13 results on '"MacLeod CS"'
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2. Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study
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Nepogodiev, D, Walker, K, Glasbey, JC, Drake, TM, Borakati, A, Kamarajah, S, McLean, K, Khatri, C, Arulkumaran, N, Harrison, EM, Fitzgerald, JE, Cromwell, D, Prowle, J, Bhangu, A, Bath, MF, Claireaux, HA, Gundogan, B, Mohan, M, Deekonda, P, Kong, C, Joyce, H, Mcnamee, L, Woin, E, Burke, J, Bell, S, Duthie, F, Hughes, J, Pinkney, TD, Richards, T, Thomas, M, Dynes, K, Patel, P, Wigley, C, Suresh, R, Shaw, A, Klimach, S, Jull, P, Evans, D, Preece, R, Ibrahim, I, Manikavasagar, V, Brown, FS, Teo, R, Sim, DPY, Logan, AE, Barai, I, Amin, H, Suresh, S, Sethi, R, Bolton, W, Corbridge, O, Horne, L, Attalla, M, Morley, R, Hoskins, T, McAllister, R, Lee, S, Dennis, Y, Nixon, G, Heywood, E, Wilson, H, Ng, L, Samaraweera, S, Mills, A, Doherty, C, Belchos, J, Phan, V, Chouari, T, Gardner, T, Goergen, N, Hayes, JDB, MacLeod, CS, McCormack, R, McKinley, A, McKinstry, S, Milligan, W, Ooi, L, Rafiq, NM, Sammut, T, Sinclair, E, Smith, M, Baker, C, Boulton, APR, Collins, J, Copley, HC, Fearnhead, N, Fox, H, Mah, T, McKenna, J, Naruka, V, Nigam, N, Nourallah, B, Perera, S, Qureshi, A, Saggar, S, Sun, L, Wang, X, Yang, DD, Caroll, P, Doyle, C, Elangovan, S, Falamarzi, A, Perai, KG, Greenan, E, Jain, D, Lang-Orsini, M, Lim, S, O'Byrne, L, Ridgway, P, Van der Laan, S, Wong, J, Arthur, J, Barclay, J, Bradley, P, Edwin, C, Finch, E, Hayashi, E, Hopkins, M, Kelly, D, Kelly, M, McCartan, N, Ormrod, A, Pakenham, A, Hayward, J, Hitchen, C, Kishore, A, Martins, T, Philomen, J, Rao, R, Rickards, C, Burns, N, Copeland, M, Durand, C, Dyal, A, Ghaffar, A, Gidwani, A, Grant, M, Gribbon, C, Gruhn, A, Leer, M, Ahmad, K, Beattie, G, Beatty, M, Campbell, G, Donaldson, G, Graham, S, Holmes, D, Kanabar, S, Liu, H, McCann, C, Stewart, R, Vara, S, Ajibola-Taylor, O, Andah, EJE, Ani, C, Cabdi, NMO, Ito, G, Jones, M, Komoriyama, A, Titu, L, Basra, M, Gallogly, P, Harinath, G, Leong, SH, Pradhan, A, Siddiqui, I, Zaat, S, Ali, A, Galea, M, Looi, WL, Ng, JCK, Atkin, G, Azizi, A, Cargill, Z, China, Z, Elliot, J, Jebakumar, R, Lam, J, Mudalige, G, Onyerindu, C, Renju, M, Babu, VS, Hussain, M, Joji, N, Lovett, B, Mownah, H, Ali, B, Cresswell, B, Dhillon, AK, Dupaguntla, YS, Hungwe, C, Lowe-Zinola, JD, Tsang, JCH, Bevan, K, Cardus, C, Duggal, A, Hossain, S, McHugh, M, Scott, M, Chan, F, Evans, R, Gurung, E, Haughey, B, Jacob-Ramsdale, B, Kerr, M, Lee, J, McCann, E, O'Boyle, K, Reid, N, Hayat, F, Hodgson, S, Johnston, R, Jones, W, Khan, M, Linn, T, Long, S, Seetharam, P, Shaman, S, Smart, B, Anilkumar, A, Davies, J, Griffith, J, Hughes, B, Islam, Y, Kidanu, D, Mushaini, N, Qamar, I, Robinson, H, Schramm, M, Tan, CY, Apperley, H, Billyard, C, Blazeby, JM, Cannon, SP, Carse, S, Gopfert, A, Loizidou, A, Parkin, J, Sanders, E, Sharma, S, Slade, G, Telfer, R, Huppatz, IW, Worley, E, Chandramoorthy, L, Friend, C, Harris, L, Jain, P, Karim, MJ, Killington, K, McGillicuddy, J, Rafferty, C, Rahunathan, N, Rayne, T, Varathan, Y, Verma, N, Zanichelli, D, Arneill, M, Brown, F, Campbell, B, Crozier, L, Henry, J, McCusker, C, Prabakaran, P, Wilson, R, Asif, U, Connor, M, Dindyal, S, Math, N, Pagarkar, A, Saleem, H, Seth, I, Standfield, N, Swartbol, T, Adamson, R, Choi, JE, El Tokhy, O, Ho, W, Javaid, NR, Mehdi, AS, Menon, D, Plumptre, I, Sturrock, S, Turner, J, Warren, O, Crane, E, Ferris, B, Gadsby, C, Smallwood, J, Vipond, M, Wilson, V, Amarnath, T, Doshi, A, Gregory, C, Kandiah, K, Powell, B, Spoor, H, Toh, C, Vizor, R, Common, M, Dunleavy, K, Harris, S, Luo, C, Mesbah, Z, Kumar, AP, Redmond, A, Skulsky, S, Walsh, T, Daly, D, Deery, L, Epanomeritakis, E, Harty, M, Kane, D, Khan, K, Mackey, R, McConville, J, McGinnity, K, Ang, A, Kee, JY, Leung, E, Norman, S, Palaniappan, S, Sarathy, PP, Yeoh, T, Frost, J, Hazeldine, P, Jones, L, Karbowiak, M, Macdonald, C, Mutarambirwa, A, Omotade, A, Runkel, M, Ryan, G, Sawers, N, Searle, C, Vig, S, Ahmad, A, McGartland, R, Sim, R, Song, A, Wayman, J, Brown, R, Chang, LH, Concannon, K, Crilly, C, Arnold, TJ, Burgin, A, Cadden, F, Choy, CH, Coleman, M, Lim, D, Luk, J, Mahankali-Rao, P, Prudence-Taylor, AJ, Ramakrishnan, D, Russell, J, Fawole, A, Gohil, J, Green, B, Hussain, A, McMenamin, L, Tang, M, Azmi, F, Benchetrit, S, Cope, T, Haque, A, Harlinska, A, Holdsworth, R, Ivo, T, Martin, J, Nisar, T, Patel, A, Sasapu, K, Trevett, J, Vernet, G, Aamir, A, Bird, C, Durham-Hall, A, Gibson, W, Hartley, J, May, N, Maynard, V, Johnson, S, Wood, CM, O'Brien, M, Orbell, J, Stringfellow, TD, Tenters, F, Tresidder, S, Cheung, W, Grant, A, Tod, N, Bews-Hair, M, Lim, ZH, Lim, SW, Vella-Baldacchino, M, Auckburally, S, Chopada, A, Easdon, S, Goodson, R, McCurdie, F, Narouz, M, Radford, A, Rea, E, Taylor, O, Yu, T, Alfa-Wali, M, Amani, L, Auluck, I, Bruce, P, Emberton, J, Kumar, R, Lagzouli, N, Mehta, A, Murtaza, A, Raja, M, Dennahy, IS, Frew, K, Given, A, He, YY, Karim, MA, MacDonald, E, McDonald, E, McVinnie, D, Ng, SK, Pettit, A, Berthaume-Hawkins, SD, Charnley, R, Fenton, K, Jones, D, Murphy, C, Ng, JQ, Reehal, R, Seraj, SS, Shang, E, Tonks, A, White, P, Yeo, A, Chong, P, Gabriel, R, Patel, N, Richardson, E, Symons, L, Aubrey-Jones, D, Dawood, S, Dobrzynska, M, Faulkner, S, Griffiths, H, Mahmood, F, Perry, M, Power, A, Simpson, R, Brobbey, P, Burrows, A, Elder, P, Ganyani, R, Horseman, C, Hurst, P, Mann, H, Marimuthu, K, McBride, S, Pilsworth, E, Powers, N, Stanier, P, Innes, R, Kersey, T, Kopczynska, M, Langasco, N, Rajagopal, R, Atkins, B, Beasley, W, Lim, ZC, Gill, A, Ang, HL, Williams, H, Yogeswara, T, Carter, R, Fam, M, Fong, J, Latter, J, Long, M, Mackinnon, S, McKenzie, C, Osmanska, J, Raghuvir, V, Shafi, A, Tsang, K, Walker, L, Bountra, K, Coldicutt, O, Fletcher, D, Hudson, S, Iqbal, S, Bernal, TL, Martin, JWB, Moss-Lawton, F, Cardwell, A, Edgerton, K, Laws, J, Rai, A, Robinson, K, Waite, K, Ward, J, Youssef, H, Knight, C, Koo, PY, Lazarou, A, Stanger, S, Thorn, C, Triniman, MC, Botha, A, Boyles, L, Cumming, S, Deepak, S, Ezzat, A, Fowler, AJ, Gwozdz, AM, Hussain, SF, Khan, S, Li, H, Morrell, BL, Neville, J, Nitiahpapand, R, Pickering, O, Sagoo, H, Sharma, E, Welsh, K, Denley, S, Agarwal, M, Al-Saadi, N, Bhambra, R, Gupta, A, Jawad, ZAR, Jiao, LR, Mahir, G, Singagireson, S, Thoms, BL, Tseu, B, Wei, R, Yang, N, Britton, N, Leinhardt, D, Mahfooz, M, Palkhi, A, Price, M, Sheikh, S, Barker, M, Bowley, D, Cant, M, Datta, U, Farooqi, M, Lee, A, Morley, G, Amin, MN, Parry, A, Patel, S, Strang, S, Yoganayagam, N, Adlan, A, Chandramoorthy, S, Choudhary, Y, Das, K, Feldman, M, France, B, Grace, R, Puddy, H, Soor, P, Ali, M, Dhillon, P, Faraj, A, Gerard, L, Glover, M, Imran, H, Kim, S, Patrick, Y, Peto, J, Prabhudesai, A, Smith, R, Tang, A, Vadgama, N, Dhaliwal, R, Ecclestone, T, Harris, A, Ong, D, Patel, D, Philp, C, Stewart, E, Wang, L, Wong, E, Xu, Y, Ashaye, T, Fozard, T, Galloway, F, Kaptanis, S, Mistry, P, Nguyen, T, Olagbaiye, F, Osman, M, Philip, Z, Rembacken, R, Tayeh, S, Theodoropoulou, K, Herman, A, Lau, J, Saha, A, Trotter, M, Adeleye, O, Cave, D, Gunwa, T, Magalhaes, J, Makwana, S, Mason, R, Parish, M, Regan, H, Renwick, P, Roberts, G, Salekin, D, Sivakumar, C, Tariq, A, Liew, I, McDade, A, Stewart, D, Hague, M, Hudson-Peacock, N, Jackson, CES, James, F, Pitt, J, Walker, EY, Aftab, R, Ang, JJ, Anwar, S, Battle, J, Budd, E, Chui, J, Crook, H, Davies, P, Easby, S, Hackney, E, Ho, B, Imam, SZ, Rammell, J, Andrews, H, Perry, C, Schinle, P, Ahmed, P, Aquilina, T, Balai, E, Church, M, Cumber, E, Curtis, A, Davies, G, Dumann, E, Greenhalgh, S, Kim, P, King, S, Metcalfe, KHM, Passby, L, Redgrave, N, Soonawalla, Z, Waters, S, Zornoza, A, Gulzar, I, Hole, J, Hull, K, Ishaq, H, Karaj, J, Kelkar, A, Love, E, Thakrar, D, Vine, M, Waterman, A, Dib, NP, Francis, N, Hanson, M, Ingleton, R, Sadanand, KS, Sukirthan, N, Arnell, S, Ball, M, Bassam, N, Beghal, G, Chang, A, Dawe, V, George, A, Huq, T, Ikram, B, Kanapeckaite, L, Ramjas, D, Rushd, A, Sait, S, Serry, M, Yardimci, E, Capella, S, Chenciner, L, Episkopos, C, Karam, E, McCarthy, C, Moore-Kelly, W, Watson, N, Ahluwalia, V, Barnfield, J, Ben-Gal, O, Bloom, I, Gharatya, A, Khodatars, K, Merchant, N, Moonan, A, Moore, M, Patel, K, Spiers, H, Sundaram, K, Black, J, Chadwick, H, Huisman, L, Ingram, H, Martin, L, Metcalfe, M, Sangal, P, Seehra, J, Thatcher, A, Venturini, S, Whitcroft, I, Afzal, Z, Brown, S, Gani, A, Gomaa, A, Hussein, N, Oh, SY, Pazhaniappan, N, Sharkey, E, Sivagnanasithiyar, T, Williams, C, Yeung, J, Cruddas, L, Gurjar, S, Pau, A, Prakash, R, Randhawa, R, Chen, L, Eiben, I, Naylor, M, Osei-Bordom, D, Trenear, R, Bannard-Smith, J, Griffiths, N, Patel, BY, Saeed, F, Abdikadir, H, Bennett, M, Church, R, Clements, SE, Court, J, Delvi, A, Hubert, J, Macdonald, B, Mansour, F, Patel, RR, Perris, R, Small, S, Betts, A, Brown, N, Chong, A, Croitoru, C, Grey, A, Hickland, P, Ho, C, Hollington, D, McKie, L, Nelson, AR, Stewart, H, Eiben, P, Nedham, M, Ali, I, Brown, T, Hunt, C, Joyner, C, McAlinden, C, Rogers, D, Thachettu, A, Tyson, N, Vaughan, R, Yasin, T, Andrew, K, Bhamra, N, Leong, S, Mistry, R, Noble, H, Rashed, F, Walker, NR, Watson, L, Worsfold, M, Yarham, E, Arshad, A, Barmayehvar, B, Cato, L, Chan-lam, N, Do, V, Leong, A, Sheikh, Z, Zheleniakova, T, Coppel, J, Hussain, ST, Mahmood, R, Nourzaie, R, Sheik-Ali, S, Thomas, A, Alagappan, A, Ashour, R, Bains, H, Diamond, J, Gordon, J, Ibrahim, B, Khalil, M, Mittapalli, D, Neo, YN, Patil, P, Peck, FS, Reza, N, Swan, I, Whyte, M, Chaudhry, S, Hernon, J, Khawar, H, O'Brien, J, Pullinger, M, Rothnie, K, Ujjal, S, Bhatte, S, Curtis, J, Green, S, Mayer, A, Watkinson, G, Chapple, K, Hawthorne, T, Khaliq, M, Majkowski, L, Malik, TAM, Mclauchlan, K, En, BNW, O'Connor, T, Parton, S, Robinson, SD, Saat, M, Shurovi, BN, Varatharasasingam, K, Ward, AE, Behranwala, K, Bertelli, M, Cohen, J, Duff, F, Fafemi, O, Gupta, R, Manimaran, M, Mayhew, J, Peprah, D, Wong, MHY, Farmer, N, Houghton, C, Kandhari, N, Ladha, D, Mayes, J, McLennan, F, Panahi, P, Seehra, H, Agrawal, R, Ahmed, I, Ali, S, Birkinshaw, F, Choudhry, M, Gokani, S, Harrogate, S, Jamal, S, Nawrozzadeh, F, Swaray, A, Szczap, A, Warusavitarne, J, Abdalla, M, Asemota, N, Cullum, R, Hartley, M, Maxwell-Armstrong, C, Mulvenna, C, Phillips, J, Yule, A, Ahmed, L, Clement, KD, Craig, N, Elseedawy, E, Gorman, D, Kane, L, Livie, J, Livie, V, Moss, E, Naasan, A, Ravi, F, Shields, P, Zhu, Y, Archer, M, Cobley, H, Dennis, R, Downes, C, Guevel, B, Lamptey, E, Murray, H, Radhakrishnan, A, Saravanabavan, S, Sardar, M, Shaw, C, Tilliridou, V, Wright, R, Ye, W, Alturki, N, Helliwell, R, Jones, E, Lambotharan, S, Scott, K, Sivakumar, R, Victor, L, Boraluwe-Rallage, H, Froggatt, P, Haynes, S, Hung, YMA, Keyte, A, Matthews, L, Evans, E, Haray, P, John, I, Mathivanan, A, Morgan, L, Oji, O, Okorocha, C, Rutherford, A, Stageman, N, Tsui, A, Whitham, R, Amoah-Arko, A, Cecil, E, Dietrich, A, Fitzpatrick, H, Guy, C, Hair, J, Hilton, J, Jawad, L, McAleer, E, Taylor, Z, Yap, J, Akhbari, M, Debnath, D, Dhir, T, Elbuzidi, M, Elsaddig, M, Glace, S, Khawaja, H, Koshy, R, Lal, K, Lobo, L, McDermott, A, Meredith, J, Qamar, MA, Vaidya, A, Acquaah, F, Barfi, L, Carter, N, Gnanappiragasam, D, Ji, C, Kaminski, F, Lawday, S, Mackay, K, Sulaiman, SK, Webb, R, Ananthavarathan, P, Dalal, F, Farrar, E, Hashemi, R, Hossain, M, Jiang, J, Kiandee, M, Lex, J, Mason, L, Matthews, JH, McGeorge, E, Modhwadia, S, Pinkney, T, Radotra, A, Rickard, L, Rodman, L, Sales, A, Tan, KL, Bachi, A, Bajwa, DS, Brown, LR, Butler, A, Calciu, A, Davies, E, Gardner, I, Girdlestone, T, Ikogho, O, Keelan, G, O'Loughlin, P, Tam, J, Elias, J, Ngaage, M, Thompson, J, Bristow, S, Brock, E, Davis, H, Pantelidou, M, Sathiyakeerthy, A, Singh, K, Chaudhry, A, Dickson, G, Glen, P, Gregoriou, K, Hamid, H, Mclean, A, Mehtaji, P, Neophytou, G, Potts, S, Belgaid, DR, Durno, J, Ghailan, N, Henshaw, V, Nazir, UR, Omar, I, Riley, BJ, Roberts, J, Smart, G, Van Winsen, K, Bhatti, A, Chan, M, D'Auria, M, Keshvala, C, Michaelidou, M, Simmonds, L, Smith, C, Wimalathasan, A, Abbas, J, Cairns, C, Chin, YR, Connelly, A, Moug, S, Nair, A, Svolkinas, D, Coe, P, Subar, D, Wang, H, Zaver, V, Brayley, J, Cookson, P, Cunningham, L, Gaukroger, A, Ho, M, Hough, A, King, J, O'Hagan, D, Widdison, A, Brown, B, Chavan, A, Francis, S, Hare, L, Lund, J, Malone, N, Mavi, B, McIlwaine, A, Rangarajan, S, Abuhussein, N, Campbell, HS, Daniels, J, Fitzgerald, I, Mansfield, S, Pendrill, A, Robertson, D, Smart, YW, Teng, T, Yates, J, Belgaumkar, A, Katira, A, Kossoff, J, Kukran, S, Laing, C, Mathew, B, Mohamed, T, Myers, S, Novell, R, Phillips, BL, Turlejski, T, Turner, S, Varcada, M, Warren, L, Wynell-Mayow, W, Linley-Adams, L, Osborn, G, Saunders, M, Spencer, R, Srikanthan, M, Tailor, S, Tullett, A, Al-Masri, S, Carr, G, Ebhogiaye, O, Heng, S, Manivannan, S, Manley, J, McMillan, LE, Peat, C, Phillips, B, Thomas, S, Whewell, H, Williams, G, Bienias, A, Cope, EA, Courquin, GR, Day, L, Garner, C, Gimson, A, Harris, C, Markham, K, Moore, T, Nadin, T, Phillips, C, Subratty, SM, Brown, K, Dada, J, Durbacz, M, Filipescu, T, Harrison, E, Kennedy, ED, Khoo, E, Kremel, D, Lyell, I, Pronin, S, Tummon, R, Ventre, C, Walls, L, Wootton, E, Akhtar, A, El-Sawy, D, Farooq, M, Gaddah, M, Katsaiti, I, Khadem, N, Leong, K, Williams, I, Chean, CS, Chudek, D, Desai, H, Ellerby, N, Hammad, A, Malla, S, Murphy, B, Oshin, O, Popova, P, Rana, S, Ward, T, Abbott, TEF, Akpenyi, O, Edozie, F, El Matary, R, English, W, Jeyabaladevan, S, Morgan, C, Naidu, V, Nicholls, K, Peroos, S, Sansome, S, Torrance, HD, Townsend, D, Brecher, J, Fung, H, Kazmi, Z, Outlaw, P, Pursnani, K, Ramanujam, N, Razaq, A, Sattar, M, Sukumar, S, Tan, TSE, Chohan, K, Dhuna, S, Haq, T, Kirby, S, Lacy-Colson, J, Logan, P, Malik, Q, McCann, J, Mughal, Z, Sadiq, S, Sharif, I, Shingles, C, Simon, A, Burnage, S, Chan, SSN, Craig, ARJ, Duffield, J, Dutta, A, Eastwood, M, Iqbal, F, Mahmood, W, Patel, C, Qadeer, A, Robinson, A, Rotundo, A, Schade, A, Slade, RD, De Freitas, M, Kinnersley, H, McDowell, E, Moens-Lecumberri, S, Ramsden, J, Rockall, T, Wiffen, L, Wright, S, Bruce, C, Francois, V, Hamdan, K, Limb, C, Lunt, AJ, Manley, L, Marks, M, Phillips, CFE, Agnew, CJF, Barr, CJ, Benons, N, Hart, SJ, Kandage, D, Krysztopik, R, Mahalingam, P, Mock, J, Rajendran, S, Stoddart, MT, Clements, B, Gillespie, H, McDougall, R, Murray, C, O'Loane, R, Periketi, S, Tan, S, Amoah, R, Bhudia, R, Dudley, B, Gilbert, A, Griffiths, B, Khan, H, McKigney, N, Roberts, B, Samuel, R, Seelarbokus, A, Stubbing-Moore, A, Thompson, G, Williams, P, Ahmed, N, Akhtar, R, Chandler, E, Chappelow, I, Gil, H, Gower, T, Kale, A, Lingam, G, Rutler, L, Sellahewa, C, Sheikh, A, Stringer, H, Taylor, R, Aglan, H, Ashraf, MR, Choo, S, Das, E, Epstein, J, Gentry, R, Mills, D, Poolovadoo, Y, Ward, N, Bull, K, Cole, A, Hack, J, Khawari, S, Lake, C, Mandishona, T, Perry, R, Sleight, S, Sultan, S, Thornton, T, Williams, S, Arif, T, Castle, A, Chauhan, P, Chesner, R, Eilon, T, Kambasha, C, Lock, L, Loka, T, Mohammad, F, Motahariasl, S, Roper, L, Sadhra, SS, Toma, T, Wadood, Q, Yip, J, Ainger, E, Busti, S, Cunliffe, L, Flamini, T, Gaffing, S, Moorcroft, C, Peter, M, Simpson, L, Stokes, E, Stott, G, Wilson, J, York, J, Yousaf, A, Brown, M, Goaman, A, Hodgson, B, Ijeomah, A, Iroegbu, U, Kaur, G, Lowe, C, Mahmood, S, Sattar, Z, Sen, P, Szuman, A, Abbas, N, Al-Ausi, M, Anto, N, Bhome, R, Eccles, L, Elliott, J, Hughes, EJ, Jones, A, Karunatilleke, AS, Knight, JS, Manson, CCF, Mekhail, I, Michaels, L, Noton, TM, Okenyi, E, Reeves, T, Yasin, IH, Banfield, DA, Harris, R, Mason-Apps, C, Roe, T, Sandhu, J, Shafiq, N, Stickler, E, Tam, JP, Williams, LM, Ainsworth, P, Boualbanat, Y, Doull, C, Egan, E, Evans, L, Hassanin, K, Ninkovic-Hall, G, Odunlami, W, Shergill, M, Traish, M, Cummings, D, Kershaw, S, Ong, J, Reid, F, Toellner, H, Alwandi, A, Amer, M, George, D, Haynes, K, Hughes, K, Peakall, L, Premakumar, Y, Punjabi, N, Ramwell, A, Sawkins, H, Ashwood, J, Baker, A, Baron, C, Bhide, I, Blake, E, De Cates, C, Esmail, R, Hosamuddin, H, Kapp, J, Nguru, N, Thomson, F, Ahmed, H, Aishwarya, G, Al-Huneidi, R, Aziz, R, Burke, D, Clarke, B, Kausar, A, Maskill, D, Mecia, L, Myers, L, Smith, ACD, Walker, G, Wroe, N, Donohoe, C, Gibbons, D, Jordan, P, Keogh, C, Kiely, A, Lalor, P, McCrohan, M, Powell, C, Foley, MP, Reynolds, J, Silke, E, Thorpe, O, Kong, JTH, White, C, Ali, Q, Dalrymple, J, Ge, Y, Luo, RS, Paine, H, Paraskeva, B, Parker, L, Pillai, K, Salciccioli, J, Selvadurai, S, Sonagara, V, Springford, LR, Tan, L, Appleton, S, Leadholm, N, Zhang, Y, Ahern, D, Cotter, M, Cremen, S, Durrigan, T, Flack, V, Hrvacic, N, Jones, H, Jong, B, Keane, K, O'Connell, PR, O'Sullivan, J, Pek, G, Shirazi, S, Barker, C, Brown, A, Carr, W, Chen, Y, Guillotte, C, Harte, J, Kokayi, A, Lau, K, McFarlane, S, Morrison, S, Broad, J, Kenefick, N, Makanji, D, Printz, V, Saito, R, Thomas, O, Breen, H, Kirk, S, Kong, CH, O'Kane, A, Eddama, M, Engledow, A, Freeman, SK, Frost, A, Goh, C, Lee, G, Poonawala, R, Suri, A, Taribagil, P, Brown, H, Christie, S, Dean, S, Gravell, R, Haywood, E, Holt, F, Rabiu, R, Roscoe, HW, Shergill, S, Sriram, A, Sureshkumar, A, Tan, LC, Tanna, A, Vakharia, A, Bhullar, S, Brannick, S, Dunne, E, Frere, M, Kerin, M, Kumar, KM, Pratumsuwan, T, Quek, R, Salman, M, Van Den Berg, N, Wong, C, Ahluwalia, J, Bagga, R, Borg, CM, Calabria, C, Draper, A, Farwana, M, Khan, A, Mazza, M, Pankin, G, Sait, MS, Sandhu, N, Virani, N, Woodhams, K, Croghan, N, Ghag, S, Hogg, G, Ismail, O, John, N, Nadeem, K, Naqi, M, Noe, SM, Sharma, A, Begum, F, Best, R, Collishaw, A, Glasbey, J, Golding, D, Gwilym, B, Harrison, P, Jackman, T, Lewis, N, Luk, YL, Porter, T, Potluri, S, Stechman, M, Tate, S, Thomas, D, Walford, B, Auld, F, Bleakley, A, Johnston, S, Jones, C, Khaw, J, Milne, S, O'Neill, S, Singh, KKR, Swan, A, Thorley, N, Yalamarthi, S, Yin, ZD, Balian, V, Bana, R, Clark, K, Livesey, C, McLachlan, G, Mohammad, M, Pranesh, N, Richards, C, Ross, F, Sajid, M, Brooke, M, Francombe, J, Gresly, J, Hutchinson, S, Kerrigan, K, Matthews, E, Nur, S, Parsons, L, Sandhu, A, Vyas, M, White, F, Zulkifli, A, Zuzarte, L, Al-Mousawi, A, Arya, J, Azam, S, Yahaya, AA, Gill, K, Hallan, R, Hathaway, C, Leptidis, I, McDonagh, L, Mitrasinovic, S, Mushtaq, N, Pang, N, Peiris, GB, Rinkoff, S, Chan, L, Christopher, E, Farhan-Alanie, MMH, Gonzalez-Ciscar, A, Graham, CJ, Lim, H, McLean, KA, Paterson, HM, Rogers, A, Roy, C, Rutherford, D, Smith, F, Zubikarai, G, Al-Khudairi, R, Bamford, M, Chang, M, Cheng, J, Hedley, C, Joseph, R, Mitchell, B, Rothwell, L, Siddiqui, A, Smith, J, Taylor, K, Wright, OW, Baryan, HK, Boyd, G, Conchie, H, Cox, L, Gardner, S, Hill, N, Krishna, K, Lakin, F, Scotcher, S, Alberts, J, Asad, M, Barraclough, J, Campbell, A, Marshall, D, Wakeford, W, Cronbach, P, D'Souza, F, Gammeri, E, Houlton, J, Hall, M, Kethees, A, Patel, R, Perera, M, Shaid, M, Webb, E, Beattie, S, Chadwick, M, El-Taji, O, Haddad, S, Mann, M, Patel, M, Popat, K, Rimmer, L, Riyat, H, Smith, H, Anandarajah, C, Cipparrone, M, Desai, K, Gao, C, Goh, ET, Howlader, M, Jeffreys, N, Karmarkar, A, Mathew, G, Mukhtar, H, Ozcan, E, Renukanthan, A, Sarens, N, Sinha, C, Woolley, A, Bogle, R, Komolafe, O, Loo, F, Waugh, D, Zeng, R, Crewe, A, Mathias, J, Owen, A, Prior, A, Saunders, I, Crilly, L, McKeon, J, Ubhi, HK, Adeogun, A, Carr, R, Davison, C, Devalia, S, Hayat, A, Karsan, RB, Osborne, C, Weegenaar, C, Wijeyaratne, M, Babatunde, F, Barnor-Ahiaku, E, Chitsabesan, P, Dixon, O, Hall, N, Ilenkovan, N, Mackrell, T, Nithianandasivam, N, Orr, J, Palazzo, F, Saad, M, Sandland-Taylor, L, Sherlock, J, Ashdown, T, Chandler, S, Garsaa, T, Lloyd, J, Loh, SY, Ng, S, Perkins, C, Powell-Chandler, A, and Underhill, R
- Subjects
COMPLICATIONS ,Science & Technology ,RENAL-FAILURE ,STARSurg Collaborative ,MORTALITY ,RISK-FACTORS ,Surgery ,Life Sciences & Biomedicine - Abstract
Background Acute illness, existing co‐morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2‐week blocks over a continuous 3‐month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30‐day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30‐day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin‐converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c‐statistic 0·65). Discussion Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability.
- Published
- 2018
3. Processes and approaches to perioperative pain management in patients undergoing major lower extremity amputations secondary to vascular disease: a multi-specialty modified Delphi consensus study protocol.
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Ekkunagul T, MacLeod CS, Celnik A, Chalmers J, Thomson R, Nagy J, and Forget P
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- Humans, United Kingdom, Vascular Diseases surgery, Pain, Postoperative, Perioperative Care methods, Perioperative Care standards, Research Design, Delphi Technique, Amputation, Surgical, Pain Management methods, Pain Management standards, Lower Extremity surgery, Consensus
- Abstract
Introduction: Pain surrounding major lower extremity amputations (MLEAs) in the vascular surgical patient can be severe, conferring significant debilitation from the preoperative stage through to the chronic rehabilitation phase. Although there is an evolving understanding of the array of existing analgesic medications and modalities, pain management in this context continues to be challenging. A previous report in the UK revealed that MLEA pain management practices may not be optimal from the perspective of patients. There are also limitations in the comprehensiveness and quality of existing evidence, and existing practices can be heterogeneous. Identifying effective pain management approaches in MLEA has thus been recognised as a key practice and research priority. Therefore, the aim of this study protocol will be to elucidate a multi-specialty view on the perceptions, processes and approaches to perioperative pain management in patients undergoing MLEAs secondary to vascular disease in the UK., Methods and Analysis: A modified Delphi methodology will be used to gain consensus among a UK-wide multi-specialty panel of clinical experts. At least three iterative rounds of structured anonymous electronic surveys will be circulated to a minimum cohort of 40 participants across relevant specialties. Expert agreement on pre-developed consensus statements pertaining to the approaches and techniques in MLEA pain management will be sought from the first round and quantified by a 5-point Likert scale. Quantitative and qualitative analyses will be performed to evaluate the level of agreement and participant feedback, respectively. A consensus criterion of ≥75% panellist agreement with a ≤10% between-round stability will be used for each statement. The process will be repeated with the results and implementation of feedback highlighted to panellists in each subsequent round., Ethics and Dissemination: Ethical approval was not required for this study as the participants and methodology fall outwith the requirements for a National Health Service Research Ethics Committee review. The results will be disseminated in a peer-reviewed publication and presented at relevant conferences., Competing Interests: Competing interests: PF is supported by the European Society of Anaesthesiology and Intensive Care for Pain and Opioids after Surgery and the EuroPeriscope Research Groups and has received advisory board/speaker fees from Grunenthal, GE Healthcare and Oncomfort., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2024
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4. REPAIRS Delphi: A UK and Ireland Consensus Statement on the Management of Infected Arterial Pseudoaneurysms Secondary to Groin Injecting Drug Use.
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MacLeod CS, Nagy J, Radley A, Khan F, Rae N, Wilson MSJ, and Suttie SA
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- Humans, Ireland, United Kingdom, Vascular Surgical Procedures adverse effects, Vascular Surgical Procedures standards, Delphi Technique, Substance Abuse, Intravenous complications, Aneurysm, False etiology, Aneurysm, False diagnostic imaging, Aneurysm, False therapy, Aneurysm, False diagnosis, Consensus, Groin blood supply, Aneurysm, Infected microbiology, Aneurysm, Infected diagnosis, Aneurysm, Infected surgery, Aneurysm, Infected diagnostic imaging, Aneurysm, Infected therapy
- Abstract
Objective: Consensus guidelines on the optimal management of infected arterial pseudoaneurysms secondary to groin injecting drug use are lacking. This pathology is a problem in the UK and globally, yet operative management options remain contentious. This study was designed to establish consensus to promote better management of these patients, drawing on the expert experience of those in a location with a high prevalence of illicit drug use., Methods: A three round modified Delphi was undertaken, systematically surveying consultant vascular surgeons in the UK and Ireland using an online platform. Seventy five vascular surgery units were invited to participate, with one consultant providing the unit consensus practice. Round one responses were thematically analysed to generate statements for round two. These statements were evaluated by participants using a five point Likert scale. Consensus was achieved at a threshold of 70% or more agreement or disagreement. Those statements not reaching consensus were assessed and modified for round three. The results of the Delphi process constituted the consensus statement., Results: Round one received 64 (86%) responses, round two 59 (79%) responses, and round three 62 (83%) responses; 73 (97%) of 75 units contributed. Round two comprised 150 statements and round three 24 statements. Ninety one statements achieved consensus agreement and 15 consensus disagreement. The Delphi statements covered sequential management of these patients from diagnosis and imaging, antibiotics and microbiology, surgical approach, wound management, follow up, and additional considerations. Pre-operative imaging achieved consensus agreement (97%), with computed tomography angiography being the modality of choice (97%). Ligation and debridement without arterial reconstruction was the preferred approach at initial surgical intervention (89%). Multidisciplinary management, ensuring holistic care and access to substance use services, also gained consensus agreement., Conclusion: This comprehensive consensus statement provides a strong insight into the standard of care for these patients., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)
- Published
- 2024
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5. A Dangerous Dislocation.
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MacLeod CS and Nagy J
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- 2023
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6. The Safety and Efficacy of Phage Therapy for Infections in Cardiac and Peripheral Vascular Surgery: A Systematic Review.
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Simpson EA, MacLeod CS, Stacey HJ, Nagy J, and Jones JD
- Abstract
New approaches to managing infections in cardiac and peripheral vascular surgery are required to reduce costs to patients and healthcare providers. Bacteriophage (phage) therapy is a promising antimicrobial approach that has been recommended for consideration in antibiotic refractory cases. We systematically reviewed the clinical evidence for phage therapy in vascular surgery to support the unlicensed use of phage therapy and inform future research. Three electronic databases were searched for articles that reported primary data about human phage therapy for infections in cardiac or peripheral vascular surgery. Fourteen reports were eligible for inclusion, representing 40 patients, among which an estimated 70.3% of patients (n = 26/37) achieved clinical resolution. A further 10.8% (n = 4/37) of patients showed improvement and 18.9% (n = 7/37) showed no improvement. Six of the twelve reports that commented on the safety of phage therapy did not report adverse effects. No adverse effects documented in the remaining six reports were directly linked to phages but reflected the presence of manufacturing contaminants or release of bacterial debris following bacterial lysis. The reports identified by this review suggest that appropriately purified phages represent a safe and efficacious treatment option for infections in cardiac and peripheral vascular surgery.
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- 2023
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7. Management of the infected arterial pseudoaneurysm secondary to groin injecting drug use and outcomes: a systematic review protocol.
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MacLeod CS, Radley A, Strachan D, Khan F, Nagy J, and Suttie S
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- Humans, Arteries, Groin, Intermittent Claudication, Vascular Surgical Procedures, Aneurysm, False etiology, Aneurysm, False surgery, Substance-Related Disorders, Systematic Reviews as Topic methods
- Abstract
Introduction: People who inject drugs are at risk of a range of injecting-related infections and injuries, which can threaten life and limb. In parallel to escalating rates of drug-related deaths seen in Scotland and the UK, there has also been an increase in hospital admissions for skin and soft tissue infections related to injecting drug use. One such injecting complication is the infected arterial pseudoaneurysm, which risks rupture and life-threatening haemorrhage. Surgical management options for the infected arterial pseudoaneurysm secondary to groin injecting drug use remain contentious, with some advocates for ligation and debridement alone, whilst others promote acute arterial reconstruction (suture or patch repair, bypass or, more recently, endovascular stent-graft placement). Rates of major lower limb amputations related to surgical management for this pathology vary in the literature. This review aims to evaluate the outcomes of arterial ligation alone compared with arterial reconstruction, including open and endovascular options, for the infected arterial pseudoaneurysm secondary to groin injecting drug use., Methods and Analysis: The methods will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Three electronic databases will be searched and the resultant papers screened according to the study inclusion and exclusion criteria (detailed in the Population, Intervention, Comparison, Outcomes and Study design statement). Grey literature will be excluded. All papers at each stage will be screened by two independent authors, with disagreements arbitrated by a third. Papers will be subject to appropriate standardised quality assessments., Primary Outcome: Major lower limb amputation., Secondary Outcomes: Reintervention rate, rebleeding rate, development of chronic limb-threatening ischaemia 30-day mortality and claudication., Ethics and Dissemination: This is a systematic review based on previously conducted studies, therefore, no ethical approval is required. The results of this work will be published in a peer-reviewed journal and presented at relevant conferences., Prospero Registration Number: CRD42022358209., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2023
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8. Predicting necrotising soft tissue infections in people who inject drugs: poor performance of the Laboratory Risk Indicator for Necrotising Fasciitis score and development of a novel clinical predictive nomogram in a retrospective cohort with internal validation.
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MacLeod CS, O'Neill HL, Shaalan R, Nagy J, Flett MM, Guthrie GJK, McLeod G, and Suttie SA
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- Humans, Retrospective Studies, Nomograms, C-Reactive Protein, Risk Factors, Albumins, Fasciitis, Necrotizing diagnosis, Fasciitis, Necrotizing etiology, Soft Tissue Infections diagnosis, Soft Tissue Infections etiology, Soft Tissue Infections therapy, Drug Users, Substance Abuse, Intravenous complications
- Abstract
Introduction: Necrotising soft tissue infections (NSTI) can threaten life and limb. Early identification and urgent surgical debridement are key for improved outcomes. NSTI can be insidious. Scoring systems, like the Laboratory Risk Indicator for Necrotising Fasciitis (LRINEC), exist to aid diagnosis. People who inject drugs (PWID) are high risk for NSTI. This study aimed to assess the utility of the LRINEC in PWID with lower limb infections and develop a predictive nomogram., Methods: A retrospective database of all hospital admissions due to limb-related complications secondary to injecting drug use between December 2011 and December 2020 was compiled through discharge codes and a prospectively maintained Vascular Surgery database. All lower limb infections were extracted from this database, dichotomised by NSTI and non-NSTI with the LRINEC applied. Specialty management times were evaluated. Statistical analyses involved: chi-square; Analysis of "variance"; Kaplan-Meier, and receiver operating characteristic curves. Nomograms were developed to facilitate diagnosis and predict survival., Results: There were 557 admissions for 378 patients, with 124 (22.3%; 111 patients) NSTI. Time from admission to: theatre and computed tomography imaging respectively varied significantly between specialties ( P =0.001). Surgical specialties were faster than medical ( P =0.001). Vascular surgery received the most admissions and had the quickest time to theatre. During follow-up there were 79 (20.9%) deaths: 27 (24.3%) NSTI and 52 (19.5%) non-NSTI. LRINEC ≥6 had a positive predictive value of 33.3% and sensitivity of 74% for NSTI. LRINEC <6 had a negative predictive value of 90.7% and specificity of 63.2% for non-NSTI. Area under the curve was 0.697 (95% CI: 0.615-0.778). Nomogram models found age, C-reactive protein, and non-linear albumin to be significant predictors of NSTI, with age, white cell count, sodium, creatinine, C-reactive protein, and albumin being significant in predicting survival on discharge., Conclusion: There was reduced performance of the LRINEC in this PWID cohort. Diagnosis may be enhanced through use of this predictive nomogram., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)
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- 2023
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9. The Needle and the Damage Done: A Retrospective Review of the Health Impact of Recreational Intravenous Drug Use and the Collateral Consequences for Vascular Surgery.
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MacLeod CS, Senior Y, Lim J, Mittapalli D, Rae N, Guthrie GJ, and Suttie SA
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- Abscess etiology, Adult, Amputation, Surgical statistics & numerical data, Aneurysm, False epidemiology, Aneurysm, False etiology, Aneurysm, False surgery, Cellulitis epidemiology, Cellulitis etiology, Female, Humans, Length of Stay, Male, Retrospective Studies, Scotland epidemiology, Soft Tissue Infections etiology, Soft Tissue Infections surgery, Specialties, Surgical, Vascular Surgical Procedures, Venous Thrombosis epidemiology, Venous Thrombosis etiology, Venous Thrombosis surgery, Abscess epidemiology, Soft Tissue Infections epidemiology, Substance Abuse, Intravenous complications
- Abstract
Background: The UK has one of the highest rates of recreational drug use and consequent deaths in Europe. Scotland is the "Drug deaths capital of Europe." Intravenous drug use can result in limb- and life-threatening pathology. This study aimed to characterise limb-related admissions associated with intravenous drug use, outcomes and healthcare expenditure., Methods: Retrospective data collection between December 2011 and August 2018. Patients were identified through discharge codes. Admission details were extracted from electronic records and a database compiled. Statistical analyses were performed using Statistical Package for the Social Science, P < 0.05 denoted significance., Results: There were 558 admissions for 330 patients (1-9 admissions/patient), mean age 37 years (+/-7.6 SD) and 196 (59.2%; 319 admissions, 57.2%) were male. Three hundred forty-eight (62.4%) admissions were to surgical specialties, predominantly Vascular Surgery (247). Including onward referrals, Vascular ultimately managed 54.8% of admissions. Patients presented with multiple pathologies: 249 groin abscesses; 38 other abscesses; 74 pseudoaneurysms; 102 necrotising soft tissue infections (NSTI); 85 cellulitis; 138 deep venous thrombosis (DVTs); 28 infected DVTs and 70 other diagnoses. Two hundred and seventy-seven admissions (220 patients) required operations, with 361 procedures performed (1-7 operations/admission). There were 24 major limb amputations and 74 arterial ligations. Eleven amputations were due to NSTI and 13 followed ligation (17.6% of ligations). During follow-up 50 (15.2%) patients died, of which 6 (12%) had amputations (OR 3.2, 95% CI 1.04-9.61, P = 0.043). Cumulative cost of acute care was £4,783,241., Conclusions: Limb-related sequalae of intravenous drug use represents a substantial surgical workload, especially for Vascular. These are complex, high-risk patients with poor outcomes and high healthcare costs., (Copyright © 2021 Elsevier Inc. All rights reserved.)
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- 2022
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10. The Great Stent Graft Escape.
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MacLeod CS and Velineni R
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- Aged, Foreign-Body Migration etiology, Humans, Male, Tomography, X-Ray Computed, Blood Vessel Prosthesis adverse effects, Femoral Artery, Foreign-Body Migration diagnostic imaging, Stents adverse effects
- Published
- 2021
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11. Predicting 30-day mortality following PEG insertion: External validation of the Sheffield Gastrostomy Score and analysis for additional predictors.
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MacLeod CS, McKay R, Barber D, McKinlay AW, and Leeds JS
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- Humans, Middle Aged, ROC Curve, Retrospective Studies, Risk Factors, C-Reactive Protein analysis, Gastrostomy
- Abstract
Background: and study aims: The Sheffield Gastrostomy Score (SGS) was devised to stratify patients by calculating their risk of mortality at 30 days following PEG insertion. The aim was to externally validate the SGS and identify any further predictors of 30-day mortality., Patients and Methods: Retrospective review of all PEG insertions performed over a ten year period in our centre. All patients who had a new PEG inserted were identified and the SGS calculated. Additionally, demographic, indication for PEG insertion and other blood results were recorded. Receiver operating characteristic curves were calculated and subsequent univariate and multivariate analysis was performed to identify additional risk factors for 30 day mortality., Results: The PEG database comprised 1373 patients, of which 808 were suitable for analysis. For each increasing SGS gradation mortality rose, with 4% of those scoring 0 compared to 50% scoring 3. An area under the ROC curve of 0.69 (95% confidence interval 0.64-0.74) indicated good discriminative capacity. Multivariate analysis demonstrated that age ≥60 years (OR = 2.1 p = 0.016), serum albumin concentrations of 25-34 g/l (OR = 2.5 p = 0.001) or <25 g/l (OR = 6.8 p < 0.001), C-Reactive Protein ≥10 mg/l (OR = 2.7 p = 0.009) and lymphocyte count of <1.5 × 10
9 /l (OR = 2.0 p = 0.004) increased the odds of 30-day mortality, whilst referral for PEG placement whilst an inpatient decreased the risk of death (OR = 0.53 p = 0.005)., Conclusions: The SGS displayed reasonable predictive ability but the area under the curve is not high enough for routine clinical use. Modelling of further predictors from a multicentre study could provide scope for updating the SGS potentially improving patient selection., Competing Interests: Declaration of competing interest None of the authors have any conflicts of interest to declare., (Copyright © 2021 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)- Published
- 2021
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12. An Aortic Band.
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MacLeod CS and Velineni R
- Subjects
- Female, Humans, Middle Aged, Tomography, X-Ray Computed, Aorta, Esophagus, Foreign-Body Migration diagnostic imaging, Foreign-Body Migration etiology, Gastroplasty adverse effects, Gastroplasty instrumentation
- Published
- 2021
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13. Complications after laparoscopic and open subtotal colectomy for inflammatory colitis: a case-matched comparison.
- Author
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Parnaby CN, Ramsay G, Macleod CS, Hope NR, Jansen JO, and McAdam TK
- Subjects
- Acute Disease, Adult, Blood Loss, Surgical, Colitis etiology, Female, Humans, Ileostomy adverse effects, Inflammatory Bowel Diseases complications, Length of Stay, Male, Middle Aged, Operative Time, Patient Readmission, Retrospective Studies, Colectomy adverse effects, Colectomy methods, Colitis surgery, Inflammatory Bowel Diseases surgery, Laparoscopy adverse effects
- Abstract
Aim: The aim of this study was to compare the early postoperative outcome of patients undergoing laparoscopic subtotal colectomy with those undergoing open subtotal colectomy for colitis refractory to medical treatment., Method: A retrospective observational study was carried out of patients who underwent subtotal colectomy for refractory colitis, at a single centre, between 2006 and 2012. Patients were matched for age, gender, American Society of Anesthesiology (ASA) grade, urgency of operation and immunosuppressant/modulator treatment. The primary outcome measure was the number of postoperative complications, classified using the Clavien-Dindo scale. Secondary end-points included procedure duration, laparoscopic conversion rates, blood loss, 30-day readmission rates and length of hospital stay., Results: Ninety-six patients were included, 39 of whom had laparoscopic surgery. Thirty-two of these were matched to similar patients who underwent an open procedure. The overall duration of the procedure was longer for laparoscopic surgery than for open surgery (median: 240 vs 150 min, P < 0.005) but estimated blood loss was less (median: 75 vs 400 ml, P < 0.005). In the laparoscopic group, 23 patients experienced 27 complications, and in the open surgery group, 23 patients experienced 30 complications. Most complications were minor (Grade I/II), and the distribution of complications, by grade, was similar between the two groups. There was no statistically significant difference in 30-day readmission rates between the laparoscopic and open groups (five readmissions vs eight readmissions, P = 0.536). Length of hospital stay was 4 days shorter for laparoscopic surgery, but this difference was not statistically significant (median: 7 vs 11 days, P = 0.159)., Conclusion: In patients requiring colectomy for acute severe colitis, laparoscopic surgery reduced blood loss but increased operating time and was not associated with a reduction in early postoperative complications, length of hospital stay or readmission rates., (Colorectal Disease © 2013 The Association of Coloproctology of Great Britain and Ireland.)
- Published
- 2013
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