kendall, J., Muthuswamy, M. B., Cruikshanks, A., Wrench, I., Zeidan, L., Ardern, D., Harris, B., Hellstrom, J., Martin, J., Thomas, R., Varsani, N., Brown, C. W., Docherty, P., Gillies, M., Mcgregor, E., Usher, H., Craig, J., Bodger, P., Creary, T., Everingham, K., Fowler, A., Hewson, R., Ijuo, E., Januszewska, M., Jones, T., Kantsedikas, I., Lahiri, S., Mclean, A. L., Niebrzegowska, E., Phull, M., Wickboldt, N., Baldwin, J., Doyle, D., Mcmullan, S., Oladapo, M., Owen, T., Williams, A., Gregory, P., Husain, T., Kirk-Bayley, J., Mathers, E., Montague, L., Harper, M., Jack, J., Ridley, C., Avis, J., Cook, T., Dali-Kemmery, L., Kerslake, I., Lambourne, V., Pearson, A., Boyd, C., Callaghan, M., Lawson, C., Mccrossan, R., Nesbitt, V., O'Connor, L., Sinclair, R., Farid, N., Morgese, C., Bhatia, K., Karmarkar, S., Ahmed, J., Branagan, G., Hutton, M., Swain, A., Brookes, J., Cornell, J., Dolan, R., Hulme, J., Van Vuuren, A. J., Jowitt, T., Kalashetty, G., Lloyd, F., Kiran, Patel, Sherwood, N., Brown, L., Chandler, B., Deighton, K., Emma, T., Haunch, K., Cheeseman, M., Dent, K., Gray, C., Hood, M., Jones, D., Juj, J., Rao, R., Walker, T., Al Anizi, M., Cheah, C., Cheing, Y., Coutinho, F., Gondo, P., Hadebe, B., Hove, M. O., Khader, A., Krishnachetty, B., Rhodes, K., Sokhi, J., Baker, K. -A., Bertram, W., Looseley, A., Mouton, R., Hanna, G., Arnold, G., Arya, S., Balfoussia, D., Baxter, L., Harris, J., Jones, C., Knaggs, A., Markar, S., Perera, A., Scott, A., Shida, A., Sirha, R., Wright, S., Frost, V., Andrews, E., Arrandale, L., Barrett, S., Cifra, E., Cooper, M., Dragnea, D., Elna, C., Maclean, J., Meier, S., Milliken, D., Munns, C., Ratanshi, N., Ramessur, S., Salvana, A., Watson, A., Ali, H., Critchley, R., Endersby, S., Hicks, C., Liddle, A., Pass, M., Ritchie, C., Thomas, C., Too, L., Welsh, S., Gill, T., Johnson, J., Reed, J., Davis, E., Papadopoullos, S., Attwood, C., Biffen, A., Boulton, K., Gray, S., Hay, D., Mills, S., Montgomery, J., Riddell, R., Simpson, J., Bhardwaj, N., Paul, E., Uwubamwen, N., Alexander, M., Arrich, J., Arumugam, S., Blackwood, D., Boggiano, V., Lam, Y., Chatterjee, D., Chhabra, A., Christian, R., Costelloe, H., Matthewman, M. C., Dalton, E., Darko, J., Davari, M., Dave, T., Deacon, M., Deepak, S., Edmond, H., Ellis, J., El-Sayed, A., Eneje, P., English, R., Ewe, R., Foers, W., Franklin, J., Gallego, L., Garrett, E., Goldberg, O., Goss, H., Greaves, R., Harris, R., Hennings, C., Jones, E., Kamali, N., Kokkinos, N., Lewis, C., Lignos, L., Malgapo, E. V., Malik, R., Milne, A., Mulligan, J. -P., Nicklin, P., Palipane, N., Parsons, T., Piper, R., Prakash, R., Ramesh, B., Rasip, S., Reading, J., Rela, M., Reyes, A., Stephens, R., Rooms, M., Shah, K., Simons, H., Solanki, S., Spowart, E., Stevens, A., Waggett, H., Yassaee, A., Kennedy, A., Scott, S., Somanath, S., Berg, A., Hernandez, M., Nanda, R., Tank, G., Wilson, N., Wilson, D., Al-Soudaine, Y., Baldwin, M., Cornish, J., Davies, Z., Davies, L., Edwards, M., Frewer, N., Gallard, S., Glasbey, J., Harries, R., Hopkins, L., Kim, T., Koompirochana, V., Lawson, S., Lewis, M., Makzal, Z., Scourfield, S., Ahmad, Y., Bates, S., Blackwell, C., Bryant, H., Collins, H., Coulter, S., Cruickshank, R., Daniel, S., Daubeny, T., Golder, K., Hawkins, L., Helen, B., Hinxman, H., Levett, D., Salmon, K., Seaward, L., Ben, L., Tyrell, B., Wadams, B., Walsgrove, J., Dickson, J., Constantin, K., Karen, M., O'Brien, P., O'Donohoe, L., Payne, H., Sundayi, S., Walker, E., Brooke, J., Cardy, J., Humphreys, S., Kessack, L., Kubitzek, C., Kumar, S., Cotterill, D., Hodzovic, E., Hosdurga, G., Miles, E., Saunders, G., Campbell, M., Chan, P., Jemmett, K., Raj, A., Naik, A., Oshowo, A., Ramamoorthy, R., Shah, N., Sylvan, A., Blyth, K., Burtenshaw, A., Freeman, D., Johnson, E., Lo, P., Martin, T., Plunkett, E., Wollaston, J., Allison, J., Carroll, C., Craw, N., Craw, S., Pitt-Kerby, T., Rowland-Axe, R., Spurdle, K., Mcdonald, A., Simon, D., Sinha, V., Banner-Goodspeed, V., Boone, M., Campbell, K., Lu, F., Scannell, J., Sobol, J., Balajonda, N., Clemmons, K., Conde, C., Elgasim, M., Funk, B., Hopkins, T., Olaleye, O., Omer, O., Pender, M., Porto, A., Waweru, P., Yeh, E., Bodansky, D., Evans, A., Kleopoulos, S., Maril, R., Mathney, E., Sanchez, A., Tinuoye, E., Bateman, B., Eng, K., Jiang, N., Ladha, K., Needleman, J., Chen, L. -L., Lane, R., Robinowitz, D., Ghushe, N., Irshad, M., O'Connor, J., Patel, S., Takemoto, S., Wallace, A., Mazzeffi, M., Rock, P., Wallace, K., Chua, P., Mattera, M., Sharar, R., Thilen, S., Treggiari, M., Morgan, A., Sofjan, I., Subramaniam, K., Avidan, M., Maybrier, H., Muench, M., and Wildes, T.
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operative ,Male ,Pediatrics ,GLOBAL HEALTH ,Cohort Studies ,0302 clinical medicine ,Postoperative Complications ,030202 anesthesiology ,surgical procedures, operative, mortality ,Health care ,statistics and numerical data ,030212 general & internal medicine ,Hospital Mortality ,Prospective Studies ,Prospective cohort study ,Aged, 80 and over ,HIGH-RISK SURGERY ,COMPLICATIONS ,OUTCOMES ,Incidence (epidemiology) ,Middle Aged ,PATIENT MORTALITY ,Female ,SURGICAL MORTALITY ,Cohort study ,Adult ,medicine.medical_specialty ,methods ,03 medical and health sciences ,Anesthesiology ,medicine ,QUALITY ,Humans ,Elective surgery ,postoperative care, statistics and numerical data ,Aged ,Quality of Health Care ,Postoperative Care ,business.industry ,Postoperative complication ,mortality ,CANCER-SURGERY ,surgical procedures ,Anesthesiology and Pain Medicine ,Logistic Models ,VOLUME ,postoperative care, methods ,Human medicine ,Complication ,business - Abstract
Background.The incidence and impact of postoperative complications are poorly described. Failure-to-rescue, the rate of death following complications, is an important quality measure for perioperative care but has not been investigated across multiple health care systems.Methods.We analysed data collected during the International Surgical Outcomes Study, an international 7-day cohort study of adults undergoing elective inpatient surgery. Hospitals were ranked by quintiles according to surgical procedural volume (Q1 lowest to Q5 highest). For each quintile we assessed in-hospital complications rates, mortality, and failure-to-rescue. We repeated this analysis ranking hospitals by risk-adjusted complication rates (Q1 lowest to Q5 highest).Results.A total of 44 814 patients from 474 hospitals in 27 low-, middle-, and high-income countries were available for analysis. Of these, 7508 (17%) developed one or more postoperative complication, with 207 deaths in hospital (0.5%), giving an overall failure-to-rescue rate of 2.8%. When hospitals were ranked in quintiles by procedural volume, we identified a three-fold variation in mortality (Q1: 0.6% vs Q5: 0.2%) and a two-fold variation in failure-to-rescue (Q1: 3.6% vs Q5: 1.7%). Ranking hospitals in quintiles by risk-adjusted complication rate further confirmed the presence of important variations in failure-to-rescue, indicating differences between hospitals in the risk of death among patients after they develop complications.Conclusions.Comparison of failure-to-rescue rates across health care systems suggests the presence of preventable postoperative deaths. Using such metrics, developing nations could benefit from a data-driven approach to quality improvement, which has proved effective in high-income countries.
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- 2017
28. II. From coronary steal to myocardial, renal, and cerebral protection: more questions than answers in anaesthetic preconditioning?
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Kunst, G.
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- 2014
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29. The effect of cyclosporin-A on peri-operative myocardial injury in adult patients undergoing coronary artery bypass graft surgery: a randomised controlled clinical trial
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Hausenloy, DJ, Kunst, G, Boston-Griffiths, E, Kolvekar, S, Chaubey, S, John, L, Desai, J, and Yellon, DM
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- 2014
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30. Time critical diagnosis and transfer of patients with acute type a aortic dissection in the United Kingdom – a need to define standards?
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Gilbey, T., primary, Milne, B., additional, Kunst, G., additional, and Arrowsmith, J., additional
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- 2020
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31. A narrative review of the impact of surgery and anaesthesia on acute kidney injury
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Ostermann, M., primary, Cennamo, A., additional, Meersch, M., additional, and Kunst, G., additional
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- 2020
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32. Anaesthetic depth and complications after major surgery: an international, randomised controlled trial
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Short, Timothy G, primary, Campbell, Douglas, additional, Frampton, Christopher, additional, Chan, Matthew T V, additional, Myles, Paul S, additional, Corcoran, Tomás B, additional, Sessler, Daniel I, additional, Mills, Gary H, additional, Cata, Juan P, additional, Painter, Thomas, additional, Byrne, Kelly, additional, Han, Ruquan, additional, Chu, Mandy H M, additional, McAllister, Davina J, additional, Leslie, Kate, additional, Shulman, M, additional, Wallace, S, additional, Farrington, C, additional, Gallagher, W, additional, Ditoro, A, additional, Peyton, P, additional, Baulch, S, additional, Dalyell, A, additional, Sidiropoulos, S, additional, Reynolds, J, additional, Rowley, J, additional, Tan, N, additional, McCallum, D, additional, O'Loughlin, E, additional, Wong, S, additional, Owen, K, additional, Sim, I-K, additional, Glazov, L, additional, Coutts, P, additional, Pushpanathan, M, additional, Findlay, V, additional, Paech, M, additional, Cavill, D, additional, Chuan, A, additional, Pope, L, additional, Lucas, J, additional, Robinson, B, additional, Millard, A, additional, Allen, S, additional, Allen, M, additional, McKeown, S, additional, Sivalingam, P, additional, Wilkes, T, additional, Jowett, C, additional, Kearney, A, additional, Bennett, M, additional, Favero, J-P, additional, Sawhney, S, additional, Drummond, K, additional, Osborn, S, additional, Wing, A, additional, Taylor, J, additional, Edwards, M, additional, Reynolds, H, additional, Town, C, additional, Terblanche, N, additional, Challis, M, additional, Seale, R, additional, Button, K, additional, Cotter, R, additional, Stewart, M, additional, Zingerle, N, additional, Hannon, S, additional, Middleton, D, additional, Edgley, C, additional, March, S, additional, McCulloch, T, additional, Wong, G, additional, Jeong, S, additional, Connell, K, additional, Kramer, K, additional, Henderson, G, additional, Ward, V, additional, Buller, Y, additional, Hird, N, additional, Scott, D, additional, Evered, L, additional, Snyder, G, additional, Silbert, B, additional, Corcoran, P, additional, Fitzgerald, E, additional, Said, S, additional, Watson, A, additional, Baby, D, additional, Bolsin, S, additional, Marriott, A, additional, Ives, K, additional, Wakefeld, B-J, additional, Jeffreys, A, additional, Bates, S, additional, Halliwell, R, additional, Elliott, D, additional, Cope, L, additional, Paranthoiene, R, additional, Peng, P, additional, Liu, X, additional, Zhou, X, additional, Jin, X, additional, Liu, H, additional, An, L, additional, Cui, W, additional, Zhang, L, additional, Jia, B, additional, Fang, J, additional, Koo, E, additional, Lo, E, additional, Fung, B, additional, Tsang, M, additional, Lam, L, additional, Pang, E, additional, Lau, V, additional, Choi, G, additional, Kwok, R, additional, Yau, K, additional, Cheng, B, additional, Lam, C, additional, Lee, E, additional, Buggy, D, additional, Keane, H, additional, Byrne, K, additional, Connolly, C, additional, Ali, M, additional, Cervantes, A, additional, Kumar, K, additional, Dandy, S, additional, Ritchie, L, additional, Kennedy, R, additional, McKellow, M, additional, Read, C, additional, France, D, additional, Truong, H, additional, Chapman, C, additional, Walker, S, additional, Olliff, S, additional, Houston, H, additional, Scott, M, additional, Minchin, I, additional, Moniwa, A, additional, McAlpine, J, additional, Chaddock, M, additional, Gray, L, additional, Czepanski, C, additional, Vinish, S, additional, Buehner, U, additional, Williams, E, additional, Zhou, C, additional, Goodman, L, additional, Bermaat, J, additional, Mans, G, additional, Garden, A, additional, Franks, R, additional, Deiterle, J, additional, Barrett, J, additional, Roubos, S, additional, van Lier, F, additional, Verbrugge, S, additional, Kalkman, C, additional, Dieleman, J, additional, Verdam-Veldkamp, J, additional, van Kampen, A, additional, Pai, A, additional, Sevillano, A, additional, Yeung, J, additional, Melody, T, 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additional, Malhotra, J, additional, Steinkamp, M, additional, Cooke, F, additional, and Friedlander, R, additional
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- 2019
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33. An approach to multidisciplinary team development in cardiothoracic theatres utilising video reflexive ethnography
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Gatherer, R., primary, Begum, N., additional, and Kunst, G., additional
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- 2019
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34. Preoperative anaemia management in patients undergoing vascular surgery.
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Nandhra, S., Chau, M., Klein, A. A., Yeates, J. A., Collier, T., Evans, C., Agarwal, S., Richards, T., Kunst, G., Mellor, A., Sugavanam, A., Dhesi, J., Clarke, M., Green, R., Chant, H., Kelleher, D., Martin, D., Bown, M., and Vohra, A.
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VASCULAR surgery ,ANEMIA ,RED blood cell transfusion - Published
- 2020
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35. In-hospital clinical outcomes after upper gastrointestinal surgery: Data from an international observational study
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Campbell, M, Chan, P, Jemmett, K, Raj, A, Naik, A, Oshowo, A, Ramamoorthy, R, Shah, N, Sylvan, A, Blyth, K, Burtenshaw, A, Freeman, D, Johnson, E, Lo, P, Martin, T, Plunkett, E, Wollaston, J, Allison, J, Carroll, C, Craw, N, Craw, S, Pitt-Kerby, T, Rowland-Axe, R, Spurdle, K, McDonald, A, Simon, D, Sinha, V, Banner-Goodspeed, V, Boone, M, Campbell, K, Lu, F, Scannell, J, Sobol, J, Balajonda, N, Clemmons, K, Conde, C, Elgasim, M, Funk, B, Hopkins, T, Olaleye, O, Omer, O, Pender, M, Porto, A, Waweru, P, Yeh, E, Bodansky, D, Evans, A, Kleopoulos, S, Maril, R, Mathney, E, Sanchez, A, Tinuoye, E, Bateman, B, Eng, K, Jiang, N, Ladha, K, Needleman, J, Chen, L-L, Lane, R, Robinowitz, D, Ghushe, N, Irshad, M, O'Connor, J, Patel, S, Takemoto, S, Wallace, A, Mazzeffi, M, Rock, P, Wallace, K, Chua, P, Fleisher, L, Mattera, M, Sharar, R, Thilen, S, Treggiari, M, Morgan, A, Sofjan, I, Subramaniam, K, Avidan, M, Maybrier, H, Muench, M, Wildes, T, ISOS, ISOS, Int Surgical Outcomes Study ISOS, Anesthesiology, ACS - Diabetes & metabolism, ACS - Microcirculation, ACS - Amsterdam Cardiovascular Sciences, APH - Quality of Care, ACS - Heart failure & arrhythmias, and International Surgical Outcomes Study (ISOS) group
- Subjects
Male ,IMPACT ,Cancer ,Complication rate ,Mortality ,Oesophagectomy ,Postoperative care ,Upper gastrointestinal surgery ,SURGICAL COMPLICATIONS ,0302 clinical medicine ,Postoperative Complications ,Risk Factors ,Outcome Assessment, Health Care ,030212 general & internal medicine ,Hospital Mortality ,Prospective Studies ,ESOPHAGOGASTRIC CANCER ,Prospective cohort study ,Digestive System Surgical Procedures ,RISK ,Perioperative medicine ,General Medicine ,Middle Aged ,Oncology ,Length of Stay/statistics & numerical data ,Elective Surgical Procedures ,MORTALITY FOLLOWING ESOPHAGECTOMY ,030220 oncology & carcinogenesis ,Female ,Elective Surgical Procedure ,Cohort study ,medicine.medical_specialty ,ENHANCED RECOVERY ,PERIOPERATIVE MEDICINE ,Postoperative Complications/mortality ,NO ,03 medical and health sciences ,Outcome Assessment (Health Care) ,MORBIDITY ,medicine ,Humans ,Digestive System Surgical Procedures/mortality ,business.industry ,LONG-TERM SURVIVAL ,Odds ratio ,Length of Stay ,CARE ,medicine.disease ,Confidence interval ,Surgery ,Human medicine ,Complication ,business - Abstract
Aims: Previous research suggests that patients undergoing upper gastrointestinal surgery are at high risk of poor postoperative outcomes. The aim of our study was to describe patient outcomes after elective upper gastrointestinal surgery at a global level.Methods: Prospective analysis of data collected during an international seven-day cohort study of 474 hospitals in 27 countries. Patients undergoing elective upper gastrointestinal. surgery were recruited. Outcome measures were in-hospital complications and mortality at 30-days. Results are presented as n(%) and odds ratios with 95% confidence intervals.Results: 2139 patients were included, of whom 498 (23.2%) developed one or more postoperative complications, with 30 deaths (1.4%). Patients with complications had longer median hospital stay 11 (6-18) days vs. 5 (2-10) days. Infectious complications were most frequent, affecting 368 (17.2%) patients. 328 (15.3%) patients were admitted to critical care postoperatively, of whom 161 (49.1%) developed a complication with 14 deaths (4.3%). In a multivariable logistic regression model we identified age (OR 1.02 [1.01-1.03]), American Society of Anesthesiologists physical status III (OR 2.12 [1.44-3.16]) and IV (OR 3.23 [1.72-6.09]), surgery for cancer (OR 1.63 [1.27-2.11]), open procedure (OR 1.40 [1.10-1.78]), intermediate surgery (OR 1.75 [1.12-2.81]) and major surgery (OR 2.65 [1.72-4.23]) as independent risk factors for postoperative complications. Patients undergoing major surgery for upper gastrointestinal cancer experienced twice the rate of complications compared to those undergoing other procedures (224/578 patients [38.8%] versus 274/1561 patients [17.6%]).Conclusions: Complications and death are common after upper gastrointestinal surgery. Patients undergoing major surgery for cancer are at greatest risk. (C) 2017 Elsevier Ltd, BASO similar to The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
- Published
- 2017
36. Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries
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Alexander, Lockwood, Geoffrey, Tsakok, Maria, Tsiligiannis, Sophia, Peat, William, Stephenson, Lorraine, Bradburn, Mike, Pick, Sara, Cunha, Pedro, Olagbaiye, Olufemi, Tayeh, Salim, Packianathaswamy, Balaji, Abernethy, Caroline, Balasubramaniam, Madhu, Bennett, Rachael, Bolton, David, Martinson, Victoria, Bell, Stephanie, Heather, Blaylock, Kushakovsky, Vlad, Alcock, Liam, Alexander, Hazel, Anderson, Colette, Baker, Paul, Brookes, Morag, Cawthorn, Louise, Cirstea, Emanuel, Clarkson, Rachel, Colling, Kerry, Coulter, Ian, Das, Suparna, Haigh, Kathryn, Hamdan, Alhafidz, Hugill, Keith, Kottam, Lucksy, Lisseter, Emily, Mawdsley, Matthew, Mcgivern, Julie, Padala, Krishnaveni, Phelps, Victoria, Kumar, Vineshykaa Ramesh, Stewart, Kirsten, Towse, Kayley, Tregonning, Julie, Vahedi, Ali, Walker, Alycon, Baines, Duncan, Bilolikar, Anjali, Chande, Shiv, Copley, Edward, Dunk, Nigel, Kulkarni, Raghavendra, Kumar, Pawan, Metodiev, Yavor, Ncomanzi, Dumisani, Raithatha, Bhavesh, Raymode, Parizade, Szafranski, Jan, Twohey, Linda, Watt, Philip, Weatherall, Lucie, Weatherill, J., Whitman, Zoe, Wighton, Elinor, Abayasinghe, Chamika, Chan, Alexander, Darwish, Sharif, Gill, Jame, Glasgow, Emma, Hadfield, Daniel, Harris, Clair, Hopkins, Phil, Kochhar, Arun, Kunst, Gudrun, Mellis, Clare, Pool, Andrew, Riozzi, Paul, Selman, Andrew, Smith, Emma-Jane, Vele, Liana, Gercek, Yuksel, Guy, Kramer, Holden, Dougla, Watson, Nichola, Whysall, Karen, Andreou, Prematie, Hales, Dawn, Thompson, Jonathan, Bowrey, Sarah, Mcdonald, Shara, Gilmore, Jemma, Hills, Vicky, Kelly, Chan, Kelly, Sinead, Lloyd, Geraint, Abbott, Tom, Gall, Lewi, Torrance, Hew, Vivian, Mark, Berntsen, Emer, Nolan, Tracey, Turner, Angu, Vohra, Akbar, Brown, Andrew, Clark, Richard, Coughlan, Elaine, Daniel, Conway, Patvardhan, Chinmay, Pearson, Rachel, Predeep, Sheba, Saad, Hesham, Shanmugam, Mohanakrishnan, Varley, Simon, Wylie, Katharine, Cooper, Lucy, Makowski, Arystarch, Misztal, Beata, Moldovan, Eliza, Pegg, Claire, Donovan, Andrew, Foot, Jayne, Large, Simon, Claxton, Andrew, Netke, Bhagyashree, Armstrong, Richard, Calderwood, Claire, Kwok, Andy, Mohr, Otto, Oyeniyi, Peter, Patnaik, Lisa, Post, Benjamin, Ali, Sarah, Arshad, Homa, Baker, Gerard, Brenner, Laura, Brincat, Maximilian, Brunswicker, Annemarie, Cox, Hannah, Cozar, Octavian Ionut, Cheong, Edward, Durst, Alexander, Fengas, Lior, Flatt, Jim, Glister, Georgina, Narwani, Vishal, Photi, Evangelo, Rankin, Adeline, Rosbergen, Melissa, Tan, Mark, Beaton, Ceri, Horn, Rachel, Hunt, Jane, Rousseau, Guy, Stancombe, Lucia, Absar, Mohammed, Allsop, Joanne, Drinkwater, Zoe, Hodgkiss, Tracey, Smith, Kirsty, Brown, Jamie, Alexander-Sefre, Farhad, Campey, Lorraine, Dudgeon, Lucy, Hall, Kathryn, Hitchcock, Rachael, James, Lynne, Smith, Kate, Winstone, Ulrika, Ahmad, Norfaizan, Bauchmuller, Kri, Harrison, Jonathan, Jeffery, Holly, Miller, Duncan, Pinder, Angela, Pothuneedi, Sailaja, Rosser, Jonathan, Sanghera, Sumayer, Swift, Diane, Walker, Rachel, Bester, Delia, Cavanagh, Sarah, Cripps, Heather, Daniel, Harvey, Lynch, Julie, Paton, Alison, Pyke, Shirley, Scholefield, John, Whitworth, Helen, Bottrill, Fiona, Ramalingam, Ganesh, Webb, Stephen, Akerman, Nik, Antill, Philip, Bourner, Lynsey, Buckley, Sarah, Castle, Gail, Charles, Rob, Eggleston, Christopher, Foster, Rebecca, Gill, Satwant, Lindley, Kate, Lklouk, Mohamed, Lowery, Tracey, Martin, Oliver, Milne, David, O'Connor, Patrick, Ratcliffe, Andrew, Rose, Alastair, Smith, Annie, Varma, Sandeep, Ward, Jackie, Barcraft-Barnes, Helena, Camsooksai, Julie, Colvin, Carolyn, Reschreiter, Henrik, Tbaily, Lee, Venner, Nicola, Hamilton, Caroline, Kelly, Lewi, Toth-Tarsoly, Piroska, Dodsworth, Kerry, Foord, Denise, Gordon, Paul, Hawes, Elizabeth, Lamb, Nikki, Mouland, Johanna, Nightingale, Jeremy, Rose, Steve, Schrieber, Joe, Al'Amri, Khalid, Aladin, Hafiz, Arshad, Mohammed Asif, Barraclough, Jame, Bentley, Conor, Bergin, Colin, Carrera, Ronald, Clarkson, Aisling, Collins, Michelle, Cooper, Lauren, Denham, Samuel, Griffiths, Ewen, Peter, Ip, Jeyanthan, Somasundaram, Joory, Kavita, Kaur, Satwant, Marriott, Paul, Mitchell, Natalie, Nagaiah, Sukumar, Nilsson, Annette, Parekh, Nilesh, Pope, Martin, Seager, Joseph, Serag, Hosam, Tameem, Alifia, Thomas, Anna, Thunder, Joanne, Torrance, Andrew, Vohra, Ravinder, Whitehouse, Arlo, Wong, Tony, Blunt, Mark, Wong, Kate, Giles, Julian, Reed, Isabelle, Weller, Debbie, Bell, Gillian, Birch, Julie, Damant, Rose, Maiden, Jane, Mewies, Clare, Prince, Claire, Radford, Jane, Reynolds, Tim, Balain, Birender, Banerjee, Robin, Barnett, Andrew, Burston, Ben, Davies, Kirsty, Edwards, Jayne, Evans, Chri, Ford, David, Gallacher, Pete, Hill, Simon, Jaffray, David, Karlakki, Sudheer, Kelly, Cormac, Kennedy, Julia, Kiely, Nigel, Lewthwaite, Simon, Marquis, Chri, Ockendon, Matthew, Phillips, Stephen, Pickard, Simon, Richardson, Jame, Roach, Richard, Smith, Tony, Spencer-Jones, Richard, Steele, Niall, Steen, Julie, Van Liefland, Marck, White, Steve, Faulds, Matthew, Harris, Meredyth, Kelly, Carrie, Nicol, Scott, Pearson, Sally Anne, Chukkambotla, Srikanth, Andrew, Alyson, Attrill, Elizabeth, Campbell, Graham, Datson, Amanda, Fouracres, Anna, Graterol, Juan, Graves, Lynne, Hong, Bosun, Ishimaru, Alexander, Karthikeyan, Arvind, King, Helen, Lawson, Tom, Lee, Gregory, Lyons, Saoirse, Hall, Andrew Macalister, Mathoulin, Sophie, Mcintyre, Eilidh, Mclaughlin, Danny, Mulcahy, Kathleen, Paddle, Jonathan, Ratcliffe, Anna, Robbins, Jame, Sung, Weilin, Tayo, Adeoluwa, Trembath, Lisa, Venugopal, Suneetha, Walker, Robert, Wigmore, Geoffrey, Boereboom, Catherine, Downes, Charlotte, Humphries, Ryan, Melbourne, Susan, Smith, Coral, Tou, Samson, Ullah, Shafa, Batchelor, Nick, Boxall, Leigh, Broomby, Rupert, Deen, Tariq, Hellewell, Alistair, Helliwell, Laurence, Hutchings, Melanie, Hutchins, David, Keenan, Samantha, Mackie, Donna, Potter, Alison, Smith, France, Stone, Lucy, Thorpe, Kevin, Wassall, Richard, Woodgate, Andrew, Baillie, Shelley, Campbell, Tara, James, Sarah, King, Chri, De Araujo, Daniela Marque, Martin, Danial, Morkane, Clare, Neely, Julia, Rajendram, Rajkumar, Burton, Megan, James, Kathryn, Keevil, Edward, Minik, Orsolya, Morgan, Jenna, Musgrave, Anna, Rajanna, Harish, Roberts, Tracey, Szakmany, Tama, Adamson, Michael, Jumbe, Sandra, Kendall, Jennie, Muthuswamy, Mohan Babu, Anderson, Charlotte, Cruikshanks, Andrew, Wrench, Ian, Zeidan, Lisa, Ardern, Diane, Harris, Benjamin, Hellstrom, Johanna, Martin, Jane, Thomas, Richard, Varsani, Nimu, Brown, Caroline Wrey, Docherty, Philip, Gillies, Michael, Mcgregor, Euan, Usher, Helen, Craig, Jayne, Smith, Andrew, Ahmad, Tahania, Bodger, Phoebe, Creary, Thai, Everingham, Kirsty, Fowler, Alexander, Hewson, Russell, Ijuo, Eke, Januszewska, Marta, Jones, Timothy, Kantsedikas, Ilya, Lahiri, Sumitra, Mclean, Aaron Lawson, Niebrzegowska, Edyta, Phull, Mandeep-Kaur, Wang, Difei, Wickboldt, Nadine, Baldwin, Jacqueline, Doyle, Donna, Mcmullan, Sean, Oladapo, Michelle, Owen, Thoma, Williams, Alexandra, Daniel, Hull, Gregory, Peter, Husain, Tauqeer, Kirk-Bayley, Justin, Mathers, Edward, Montague, Laura, Harper, Mark, White, Stuart, Jack, Jame, Ridley, Carrie, Avis, Joanne, Cook, Tim, Dali-Kemmery, Lola, Kerslake, Ian, Lambourne, Victoria, Pearson, Annabel, Boyd, Christine, Callaghan, Mark, Lawson, Cathy, Mccrossan, Roopa, Nesbitt, Vanessa, O'Connor, Laura, Scott, Julia, Sinclair, Rhona, Farid, Nahla, Morgese, Ciro, Bhatia, Kailash, Karmarkar, Swati, Ahmed, Jamil, Branagan, Graham, Hutton, Monica, Swain, Andrew, Brookes, Jamie, Cornell, Jonathan, Dolan, Rachael, Hulme, Jonathan, Van Vuuren, Amanda Jansen, Jowitt, Tom, Kalashetty, Gunasheela, Lloyd, Fran, Patel, Kiran, Sherwood, Nichola, Brown, Lynne, Chandler, Ben, Deighton, Kerry, Emma, Temlett, Haunch, Kirsty, Cheeseman, Michelle, Dent, Kathy, Garg, Sanjeev, Gray, Carol, Hood, Marion, Jones, Dawn, Juj, Joanne, Rao, Roshan, Walker, Tara, Al Anizi, Mashel, Cheah, Clarissa, Cheing, Yushio, Coutinho, Francisco, Gondo, Prisca, Hadebe, Bernard, Hove, Mazvangu Onie, Khader, Ahamed, Krishnachetty, Bobby, Rhodes, Karen, Sokhi, Jagdish, Baker, Katie-Anne, Bertram, Wendy, Looseley, Alex, Mouton, Ronelle, Hanna, George, Arnold, Glenn, Arya, Shobhit, Balfoussia, Danai, Baxter, Linden, Harris, Jame, Jones, Craig, Knaggs, Alison, Markar, Sheraz, Perera, Anisha, Scott, Alasdair, Shida, Asako, Sirha, Ravneet, Wright, Sally, Frost, Victoria, Gray, Catherine, Andrews, Emma, Arrandale, Lindsay, Barrett, Stephen, Cifra, Elna, Cooper, Mariese, Dragnea, Drago, Elna, Cifra, Maclean, Jennifer, Meier, Sonja, Milliken, Donald, Munns, Christopher, Ratanshi, Nadir, Ramessur, Suneil, Salvana, Abegail, Watson, Anthony, Hani, Ali, Campbell, Gill, Critchley, Rebecca, Endersby, Simon, Hicks, Catherine, Liddle, Alison, Pass, Marc, Ritchie, Charlotte, Thomas, Charlotte, Too, Lingxi, Welsh, Sarah, Gill, Talvinder, Johnson, Joanne, Reed, Joanne, Davis, Edward, Papadopoullos, Sam, Attwood, Clare, Biffen, Andrew, Boulton, Kerenza, Gray, Sophie, Hay, David, Mills, Sarah, Montgomery, Jane, Riddell, Rory, Simpson, Jame, Bhardwaj, Neeraj, Paul, Elaine, Uwubamwen, Nosakhare, Alexander, Maini, Arrich, Jame, Arumugam, Swarna, Blackwood, Dougla, Boggiano, Victoria, Brown, Robyn, Chan, Yik Lam, Chatterjee, Devnandan, Chhabra, Ashok, Christian, Rachel, Costelloe, Hannah, Matthewman, Madeline Coxwell, Dalton, Emma, Darko, Julia, Davari, Maria, Dave, Tejal, Deacon, Matthew, Deepak, Shantal, Edmond, Holly, Ellis, Jessica, El-Sayed, Ahmed, Eneje, Philip, English, Rose, Ewe, Renee, Foers, William, Franklin, John, Gallego, Laura, Garrett, Emily, Goldberg, Olivia, Goss, Harry, Greaves, Rosanna, Harris, Rudy, Hennings, Charle, Jones, Eleanor, Kamali, Nelson, Kokkinos, Naomi, Lewis, Cary, Lignos, Leda, Malgapo, Evaleen Victoria, Malik, Rizwana, Milne, Andrew, Mulligan, John-Patrick, Nicklin, Philippa, Palipane, Natasha, Parsons, Thoma, Piper, Rebecca, Prakash, Rohan, Ramesh, Byron, Rasip, Sarah, Reading, Jacob, Rela, Mariam, Reyes, Anna, Robert, Stephen, Rooms, Martin, Shah, Karishma, Simons, Henry, Solanki, Shalil, Spowart, Emma, Stevens, Amy, Thomas, Christopher, Waggett, Helena, Yassaee, Arrash, Kennedy, Anthony, Scott, Sara, Somanath, Sameer, Berg, Andrew, Miguel, Hernandez, Nanda, Rajesh, Tank, Ghanshyambhai, Wilson, Natalie, Wilson, Debbie, Al-Soudaine, Yassr, Baldwin, Matthew, Cornish, Julie, Davies, Zoe, Davies, Leigh, Edwards, Marc, Frewer, Natasha, Gallard, Sian, Glasbey, Jame, Harries, Rhiannon, Hopkins, Luke, Kim, Taeyang, Koompirochana, Vilavan, Lawson, Simon, Lewis, Megan, Makzal, Zaid, Scourfield, Sarah, Ahmad, Yousra, Bates, Sarah, Blackwell, Clare, Bryant, Helen, Collins, Hannah, Coulter, Suzanne, Cruickshank, Ro, Daniel, Sonya, Daubeny, Thoma, Edwards, Mark, Golder, Kim, Hawkins, Lesley, Helen, Bryant, Hinxman, Honor, Levett, Denny, Salmon, Karen, Seaward, Leanne, Skinner, Ben, Tyrell, Bryony, Wadams, Beverley, Walsgrove, Joseph, Dickson, Jane, Constantin, Kathryn, Karen, Markwell, O'Brien, Peter, O'Donohoe, Lynn, Payne, Hannah, Sundayi, Saul, Walker, Elaine, Brooke, Jenny, Cardy, Jon, Humphreys, Sally, Kessack, Laura, Kubitzek, Christiane, Kumar, Suha, Cotterill, Donna, Hodzovic, Emil, Hosdurga, Gurunath, Miles, Edward, Saunders, Glenn, Campbell, Marta, Chan, Peter, Jemmett, Kim, Raj, Ashok, Naik, Aditi, Oshowo, Ayo, Ramamoorthy, Rajarajan, Shah, Nimesh, Sylvan, Axel, Blyth, Katharine, Burtenshaw, Andrew, Freeman, David, Johnson, Emily, Philip, Lo, Martin, Terry, Plunkett, Emma, Wollaston, Julie, Allison, Joanna, Carroll, Christine, Craw, Nichola, Craw, Sarah, Pitt-Kerby, Tressy, Rowland-Axe, Rebecca, Spurdle, Katie, Mcdonald, Andrew, Simon, Davie, Sinha, Vivek, Smith, Thoma, Banner-Goodspeed, Valerie, Boone, Myle, Campbell, Kathleen, Fengxin, Lu, Scannell, Joseph, Sobol, Julia, Balajonda, Naraida, Clemmons, Karen, Conde, Carlo, Elgasim, Magdi, Funk, Bonita, Hall, Roger, Hopkins, Thoma, Olaleye, Omowunmi, Omer, Omer, Pender, Michelle, Porto, Angelo, Stevens, Alice, Waweru, Peter, Yeh, Erlinda, Bodansky, Daniella, Evans, Adam, Kleopoulos, Steven, Maril, Robert, Mathney, Edward, Sanchez, Angela, Tinuoye, Elizabeth, Bateman, Brian, Eng, Kristen, Jiang, Ning, Ladha, Karim, Needleman, Joseph, Chen, Lee-Lynn, Lane, Rondall, Robinowitz, David, Ghushe, Neil, Irshad, Mariam, O'Connor, John, Patel, Samir, Myles, Paul, Hiesmayr, Michael, Fang, Xiangming, Slim, Karem, Sander, Michael, Koulenti, Despoina, Chan, Mathew, Abbas, Muntadhar, Sivasakthi, Datin, Osinaike, Tunde, Matos, Ricardo, Grigoras, Ioana, Hubner, Martyn, Other departments, The International Surgical Outcomes Study, Group, Beretta, L, Landoni, G, and Zangrillo, A
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Critical Care/utilization ,Postoperative Complications/epidemiology ,Male ,cohort studies, critical care/utilisation, operative/mortality, postoperative care/methods, postoperative care/statistics and numerical data, surgery, surgical procedures ,Global Health ,law.invention ,surgery ,Postoperative Complications ,0302 clinical medicine ,Correction Notice ,cohort studies ,Anesthesiology ,030202 anesthesiology ,law ,cohort studiescritical care/utilisationoperative/mortalitypostoperative care/methodspostoperative care/statistics and numerical datasurgerysurgical procedures ,80 and over ,Hospital Mortality ,Prospective Studies ,030212 general & internal medicine ,Prospective cohort study ,Aged, 80 and over ,International Surgical Outcomes Study group ,Elective Surgical Procedures/mortality ,HCC NEF ,Middle Aged ,Elective Surgical Procedures/adverse effects ,Intensive care unit ,surgical procedure ,3. Good health ,Treatment Outcome ,Length of Stay/statistics & numerical data ,operative/mortality ,Elective Surgical Procedures ,Female ,Elective Surgical Procedure ,Life Sciences & Biomedicine ,Cohort study ,Adult ,medicine.medical_specialty ,Adolescent ,Critical Care ,critical care/utilisation ,postoperative care/methods ,postoperative care/statistics and numerical data ,surgical procedures ,Aged ,Humans ,Length of Stay ,Poverty ,Socioeconomic Factors ,Young Adult ,Anesthesiology and Pain Medicine ,NO ,Clinical Practice ,03 medical and health sciences ,Intensive care ,Journal Article ,medicine ,postoperative care/method ,Elective surgery ,Science & Technology ,business.industry ,Postoperative complication ,030208 emergency & critical care medicine ,1103 Clinical Sciences ,Surgery ,Global Health/statistics & numerical data ,Emergency medicine ,business ,cohort studie - Abstract
Background:As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. Methods:We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. Results:A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44814 patients with a median hospital stay of 4 (range 2–7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. Conclusions:Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. Study registration:ISRCTN51817007
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- 2016
37. Complications related to peri-operative transoesophageal echocardiography - a one-year prospective national audit by the Association of Cardiothoracic Anaesthesia and Critical Care.
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Ramalingam, G., Choi, S.‐W., Agarwal, S., Kunst, G., Gill, R., Fletcher, S. N., Klein, A. A., Shashidaran, P., Waghmare, K., Kadayam, R., Flynn, F., Gavin, N., Mairead‐Machugh, U., Bell, M., Hawthorn, A., Sajgalik, P., Burri, N., Meraglia, A., Choi, S-W, and Association of Cardiothoracic Anaesthesia and Critical Care
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AUDITING ,PERIOPERATIVE care ,CARDIAC surgery ,RESEARCH ,TRANSESOPHAGEAL echocardiography ,RESEARCH methodology ,EVALUATION research ,MEDICAL cooperation ,SEVERITY of illness index ,COMPARATIVE studies ,LONGITUDINAL method ,MEDICAL societies - Abstract
Previous studies on the safety of peri-operative transoesophageal echocardiography seem to suggest a low rate of associated morbidity and mortality. That said, there has been a paucity of prospective multicentre studies in this important area of clinical practice. We carried out a one-year prospective study in 2017, co-ordinated by the Association of Cardiothoracic Anaesthesia and Critical Care, to determine the rate and severity of complications associated with peri-operative transoesophageal echocardiography in anaesthetised cardiology and cardiac surgical patients. With the help of clinicians from 28 centres across the UK and Ireland, we recorded the total number of examinations conducted in anaesthetised patients during the study period. All major complications at each centre were prospectively reported and recorded. Of the 22,314 examinations, there were 17 patients diagnosed with a major complication which caused either palatal injury or gastro-oesophageal disruption. This corresponds to an incidence of 0.08% (95%CI 0.05-0.13%) or approximately 1:1300 examinations. There were seven deaths reported during the study period which were directly attributed to these complications, corresponding to an incidence of 0.03% (95%CI 0.01-0.07%) or approximately 1:3000. These figures are higher than previously reported and suggest a high probability of death following the development of a complication (~40%). Most complications occurred in patients without known risk factors for transoesophageal echocardiography associated gastro-oesophageal injury. We suggest clinicians and departments review their procedural guidelines, especially in relation to probe insertion techniques, together with the information communicated to patients when the risks and benefits of such examinations are discussed. [ABSTRACT FROM AUTHOR]
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- 2020
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38. Erratum to “Intraoperative permissive oliguria – how much is too much?” [Br J Anaesth 119 (2017) 1075–1077]
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Kunst, G., primary and Ostermann, M., additional
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- 2018
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39. Pre-operative frailty scores as markers for assessing disability-free survival in cardiac surgery?
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de Carvalho, Joshua Lucas, primary, Kwanten, L, additional, McNulty, R, additional, Du, W, additional, Berti, J, additional, Ayis, S, additional, and Kunst, G, additional
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- 2017
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40. Delirium in Critical Care
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Kunst, G., primary
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- 2015
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41. Gastric banding outcomes are better if patients participate in the support group: Rezultati operacije želodca s prilagodljivim trakom so boljši, če bolniki obiskujejo klub operiranih
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Breznikar, B., Dejan Dinevski, Kunst, G., and Rožej, B.
- Abstract
Introduction: We analyzed our first five years of performing gastric bandings.We monitored weight reduction in patients with regard to their participation in the support group. Based on our experience, gastric banding is successful only with thorough assessment and treatment before surgery, as well as methodical, professional support after it. Those who participated in the support group more often had a greater weight reduction than those who were present less frequently. Patients and methods: We performed 264 gastric bandings between May 2005 and May 2010 (66.5% of all bariatric procedures). Onaverage, patients were 41.0 years old and had a BMI of 42.4 kg/m2. There were 224 female (84.8%) and 40 male patients (15.2%). We followed 192 patientsfor more than one year. 155 patients (80.7%) were evaluated with BAROS. We excluded patients with hormonal disorders and other pathologies preoperatively. Because gastric banding is not suitable for every patient, we made a thorough psychological evaluation of the patients before the procedure.We offered preoperative and postoperative psychological and dietary support when needed. Results: Patients lost on average 23.4 kg, 31.4 kg and 33.7 kg after the 1st, 2nd and 3rd year, respectively (EWL average of 50.3%, 65.6% and 69.8%, respectively). We monitored the resolution of comorbidities and complications. Both the ĆcomorbidityĆ and Ćwithout comorbidityĆ groups achieved a grade of ĆgoodĆ on the BAROS quality of life scale (4.85 and 2.64 respectively). Given the Pearson coefficient of r = 0.58 (p < 0.001), we concluded that there is a Ćmoderate to strongĆ correlation between the number of visits in the support group and EWL. Conclusions: Weight reduction is greater when patients participate in the support group after bariatric surgery.
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- 2012
42. OP59 - Pre-operative frailty scores as markers for assessing disability-free survival in cardiac surgery?
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de Carvalho, Joshua Lucas, Kwanten, L, McNulty, R, Du, W, Berti, J, Ayis, S, and Kunst, G
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- 2017
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43. End tidal carbon dioxide (ETCO2) and peripheral pulse oximetry (SpO2) trends and right-to-left shunting in neonates undergoing non cardiac surgery under general anesthesia.
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Goonasekera, C., Kunst, G., and Mathew, M.
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CAPNOGRAPHY , *OXIMETRY , *GENERAL anesthesia - Abstract
Pulse-oximetry and capnography monitoring has improved the safety of anaesthesia. Using two case-reports we illustrate how trends in combined and concurrent pulse oximetry and capnography can assist diagnosis and management of acute right-to-left shunts in neonates undergoing non-cardiac surgery under general anaesthesia. In both cases, rapid desaturation was the dominant sign resulting from right-to-left blood flow at the level of the patent ductus arteriosus and/or functionally opened foramen ovale (reversing the preoperative left-to-right shunt). The concurrent hypercarbia detected in arterial blood gas was significant but possibly not evident in ETCO2 because only a small proportion of systemic venous blood reached the pulmonary circulation for gas exchange. Treatment methods included improving oxygenation by increasing inspiratory oxygen concentration (FiO2), volume expansion to improve pulmonary blood flow, re duction of CO2 by hyperventilation and increasing the dopamine infusion dose in one infant to augment systemic vascular resistance. In the event of a reversed left to right shunt, pulmonary arterial blood CO2 (PaCO2) rises as a result of systemic recirculation. However, a rise in ETCO2 depends on the remaining pulmonary blood flow. For example, if the reversed shunt is large (i.e. increasing right to left shunt), then pulmonary blood flow is reduced and the CO2 delivered to the lungs per unit time becomes inadequate to reflect it in expired breaths as ETCO2. Therefore, ETCO2 can be low in a suddenly reversed shunt state. Poor pulmonary blood flow leads to a low CO2 elimination in expired air resulting in a low ETCO2 record. [ABSTRACT FROM AUTHOR]
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- 2017
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44. Changing Livelihoods: the case of small-scale mining in Northern Luzon, the Philippines
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Kunst, G. and Kunst, G.
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When studying the literature about livelihoods it soon becomes clear that livelihoods are changing and shifting from farm to non-farm activities. No longer are peasants seen as rural people who are solely or primarily engaged in farming. This realization has led to the livelihood approach which comes to terms with how rural people actually make a living. This is not to say that farming is declining, but that farmers are diversifying their income, with alternative livelihoods. This broadening of livelihood activities, called ‘livelihood diversification’, is a way for rural people to increase their standard of living or to secure their economic position (Ellis 2000b). One alternative livelihood is small-scale mining, an important livelihood in different countries around the world, but almost absent in the literature about livelihoods. This is how we came to the following research question, which we will explore in this thesis: which livelihoods and livelihood strategies are present in Kabayan and what is the role of farming and mining herein?
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- 2013
45. Offered to Gods, Eaten by People: Bird Bones from the Sanctuary of Jupiter Heliopolitanus in Carnuntum-Mühläcker (Austria)
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Gál, E., primary and Kunst, G. K., additional
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- 2013
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46. Saturday, 17 July 2010
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Dimova, I., primary, Hlushchuk, R., additional, Makanya, A., additional, Djonov, V., additional, Theurl, M., additional, Schgoer, W., additional, Albrecht, K., additional, Beer, A., additional, Patsch, J. R., additional, Schratzberger, P., additional, Mahata, S., additional, Kirchmair, R., additional, Didie, M., additional, Christalla, P., additional, Rau, T., additional, Eschenhagen, T., additional, Schumacher, U., additional, Lin, Q., additional, Zenke, M., additional, Zimmmermann, W., additional, Hoch, M., additional, Fischer, P., additional, Stapel, B., additional, Missol-Kolka, E., additional, Erschow, S., additional, Scherr, M., additional, Drexler, H., additional, Hilfiker-Kleiner, D., additional, Diebold, I., additional, Petry, A., additional, Kennel, P., additional, Djordjevic, T., additional, Hess, J., additional, Goerlach, A., additional, Castellano, J., additional, Aledo, R., additional, Sendra, J., additional, Costales, P., additional, Badimon, L., additional, Llorente-Cortes, V., additional, Dworatzek, E., additional, Mahmoodzadeh, S., additional, Regitz-Zagrosek, V., additional, Posa, A., additional, Varga, C., additional, Berko, A., additional, Veszelka, M., additional, Szablics, P., additional, Vari, B., additional, Pavo, I., additional, Laszlo, F., additional, Brandenburger, M., additional, Wenzel, J., additional, Bogdan, R., additional, Richardt, D., additional, Reppel, M., additional, Hescheler, J., additional, Terlau, H., additional, Dendorfer, A., additional, Heijman, J., additional, Rudy, Y., additional, Westra, R., additional, Volders, P., additional, Rasmusson, R., additional, Bondarenko, V., additional, Ertas Gokhan, M. D., additional, Ural Ertan, M. D., additional, Karaoz Erdal, P. H. D., additional, Aksoy Ayca, P. H. D., additional, Kilic Teoman, M. D., additional, Kozdag Guliz, M. D., additional, Vural Ahmet, M. D., additional, Ural Dilek, M. 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- 2010
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47. Progress in non-invasive respiratory monitoring using uncalibrated breathing movement components
- Author
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Black, A M S, primary, Bambridge, A, additional, Kunst, G, additional, and Millard, R K, additional
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- 2001
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48. Offered to Gods, Eaten by People: Bird Bones from the Sanctuary of Jupiter Heliopolitanus in Carnuntum-Mühläcker (Austria).
- Author
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Gál, E. and Kunst, G. K.
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BIRD remains (Archaeology) , *BONES , *ZOOARCHAEOLOGY , *ANTIQUITIES ,CARNUNTUM (Extinct city) - Abstract
ABSTRACT This paper discusses the bird bones from a large animal bone assemblage found in the largest pit located on the territory of the Sanctuary of Jupiter Heliopolitanus in Carnuntum-Mühläcker (Austria). Features of the material suggest that the bones result from ritual meals, perhaps from a single event. The bird bone assemblage is characterised by the dominance of domestic chicken ( Gallus domesticus), but the number of (domestic) goose ( Anser cf. domesticus) remains is outstanding. Wild species such as the greater white-fronted goose ( Anser albifrons) and the mallard ( Anas platyrhynchos) were represented by smaller numbers of remains. According to the distribution of bones, the birds were slaughtered in the sanctuary. The calculated minimum number of individuals is about 193 fowl. The slaughtering season is proposed to have been in early spring according to the seasonal presence of the greater white-fronted goose and the age at death of the domestic mammals. On the basis of the measurements of sexed tarsometatarsi, two size groups of domestic chicken were identified. Similar results regarding the dimensions of this species could be recognised from a number of civic and cultic Roman localities in Central Europe. The dominance of male over female birds in domestic chicken is notable in our assemblage, and points to an Eastern origin for the feasting habits, especially in the light of the scarcity of pig remains in this context as opposed to urban Carnuntum. Unlike the assemblages unearthed from Mithraea, however, it was mostly beef that was consumed in addition to fowl in the sanctuary of Carnuntum-Mühläcker. Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]
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- 2014
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49. ASSESSMENT OF THE THYROID STATUS AT THE TISSUE LEVEL IN PATIENTS UNDERGOING CORONARY ARTERY BYPASS SURGERY
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Kunst, G., primary, Motsch, J., additional, Pfeilschifter, J., additional, Kummermehr, G., additional, Bismar, H., additional, Luntz, S., additional, and Martin, E., additional
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- 1998
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50. SEVOFLURANE INDUCED CALCIUM RELEASE OF THE SARCOPLASMIC RETICULUM
- Author
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Kunst, G., primary, Graf, B., additional, Schreiner, R., additional, Martin, E., additional, and Fink, R. H. A., additional
- Published
- 1998
- Full Text
- View/download PDF
Catalog
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