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1. Exploring a Systemic Functional Semiotics Approach to Understanding Emotional Expression in Singing Performance: Implications for Music Education

Author

Ngo, Thu and Spreadborough, Kristal

Abstract

Engagement with songs through performance and analysis is a key component of music curricula worldwide. Music learning has a significant impact on a number of student competencies, including enhancing students' communicative abilities as they learn to manipulate, express, and share sound in both voice qualities and lyrics. However, common analyses of singing performance rarely focus exclusively on voice quality, and there is no systematic framework which considers how emotional meaning in lyrics interacts with emotional meaning in voice quality. Drawing on systemic functional semiotics, this article proposes a unified theoretical framework for examining how emotional meaning is co-constructed in the voice and lyrics in singing performance. This framework provides a novel approach for discussing and teaching song analysis and performance. The framework will be illustrated through the analysis of the interaction between voice quality and lyrics in the song "Someone Like You" performed by Adele.

Published
2022
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6. Cost‐effectiveness of emergency versus delayed laparoscopic cholecystectomy for acute gallbladder pathology

Author

Sutton, A. J., Vohra, R. S., Hollyman, M., Marriott, P. J., Buja, A., Alderson, D., Pasquali, S., Griffiths, E. A., Vohra, R. S., Spreadborough, P., Hollyman, M., Marriott, P. J., Kirkham, A., Pasquali, S., Alderson, D., Griffiths, E. A., Fenwick, S., Elmasry, M., Nunes, Q. M., Kennedy, D., Khan, R. B., Khan, M. A. S., Magee, C. J., Jones, S. M., Mason, D., Parappally, C. P., Mathur, P., Saunders, M., Jamel, S., Ul Haque, S., Zafar, S., Shiwani, M. H., Samuel, N., Dar, F., Jackson, A., Lovett, B., Dindyal, S., Winter, H., Fletcher, T., Rahman, S., Wheatley, K., Nieto, T., Ayaani, S., Youssef, H., Nijjar, R. S., Watkin, H., Naumann, D., Emesih, S., Sarmah, P. B., Lee, K., Joji, N., Heath, J., Teasdale, R. L., Weerasinghe, C., Needham, P. J., Welbourn, H., Forster, L., Finch, D., Blazeby, J. M., Robb, W., McNair, A. G. K., Hrycaiczuk, A., Charalabopoulos, A., Kadirkamanathan, S., Tang, C.‐B., Jayanthi, N. V. G., Noor, N., Dobbins, B., Cockbain, A. J., Nilsen‐Nunn, A., de Siqueira, J., Pellen, M., Cowley, J. B., Ho, W.‐M., Miu, V., White, T. J., Hodgkins, K. A., Kinghorn, A., Tutton, M. G., Al‐Abed, Y. A., Menzies, D., Ahmad, A., Reed, J., Khan, S., Monk, D., Vitone, L. J., Murtaza, G., Joel, A., Brennan, S., Shier, D., Zhang, C., Yoganathan, T., Robinson, S. J., McCallum, I. J. D., Jones, M. J., Elsayed, M., Tuck, E., Wayman, J., Carney, K., Aroori, S., Hosie, K. B., Kimble, A., Bunting, D.M., Fawole, A. S., Basheer, M., Dave, R. V., Sarveswaran, J., Jones, E., Kendal, C., Tilston, M. P., Gough, M., Wallace, T., Singh, S., Downing, J., Mockford, K. A., Issa, E., Shah, N., Chauhan, N., Wilson, T. R., Forouzanfar, A., Wild, J. R. L., Nofal, E., Bunnell, C., Madbak, K., Rao, S. T. V., Devoto, L., Siddiqi, N., Khawaja, Z., Hewes, J. C., Gould, L., Chambers, A., Rodriguez, D. U., Sen, G., Robinson, S., Carney, K., Bartlett, F., Rae, D. M., Stevenson, T. E. J., Sarvananthan, K., Dwerryhouse, S. J., Higgs, S. M., Old, O. J., Hardy, T. J., Shah, R., Hornby, S. T., Keogh, K., Frank, L., Al‐Akash, M., Upchurch, E. A., Frame, R. J., Hughes, M., Jelley, C., Weaver, S., Roy, S., Sillo, T. O., Galanopoulos, G., Cuming, T., Cunha, P., Tayeh, S., Kaptanis, S., Heshaishi, M., Eisawi, A., Abayomi, M., Ngu, W. S., Fleming, K., Bajwa, D. S., Chitre, V., Aryal, K., Ferris, P., Silva, M., Lammy, S., Mohamed, S., Khawaja, A., Hussain, A., Ghazanfar, M. A., Bellini, M. I., Ebdewi, H., Elshaer, M., Gravante, G., Drake, B., Ogedegbe, A., Mukherjee, D., Arhi, C., Iqbal, L. G. N., Watson, N. F., Aggarwal, S. K., Orchard, P., Villatoro, E., Willson, P. D., Mok, J., Woodman, T., Deguara, J., Garcea, G., Babu, B. I., Dennison, A. R., Malde, D., Lloyd, D., Satheesan, S., Al‐Taan, O., Boddy, A., Slavin, J. P., Jones, R. P., Ballance, L., Gerakopoulos, S., Jambulingam, P., Mansour, S., Sakai, N., Acharya, V., Sadat, M. M., Karim, L., Larkin, D., Amin, K., Khan, A., Law, J., Jamdar, S., Smith, S. R., Sampat, K., Oʼshea, K. M., Manu, M., Asprou, F. M., Malik, N. S., Chang, J., Johnstone, M., Lewis, M., Roberts, G. P., Karavadra, B., Photi, E., Hewes, J., Gould, L., Chambers, A., Rodriguez, D., OʼReilly, D. A., Rate, A. J., Sekhar, H., Henderson, L. T., Starmer, B. Z., Coe, P. O., Tolofari, S., Barrie, J., Bashir, G., Sloane, J., Madanipour, S., Halkias, C., Trevatt, A. E. J., Borowski, D. W., Hornsby, J., Courtney, M. J., Virupaksha, S., Seymour, K., Robinson, S., Hawkins, H., Bawa, S., Gallagher, P. V., Reid, A., Wood, P., Finch, J. G., Parmar, J., Stirland, E., Gardner‐Thorpe, J., Al‐Muhktar, A., Peterson, M., Majeed, A., Bajwa, F. M., Martin, J., Choy, A., Tsang, A., Pore, N., Andrew, D. R., Al‐Khyatt, W., Taylor, C., Bhandari, S., Chambers, A., Subramanium, D., Toh, S. K. C., Carter, N. C., Tate, S., Pearce, B., Wainwright, D., Mercer, S. J., Knight, B., Vijay, V., Alagaratnam, S., Sinha, S., Khan, S., El‐Hasani, S. S., Hussain, A. A., Bhattacharya, V., Kansal, N., Fasih, T., Jackson, C., Siddiqui, M. N., Chishti, I. A., Fordham, I. J., Siddiqui, Z., Bausbacher, H., Geogloma, I., Gurung, K., Tsavellas, G., Basynat, P., Shrestha, A. K., Basu, S., Mohan, A. C., Harilingam, M., Rabie, M., Akhtar, M., Kumar, P., Jafferbhoy, S. F., Hussain, N., Raza, S., Haque, M., Alam, I., Aseem, R., Patel, S., Asad, M., Booth, M. I., Ball, W. R., Wood, C. P. J., Pinho‐Gomes, A. C., Kausar, A., Obeidallah, M. R., Varghase, J., Lodhia, J., Bradley, D., Rengifo, C., Lindsay, D., Gopalswamy, S., Finlay, I., Wardle, S., Bullen, N., Iftikhar, S. Y., Awan, A., Ahmed, J., Leeder, P., Fusai, G., Bond‐Smith, G., Psica, A., Puri, Y., Hou, D., Noble, F., Szentpali, K., Broadhurst, J., Date, R., Hossack, M. R., Goh, Y. L., Turner, P., Shetty, V., Riera, M., Macano, C. A.W., Sukha, A., Preston, S. R., Hoban, J. R., Puntis, D. J., Williams, S. V., Krysztopik, R., Kynaston, J., Batt, J., Doe, M., Goscimski, A., Jones, G. H., Smith, S. R., Hall, C., Carty, N., Ahmed, J., Panteleimonitis, S., Gunasekera, R. T., Sheel, A. R. G., Lennon, H., Hindley, C., Reddy, M., Kenny, R., Elkheir, N., McGlone, E. R., Rajaganeshan, R., Hancorn, K., Hargreaves, A., Prasad, R., Longbotham, D. A., Vijayanand, D., Wijetunga, I., Ziprin, P., Nicolay, C. R., Yeldham, G., Read, E., Gossage, J. A., Rolph, R. C., Ebied, H., Phull, M., Khan, M. A., Popplewell, M., Kyriakidis, D., Hussain, A., Henley, N., Packer, J. R., Derbyshire, L., Porter, J., Appleton, S., Farouk, M., Basra, M., Jennings, N. A., Ali, S., Kanakala, V., Ali, H., Lane, R., Dickson‐Lowe, R., Zarsadias, P., Mirza, D., Puig, S., Al Amari, K., Vijayan, D., Sutcliffe, R., Marudanayagam, R., Hamady, Z., Prasad, A. R., Patel, A., Durkin, D., Kaur, P., Bowen, L., Byrne, J. P., Pearson, K. L., Delisle, T. G., Davies, J., Tomlinson, M. A., Johnpulle, M. A., Slawinski, C., Macdonald, A., Nicholson, J., Newton, K., Mbuvi, J., Farooq, A., Mothe, B. S., Zafrani, Z., Brett, D., Francombe, J., Spreadborough, P., Barnes, J., Cheung, M., Al‐Bahrani, A. Z., Preziosi, G., Urbonas, T., Alberts, J., Mallik, M., Patel, K., Segaran, A., Doulias, T., Sufi, P. A., Yao, C., Pollock, S., Manzelli, A., Wajed, S., Kourkulos, M., Pezzuto, R., Wadley, M., Hamilton, E., Jaunoo, S., Padwick, R., Sayegh, M., Newton, R. C., Hebbar, M., Farag, S. F., Spearman, J., Hamdan, M. F., DʼCosta, C., Blane, C., Giles, M., Peter, M. B., Hirst, N. A., Hossain, T., Pannu, A., El‐Dhuwaib, Y., Morrison, T. E. M., Taylor, G. W., Thompson, R. L. E., McCune, K., Loughlin, P., Lawther, R., Byrnes, C. K., Simpson, D. J., Mawhinney, A., Warren, C., McKay, D., McIlmunn, C., Martin, S., MacArtney, M., Diamond, T., Davey, P., Jones, C., Clements, J.M., Digney, R., Chan, W. M., McCain, S., Gull, S., Janeczko, A., Dorrian, E., Harris, A., Dawson, S., Johnston, D., McAree, B., Ghareeb, E., Thomas, G., Connelly, M., McKenzie, S., Cieplucha, K., Spence, G., Campbell, W., Hooks, G., Bradley, N., Hill, A. D. K., Cassidy, J. T., Boland, M., Burke, P., Nally, D. M., Hill, A. D. K., Khogali, E., Shabo, W., Iskandar, E., McEntee, G. P., OʼNeill, M. A., Peirce, C., Lyons, E. M., OʼSullivan, A. W., Thakkar, R., Carroll, P., Ivanovski, I., Balfe, P., Lee, M., Winter, D. C., Kelly, M. E., Hoti, E., Maguire, D., Karunakaran, P., Geoghegan, J. G., McDermott, F., Martin, S. T., Cross, K. S., Cooke, F., Zeeshan, S., Murphy, J. O., Mealy, K., Mohan, H. M., Nedujchelyn, Y., Ullah, M. F., Ahmed, I., Giovinazzo, F., Milburn, J., Prince, S., Brooke, E., Buchan, J., Khalil, A. M., Vaughan, E. M., Ramage, M. I., Aldridge, R. C., Gibson, S., Nicholson, G. A., Vass, D. G., Grant, A. J., Holroyd, D. J., Jones, M. A., Sutton, C. M. L. R., OʼDwyer, P., Nilsson, F., Weber, B., Williamson, T. K., Lalla, K., Bryant, A., Carter, C. R., Forrest, C. R., Hunter, D. I., Nassar, A. H., Orizu, M. N., Knight, K., Qandeel, H., Suttie, S., Belding, R., McClarey, A., Boyd, A. T., Guthrie, G. J. K., Lim, P. J., Luhmann, A., Watson, A. J. M., Richards, C. H., Nicol, L., Madurska, M., Harrison, E., Boyce, K. M., Roebuck, A., Ferguson, G., Pati, P., Wilson, M. S. J., Dalgaty, F., Fothergill, L., Driscoll, P. J., Mozolowski, K. L., Banwell, V., Bennett, S. P., Rogers, P. N., Skelly, B. L., Rutherford, C. L., Mirza, A. K., Lazim, T., Lim, H. C. C., Duke, D., Ahmed, T., Beasley, W. D., Wilkinson, M. D., Maharaj, G., Malcolm, C., Brown, T. H., Shingler, G. M., Mowbray, N., Radwan, R., Morcous, P., Wood, S., Kadhim, A., Stewart, D. J., Baker, A. L., Tanner, N., Shenoy, H., Hafiz, S., De Marchi, J. A., Singh‐Ranger, D., Hisham, E., Ainley, P., OʼNeill, S., Terrace, J., Napetti, S., Hopwood, B., Rhys, T., Downing, J., Kanavati, O., Coats, M., Aleksandrov, D., Kallaway, C., Yahya, S., Weber, B., Templeton, A., Trotter, M., Lo, C., Dhillon, A., Heywood, N., Aawsaj, Y., Hamdan, A., Reece‐Bolton, O., McGuigan, A., Shahin, Y., Ali, A., Luther, A., Nicholson, J. A., Rajendran, I., Boal, M., and Ritchie, J.

Published
2017
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7. Predicting the difficult laparoscopic cholecystectomy: development and validation of a pre-operative risk score using an objective operative difficulty grading system

Author

Nassar, A. H. M., Hodson, J., H. J., Ng, Vohra, R. S., Katbeh, T., Zino, S., Griffiths, E. A., Kirkham, A. J., Pasquali, S., Marriott, P., Johnstone, M., Spreadborough, P., Alderson, D., Fenwick, S., Elmasry, M., Nunes, Q. M., Kennedy, D., Khan, R. B., Khan, M. A. S., Magee, C. J., Jones, S. M., Mason, D., Parappally, C. P., Mathur, P., Saunders, M., Jamel, S., Haque, S. U., Zafar, S., Shiwani, M. H., Samuel, N., Dar, F., Jackson, A., Lovett, B., Dindyal, S., Winter, H., Fletcher, T., Rahman, S., Wheatley, K., Nieto, T., Ayaani, S., Youssef, H., Nijjar, R. S., Watkin, H., Naumann, D., Emesih, S., Sarmah, P. B., Lee, K., Joji, N., Lambert, J., Heath, J., Teasdale, R. L., Weerasinghe, C., Needham, P. J., Welbourn, H., Forster, L., Finch, D., Blazeby, J. M., Robb, W., Mcnair, A. G. K., Hrycaiczuk, A., Charalabopoulos, A., Kadirkamanathan, S., Tang, C. -B., Jayanthi, N. V. G., Noor, N., Dobbins, B., Cockbain, A. J., Nilsen-Nunn, A., de Siqueira, J., Pellen, M., Cowley, J. B., W. -M., Ho, Miu, V., White, T. J., Hodgkins, K. A., Kinghorn, A., Tutton, M. G., Al-Abed, Y. A., Menzies, D., Ahmad, A., Reed, J., Khan, S., Monk, D., Vitone, L. J., Murtaza, G., Joel, A., Brennan, S., Shier, D., Zhang, C., Yoganathan, T., Robinson, S. J., Mccallum, I. J. D., Jones, M. J., Elsayed, M., Tuck, L., Wayman, J., Carney, K., Aroori, S., Hosie, K. B., Kimble, A., Bunting, D. M., Fawole, A. S., Basheer, M., Dave, R. V., Sarveswaran, J., Jones, E., Kendal, C., Tilston, M. P., Gough, M., Wallace, T., Singh, S., Mockford, J. D. K. A., Issa, E., Shah, N., Chauhan, N., Wilson, T. R., Forouzanfar, A., Wild, J. R. L., Nofal, E., Bunnell, C., Madbak, K., Rao, S. T. V., Devoto, L., Siddiqi, N., Khawaja, Z., Hewes, J. C., Gould, L., Chambers, A., Rodriguez, D. U., Sen, G., Robinson, S., Bartlett, F., Rae, D. M., Stevenson, T. E. J., Sarvananthan, K., Dwerryhouse, S. J., Higgs, S. M., Old, O. J., Hardy, T. J., Shah, R., Hornby, S. T., Keogh, K., Frank, L., Al-Akash, M., Upchurch, E. A., Frame, R. J., Hughes, M., Jelley, C., Weaver, S., Roy, S., Sillo, T. O., Galanopoulos, G., Cuming, T., Cunha, P., Tayeh, S., Kaptanis, S., Heshaishi, M., Eisawi, A., Abayomi, M., Ngu, W. S., Fleming, K., Bajwa, D. S., Chitre, V., Aryal, K., Ferris, P., Silva, M., Lammy, S., Mohamed, S., Khawaja, A., Hussain, A., Ghazanfar, M. A., Bellini, M. I., Ebdewi, H., Elshaer, M., Gravante, G., Drake, B., Ogedegbe, A., Mukherjee, D., Arhi, C., Giwa, L., Iqbal, N., Watson, N. F., Aggarwal, S. K., Orchard, P., Villatoro, E., Willson, P. D., Mok, K. W. J., Woodman, T., Deguara, J., Garcea, G., Babu, B. I., Dennison, A. R., Malde, D., Lloyd, D., Satheesan, S., Al-Taan, O., Boddy, A., Slavin, J. P., Jones, R. P., Ballance, L., Gerakopoulos, S., Jambulingam, P., Mansour, S., Sakai, N., Acharya, V., Sadat, M. M., Karim, L., Larkin, D., Amin, K., Khan, A., Law, J., Jamdar, S., Smith, S. R., Sampat, K., O'Shea, K. M., Manu, M., Asprou, F. M., Malik, N. S., Chang, J., Lewis, M., Roberts, G. P., Karavadra, B., Photi, E., Hewes, J., Rodriguez, D., O'Reilly, D. A., Rate, A. J., Sekhar, H., Henderson, L. T., Starmer, B. Z., Coe, P. O., Tolofari, S., Barrie, J., Bashir, G., Sloane, J., Madanipour, S., Halkias, C., Trevatt, A. E. J., Borowski, D. W., Hornsby, J., Courtney, M. J., Virupaksha, S., Seymour, K., Hawkins, H., Bawa, S., Gallagher, P. V., Reid, A., Wood, P., Finch, J. G., Guy Finch, J., Parmar, J., Stirland, E., Gardner-Thorpe, J., Al-Muhktar, A., Peterson, M., Majeed, A., Bajwa, F. M., Martin, J., Choy, A., Tsang, A., Pore, N., Andrew, D. R., Al-Khyatt, W., Taylor, C., Bhandari, S., Subramanium, D., Toh, S. K. C., Carter, N. C., Tate, S., Pearce, B., Wainwright, D., Mercer, S. J., Knight, B., Vijay, V., Alagaratnam, S., Sinha, S., El-Hasani, S. S., Hussain, A. A., Bhattacharya, V., Kansal, N., Fasih, T., Jackson, C., Siddiqui, M. N., Chishti, I. A., Fordham, I. J., Siddiqui, Z., Bausbacher, H., Geogloma, I., Gurung, K., Tsavellas, G., Basynat, P., Shrestha, A. K., Basu, S., Chhabra, A., Harilingam, M., Rabie, M., Akhtar, M., Kumar, P., Jafferbhoy, S. F., Hussain, N., Raza, S., Haque, M., Alam, I., Aseem, R., Patel, S., Asad, M., Booth, M. I., Ball, W. R., Wood, C. P. J., Pinho-Gomes, A. C., Kausar, A., Obeidallah, M. R., Varghase, J., Lodhia, J., Bradley, D., Rengifo, C., Lindsay, D., Gopalswamy, S., Finlay, I., Wardle, S., Bullen, N., Iftikhar, S. Y., Awan, A., Ahmed, J., Leeder, P., Fusai, G., Bond-Smith, G., Psica, A., Puri, Y., Hou, D., Noble, F., Szentpali, K., Broadhurst, J., Date, R., Hossack, M. R., Goh, Y. L., Turner, P., Shetty, V., Riera, M., Macano, C. A. W., Sukha, A., Preston, S. R., Hoban, J. R., Puntis, D. J., Williams, S. V., Krysztopik, R., Kynaston, J., Batt, J., Doe, M., Goscimski, A., Jones, G. H., Hall, C., Carty, N., Panteleimonitis, S., Gunasekera, R. T., Sheel, A. R. G., Lennon, H., Hindley, C., Reddy, M., Kenny, R., Elkheir, N., Mcglone, E. R., Rajaganeshan, R., Hancorn, K., Hargreaves, A., Prasad, R., Longbotham, D. A., Vijayanand, D., Wijetunga, I., Ziprin, P., Nicolay, C. R., Yeldham, G., Read, E., Gossage, J. A., Rolph, R. C., Ebied, H., Phull, M., Khan, M. A., Popplewell, M., Kyriakidis, D., Henley, N., Packer, J. R., Derbyshire, L., Porter, J., Appleton, S., Farouk, M., Basra, M., Jennings, N. A., Ali, S., Kanakala, V., Ali, H., Lane, R., Dickson-Lowe, R., Zarsadias, P., Mirza, D., Puig, S., Al Amari, K., Vijayan, D., Sutcliffe, R., Marudanayagam, R., Hamady, Z., Prasad, A. R., Patel, A., Durkin, D., Kaur, P., Bowen, L., Byrne, J. P., Pearson, K. L., Delisle, T. G., Davies, J., Tomlinson, M. A., Johnpulle, M. A., Slawinski, C., Macdonald, A., Nicholson, J., Newton, K., Mbuvi, J., Farooq, A., Mothe, B. S., Zafrani, Z., Brett, D., Francombe, J., Barnes, J., Cheung, M., Al-Bahrani, A. Z., Preziosi, G., Urbonas, T., Alberts, J., Mallik, M., Patel, K., Segaran, A., Doulias, T., Sufi, P. A., Yao, C., Pollock, S., Manzelli, A., Wajed, S., Kourkulos, M., Pezzuto, R., Wadley, M., Hamilton, E., Jaunoo, S., Padwick, R., Sayegh, M., Newton, R. C., Hebbar, M., Farag, S. F., Spearman, J., Hamdan, M. F., D'Costa, C., Blane, C., Giles, M., Peter, M. B., Hirst, N. A., Hossain, T., Pannu, A., El-Dhuwaib, Y., Morrison, T. E. M., Taylor, G. W., Thompson, R. L. E., Mccune, K., Loughlin, P., Lawther, R., Byrnes, C. K., Simpson, D. J., Mawhinney, A., Warren, C., Mckay, D., Mcilmunn, C., Martin, S., Macartney, M., Diamond, T., Davey, P., Jones, C., Clements, J. M., Digney, R., Chan, W. M., Mccain, S., Gull, S., Janeczko, A., Dorrian, E., Harris, A., Dawson, S., Johnston, D., Mcaree, B., Ghareeb, E., Thomas, G., Connelly, M., Mckenzie, S., Cieplucha, K., Spence, G., Campbell, W., Hooks, G., Bradley, N., Hill, A. D. K., Cassidy, J. T., Boland, M., Burke, P., Nally, D. M., Khogali, E., Shabo, W., Iskandar, E., Mcentee, G. P., O'Neill, M. A., Peirce, C., Lyons, E. M., O'Sullivan, A. W., Thakkar, R., Carroll, P., Ivanovski, I., Balfe, P., Lee, M., Winter, D. C., Kelly, M. E., Hoti, E., Maguire, D., Karunakaran, P., Geoghegan, J. G., Mcdermott, F., Martin, S. T., Cross, K. S., Cooke, F., Zeeshan, S., Murphy, J. O., Mealy, K., Mohan, H. M., Nedujchelyn, Y., Ullah, M. F., Ahmed, I., Giovinazzo, F., Milburn, J., Prince, S., Brooke, E., Buchan, J., Khalil, A. M., Vaughan, E. M., Ramage, M. I., Aldridge, R. C., Gibson, S., Nicholson, G. A., Vass, D. G., Grant, A. J., Holroyd, D. J., Jones, M. A., Sutton, C. M. L. R., O'Dwyer, P., Nilsson, F., Weber, B., Williamson, T. K., Lalla, K., Bryant, A., Carter, C. R., Forrest, C. R., Hunter, D. I., Nassar, A. H., Orizu, M. N., Knight, K., Qandeel, H., Suttie, S., Belding, R., Mcclarey, A., Boyd, A. T., Guthrie, G. J. K., Lim, P. J., Luhmann, A., Watson, A. J. M., Richards, C. H., Nicol, L., Madurska, M., Harrison, E., Boyce, K. M., Roebuck, A., Ferguson, G., Pati, P., Wilson, M. S. J., Dalgaty, F., Fothergill, L., Driscoll, P. J., Mozolowski, K. L., Banwell, V., Bennett, S. P., Rogers, P. N., Skelly, B. L., Rutherford, C. L., Mirza, A. K., Lazim, T., Lim, H. C. C., Duke, D., Ahmed, T., Beasley, W. D., Wilkinson, M. D., Maharaj, G., Malcolm, C., Brown, T. H., Al-Sarireh, B., Shingler, G. M., Mowbray, N., Radwan, R., Morcous, P., Wood, S., Kadhim, A., Stewart, D. J., Baker, A. L., Tanner, N., Shenoy, H., Hafiz, S., De Marchi, J. A., Singh-Ranger, D., Hisham, E., Ainley, P., O'Neill, S., Terrace, J., Napetti, S., Hopwood, B., Rhys, T., Downing, J., Kanavati, O., Coats, M., Aleksandrov, D., Kallaway, C., Yahya, S., Templeton, A., Trotter, M., Lo, C., Dhillon, A., Heywood, N., Aawsaj, Y., Hamdan, A., Reece-Bolton, O., Mcguigan, A., Shahin, Y., Aymon, Luther, A. A., Nicholson, J. A., Rajendran, I., Boal, M., and Ritchie, J.

Subjects
Adult, Male, operative difficulty, medicine.medical_specialty, medicine.medical_treatment, Difficulty grading, difficult cholecystectomy, predictive score, surgery, laparoscopic, cholecystectomy, Surgical planning, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Preoperative Care, Humans, Medicine, Laparoscopic cholecystectomy, Framingham Risk Score, business.industry, General surgery, Reproducibility of Results, Middle Aged, medicine.disease, Pre operative, Single surgeon, Cholecystectomy, Laparoscopic, ROC Curve, 030220 oncology & carcinogenesis, Multivariate Analysis, Cholecystitis, Female, 030211 gastroenterology & hepatology, Surgery, Cholecystectomy, business, Abdominal surgery
Abstract

The prediction of a difficult cholecystectomy has traditionally been based on certain pre-operative clinical and imaging factors. Most of the previous literature reported small patient cohorts and have not used an objective measure of operative difficulty. The aim of this study was to develop a pre-operative score to predict difficult cholecystectomy, as defined by a validated intra-operative difficulty grading scale. Two cohorts from prospectively maintained databases of patients who underwent laparoscopic cholecystectomy were analysed: the CholeS Study (8755 patients) and a single surgeon series (4089 patients). Factors potentially predictive of difficulty were correlated to the Nassar intra-operative difficulty scale. A multivariable binary logistic regression analysis was then used to identify factors that were independently associated with difficult laparoscopic cholecystectomy, defined as operative difficulty grades 3 to 5. The resulting model was then converted to a risk score, and validated on both internal and external datasets. Increasing age and ASA classification, male gender, diagnosis of CBD stone or cholecystitis, thick-walled gallbladders, CBD dilation, use of pre-operative ERCP and non-elective operations were found to be significant independent predictors of difficult cases. A risk score based on these factors returned an area under the ROC curve of 0.789 (95% CI 0.773–0.806, p

Published
2019
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8. Impact of postoperative non-steroidal anti-inflammatory drugs on adverse events after gastrointestinal surgery

Author

Chapman, S. J., Glasbey, J., Kelly, M., Khatri, C., Nepogodiev, D., Fitzgerald, J. E. F., Bhangu, A., Harrison, E. M., Adams, R., Patel, K., Retchless, A. R., Elsaddig, M., Curtis, A. E., McMahon, R., Mittapalli, D., Ferguson, L. A., Gentry, S. V., Kong, C. Y. N., Naqvi, Z., Amin, H., Chaudhry, B., Burke, J., Henderson, I., Trecarten, S., Clements, J. M., Drake, T. M., Wild, J. R. L., Venkatesh, H., Butters, N., Ahmeidat, H., Goergen, N., Black, D., Robertson, K., Jama, G. M., McGuire, S. A., Ahl, R., Suri, T. S., Kuo, R., Fadhlillah, M., Mills, H., Mitchell, R., Goodship, J., Tan, M., Barker, T., Wright, T., Mohamad, W., Hanna, N., Laing, G., Warnock, M. W. C., Baird-Fraser, P. R., Logan, T., Young, F. M., Fane De Salis, A. C., McHugh, R., Hickson, C., Paszkiewicz, J., Anderson, L. B., Neeson, D., Mohan, M., Narang, Y., Brophy, T., Punj, R., Majumdar, S., Kauser, S., Jong, G., Palkhi, E., Finch, D., Mitchell, H., Carter, N., Viyasar, T., Sammut, T., Cook, N., Powell, M. M., Horne, S., Allen, J. L. Y., Marshall, D., McIntyre, C., S Koh, D. T., Shi, J., Reid, T., Armugam, N. P., Luck, J., Fozard, T., OʼCallaghan, J., Copley, P. C., Tilliriou, V., Aiyer, R., Yazdi, A., Wiltshire, A., Blower, E., Jewitt, C., Cheung, L. K., Fourali, S., Rahimi, Y., Velho, R., Taylor, C., Satterthwaite, L., Eze, N. V., Johnston, J. P. M., McCain, R. S., Hess, E. C. F., Thumbadoo, R. P., Turner, E. J. H., Wookey, R., Morris, R., Gasteratos, K., Heywood, E., Simpson, S. J., Rai, Z., Kazzazi, D., Ducey, J., Livesey, M. J., Finan, C., Staunton, E., Haddad, S. D., Karanjia, R., Bokobza, I., Ahmed, M., Howell, J., Grainger, C., Woo, A., McDowall, M., Bulley, F., Keating, R., Tan, B., Sng, S., Brown, C., Aidoo-Micah, G., Champsi, A., Ellis, R., Darwazeh, S., Polson, R., Chan, J. Z., Chong, B. F. H. K., Park, J. H., Kong, C. Y., Mogan, Y. P., Stevens, S., Sekhon, H. K., McIntosh, R., Ochiltree, D. W., Jamieson, P. D., Naumann, D. N., Bowley, D. M., Howell, G., Clark, T., Dear, K., James, L., Upchurch, E., Wilson, H., Hughes, M., Modayur, S. M., Datta, U., Chen, J. H. C., Williams, L. J. L., Selby, J., Prabhudesai, A., Mahomed, K., Shah, H. A., Kong, K., Chandramoorthy, S., Marshall, L., De Kauwe, C., Rana, R., Patel, J., Pezas, T., Ma, J., Stohlner, V., Kinsella, M. S., Gardiner, S. N., Smith, R. A., Glover, M., Akinfala, M., Lee, J. Z. C., Aggarwal, V., Waters, S., Atif, M., Hill, M., Ramasubramoni, A., Jaffry, Z., Sagoo, H., Jeyakumar, J., Kosasih, S., Davis, J., Stanley, G. H. M., Nijran, J., Tang, I., Mehta, K., Fillery, A., Watson, N. F., Shah, D., Naidu, S., Grewal, T. K., Singh, P., Reissis, D., Marusza, C., Pettit, W., Timbrell, S., Woods, R., Phillips, J., Vaughan, R., Dean, S., Gibby, R., Jones, T. F., Rao, R., Torrance, H. D. T., Thirumal, V., McMahon, R. K., Yap, D., Shaw, A., Claireaux, H. A., Pang, Y. L., Narramore, R., Holmes, C., Caldwell, A., Daoub, A., Bibby, L., Hague, A. G., Sykes, M. C., Morar, P., Downes, G., Shah, S., Walimohamed, S., Alsulaimi, A., Biswas, V., Gnaneswaran, B., Davies, N., Narwani, V., Hernon, J., Jumbu, A., Ilyas, M., Johal, G., Atia, F., Williams, A., Chan, C., McAnelly, S., Evans, A., Chan, K. Y., Flegg, K., Carter, S., Coley, J., Khaw, R., Jayakody, N., Jones, B., Fawcett, N., Ghali, C., Jalundhwala, K., Ariyaratnam, P., Colville, H., Walls, M., Lindsay, J., Keane, M., Ban, V. S., Kambasha, C., Sait, S., Tahir, M., Tharakan, R., Voll, J., Shiwani, H., Al-Omran, Y., Hawash, A., McCaughan, V., Shatkar, V., Gohil, K., Greenhalgh, A., Higgins, E., Moody, T., Booth, M. B., Chan, W. H., Shanthakumaran, S., Maple, N., McNish, D., Shahin, B., Nicholas, J., McDermid, R., Narayan, P., Brodie, C., Hurrey, S., Panayi, V., Turner, B., Kopala, K., Winfield, Clayton S. A., Mohamud, A., Venkatesh, A., Hosein, S., Olimpio, C., Gkiousias, V., Kilgour, J. M., Cogbill, E., Ramcham, M., Carr, G., Bannerman, A., Grundy, L., White, S., Beamish, A., Neo, Y. N., Cragg, A. R., Perkins, A., Wynn-Hebden, A., Khan, T., Ali, M., Battersby, C. L. F., Pinto, R. S., Poon, S. S., Patel, M., Patel, P., Shafi, A. M. A., Vedage, D., Ghorbhanian, S., Klimach, S., Bradley, J., de Sausmarez, E., Hayward, P., Naqib, S., Flanigan, C., Shuttleworth, R. H. A., McElvanna, K., Shelton, B., Westbrook, N., Weir, A., Webb, P., Alam, M., Bhanderi, S., Roberts, C., Al-Shakarchi, J., Lu, M., Harvey, J., Chowdhury, M. U., McGow, C., Antoniou, I., Good, D. F., Gerasimova, N., Eragat, M., Pressler, N., Santos, C. R. D., Arshad, W., Patel, H. R., Kassim, Y., Jayaratne, N., Perera, A., Chandramoorthy, L., Quan, V., Ponweera, A., Tadjkarimi, J., Moyes, L., Metcalfe, C., Napier-Hemy, T, Bull, A., Jaffer, Y., Mushtaq, J., Warren, M., Jarrar, Z., Wickenden, R., Kang, M., Holohan, G., Isbister, T., Strachan, E., Varma, R., Simpson, R., Rajasekar, N., Panayiotou, H., Walsh, E., Thacoor, A., Willson, J. M. H., Mustafa, A., Barai, I., Menon, A., Soon, W. C., Thakrar, C., McCurdie, S., Carr, E. C. F., Westwood, K. J., Wardell, H., Weinberg, D., Craig, A. R. J., Khan, F. A. S., Mulla, A., Dann, P., Saleh, M., Pignatelli, I. C., Igbagiri, K. V., Panagoulas, E. V., Tilston, T. W., Thayaparan, A. J., Navaratnam, J., Aryasomayajula, S., Joji, N., Screen, R., Quinn, C., Harrison, R., Arnaout, A., McCartan, N., Allen, W., Gabriel, R., Hartelius, C. F., Makinde, M. L., Sivasubramaniam, S., Spreadborough, P., Lobo, R., Surendran, H., Couch, L., Butters, T., Beale, K., Markiewicz, O., Kennedy, E. D., Neely, D. M., Martin, A., Al-Moasseb, Z. H., Ong, K. K., Letchumanan, S., Lam, W. L., Yapp, L., Skelly, B. L., Stallard, S., Westhuizen, P. V. D., Rafferty, A. R., Lambert, A., Tay, Y. Z., Koshnow, Z., Elamin, O., Shah, A., Kim, E., English, W., Farrell, A., Sharma, J., Rowan, Chudek. D. K., Mullan, B., Brown, R. J., McCarter, J. A., Johnston, D., Symonds, C., Gatfield, W., Messenger, D., Knox, J. D., Jani, P., Trinquet, J., Naqvi, Z. B., Hussain, K., Jaffer, A., McAleer, E., Joshi, H., Cecil, E., Lochrane, A., Woolley, T., Marriott, P., Bolton, W., Balian, V., Scott, A. J., and Tan, Y. H.

Published
2014
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9. A multicentre cohort study assessing day of week effect and outcome from emergency appendicectomy

Author

Ferguson, Henry JM, Hall, Nigel J, Bhangu, Aneel, Panagiotopoulou, I G, Chatzizacharias, N, Rana, M, Rollins, K, Ejtehadi, F, Jha, B, Tan, Y W, Fanous, N, Markides, G, Tan, A, Marshal, C, Akhtar, S, Mullassery, D, Ismail, A, Hitchins, C, Sharif, S, Osborne, L, Sengupta, N, Challand, C, Pournaras, D, Bevan, K, King, J, Massey, J, Sandhu, I, Wells, J M, Teichmann, D A, Peckham-Cooper, A, Sellers, M, Folaranmi, S E, Davies, B, Potter, S, Egbeare, D, Kallaway, C, Parsons, S, Upchurch, E, Lazaridis, A, Cocker, D, King, D, Behar, N, Loukogeorgakis, S P, Kalaiselvan, R, Marzouk, S, Turner, E J H, Kaptanis, S, Kaur, V, Shingler, G, Bennett, A, Shaikh, S, Aly, M, Coad, J, Khong, T, Nouman, Z, Crawford, J, Szatmary, P, West, H, Lambert, J, Gash, K, Hanks, K A, Griggs, E, Humphreys, L, Torrance, A, Hardman, J, Taylor, L, Rex, D, Bennett, J, Crowther, N, McAree, B, Flexer, S, Mistry, P, Jain, P, Hwang, M, Oswald, N, Wells, A, Newsome, H, Martinez, P, Alvarez, C A B, León, J, Carradice, D, Gohil, R, Mount, M, Campbell, A, Iype, S, Dyson, E, Groot-Wassink, T, Ross, A R, Jones, C, Charlesworth, P, Baylem, N, Voll, J, Sian, T, Creedon, L, Hicks, G, Goring, J, Ng, V, Tiboni, S, Palser, T, Rees, B, Ravindra, P, Neophytou, C, Dent, H, Lo, T, Broom, L, OʼConnell, M, Foulkes, R, Griffith, D, Butcher, K, Mclaren, O, Tai, A, Yano, H, Torrance, H D T, Moussa, O, Mittapalli, D, Watt, D, Basson, S, Gilliland, J, Pilgrim, S, Wilkins, A, Yee, J, Cain, H, Wilson, M, Pearson, J, Turnbull, E, Brigic, A, Yassin, N A, Clarke, J, Mallappa, S, Jackson, P, Jones, C, Lakshminarayanan, B, Sharma, A, Velineni, R, Fareed, K, Yip, G, Brown, A, Patel, N, Ghisel, M, Tanner, N, Jones, H, Witherspoon, J, Phillips, M, Ho, M F, Ng, S, Mak, T, Campain, N, Mukhey, D, Mitchell, W K, Amawi, F, Dickson, E, Aggarwal, S, Satherley, L K, Asprou, F, Keys, C, Steven, M, Johnstone, M, Muhlschlegel, J, Hamilton, E, Yin, J, Dilworth, M, Wright, A, Spreadborough, P, Singh, M, Mockford, K, Morgan, J, Ball, W, Royle, J, Lacy-Colson, J, Lai, W, Griffiths, S, Mitchell, S, Parsons, C, Joel, A S, Mason, P F, Harrison, G J, Steinke, J, Rafique, H, Battersby, C, Hawkins, W, Gurram, D, Hateley, C A, Penkethman, A, Lambden, C, Conway, A, Dent, P, Yacob, D, Oshin, O A, Hargreaves, A, Gossedge, G, Long, J, Walls, M, Futaba, K, Pinkney, T, Puig, S, Boddy, A, Jones, A, Tennuci, C, Battersby, N, Wilkin, R, Lloyd, C, Sein, E, McEvoy, K, Whisker, L, Austin, S, Colori, A, Sinclair, P, Loughran, M, Lawrence, A, Horsnell, J, Bagenal, J, Pisesky, A, Mastoridis, S, Solanki, K, Siddiq, I, Merker, L, Sarmah, P, Richardson, C, Hanratty, D, Evans, L, Mortimer, M, Bhalla, A, Bartlett, D, Beral, D, Blencowe, N S, Cornish, J, Haddow, J B, Hall, N J, Johnstone, M, Pilgrim, S, Strong, S, Velineni, R, Marriot, P, Vohra, R, Patel, A, Poon, H, and Hepburn, E

Published
2014
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12. Correction to: Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy

Author

Griffiths, E. A., Hodson, J., Vohra, R. S., Marriott, P., Katbeh, T., Zino, S., Nassar, A. H. M., Kirkham, A. J., Pasquali, S., Johnstone, M., Spreadborough, P., Alderson, D., Fenwick, S., Elmasry, M., Nunes, Q. M., Kennedy, D., Khan, R. B., Khan, M. A. S., Magee, C. J., Jones, S. M., Mason, D., Parappally, C. P., Mathur, P., Saunders, M., Jamel, S., Haque, S. U., Zafar, S., Shiwani, M. H., Samuel, N., Dar, F., Jackson, A., Lovett, B., Dindyal, S., Winter, H., Fletcher, T., Rahman, S., Wheatley, K., Nieto, T., Ayaani, S., Youssef, H., Nijjar, R. S., Watkin, H., Naumann, D., Emesih, S., Sarmah, P. B., Lee, K., Joji, N., Lambert, J., Heath, J., Teasdale, R. L., Weerasinghe, C., Needham, P. J., Welbourn, H., Forster, L., Finch, D., Blazeby, J. M., Robb, W., Mcnair, A. G. K., Hrycaiczuk, A., Charalabopoulos, A., Kadirkamanathan, S., Tang, C. -B., Jayanthi, N. V. G., Noor, N., Dobbins, B., Cockbain, A. J., Nilsen-Nunn, A., de Siqueira, J., Pellen, M., Cowley, J. B., W. -M., Ho, Miu, V., White, T. J., Hodgkins, K. A., Kinghorn, A., Tutton, M. G., Al-Abed, Y. A., Menzies, D., Ahmad, A., Reed, J., Khan, S., Monk, D., Vitone, L. J., Murtaza, G., Joel, A., Brennan, S., Shier, D., Zhang, C., Yoganathan, T., Robinson, S. J., Mccallum, I. J. D., Jones, M. J., Elsayed, M., Tuck, L., Wayman, J., Carney, K., Aroori, S., Hosie, K. B., Kimble, A., Bunting, D. M., Fawole, A. S., Basheer, M., Dave, R. V., Sarveswaran, J., Jones, E., Kendal, C., Tilston, M. P., Gough, M., Wallace, T., Singh, S., Mockford, J. D. K. A., Issa, E., Shah, N., Chauhan, N., Wilson, T. R., Forouzanfar, A., Wild, J. R. L., Nofal, E., Bunnell, C., Madbak, K., Rao, S. T. V., Devoto, L., Siddiqi, N., Khawaja, Z., Hewes, J. C., Gould, L., Chambers, A., Rodriguez, D. U., Sen, G., Robinson, S., Bartlett, F., Rae, D. M., Stevenson, T. E. J., Sarvananthan, K., Dwerryhouse, S. J., Higgs, S. M., Old, O. J., Hardy, T. J., Hornby, R. S. S. T., Keogh, K., Frank, L., Al-Akash, M., Upchurch, E. A., Frame, R. J., Hughes, M., Jelley, C., Weaver, S., Roy, S., Sillo, T. O., Galanopoulos, G., Cuming, T., Cunha, P., Tayeh, S., Kaptanis, S., Heshaishi, M., Eisawi, A., Abayomi, M., Ngu, W. S., Fleming, K., Bajwa, D. S., Chitre, V., Aryal, K., Ferris, P., Silva, M., Mohamed, S. L. S., Khawaja, A., Hussain, A., Ghazanfar, M. A., Bellini, M. I., Ebdewi, H., Elshaer, M., Gravante, G., Drake, B., Ogedegbe, A., Mukherjee, D., Arhi, C., Iqbal, L. G. N., Watson, N. F., Aggarwal, S. K., Orchard, P., Villatoro, E., Willson, P. D., Mok, K. W. J., Woodman, T., Deguara, J., Garcea, G., Babu, B. I., Dennison, A. R., Malde, D., Lloyd, D., Satheesan, S., Al-Taan, O., Boddy, A., Slavin, J. P., Jones, R. P., Ballance, L., Gerakopoulos, S., Jambulingam, P., Mansour, S., Sakai, N., Acharya, V., Sadat, M. M., Karim, L., Larkin, D., Amin, K., Khan, A., Law, J., Jamdar, S., Smith, S. R., Sampat, K., O'Shea, K. M., Manu, M., Asprou, F. M., Malik, N. S., Chang, J., Lewis, M., Roberts, G. P., Karavadra, B., Photi, E., Hewes, J., Rodriguez, D., O'Reilly, D. A., Rate, A. J., Sekhar, H., Henderson, L. T., Starmer, B. Z., Coe, P. O., Tolofari, S., Barrie, J., Bashir, G., Sloane, J., Madanipour, S., Halkias, C., Trevatt, A. E. J., Borowski, D. W., Hornsby, J., Courtney, M. J., Virupaksha, S., Seymour, K., Hawkins, H., Bawa, S., Gallagher, P. V., Reid, A., Wood, P., Finch, J. G., Guy Finch, J., Parmar, J., Stirland, E., Gardner-Thorpe, J., Al-Muhktar, A., Peterson, M., Majeed, A., Bajwa, F. M., Martin, J., Choy, A., Tsang, A., Pore, N., Andrew, D. R., Al-Khyatt, W., Bhandari, C. T. S., Subramanium, D., Toh, S. K. C., Carter, N. C., Tate, S., Pearce, B., Wainwright, D., Mercer, S. J., Knight, B., Vijay, V., Alagaratnam, S., Sinha, S., El-Hasani, S. S., Hussain, A. A., Bhattacharya, V., Kansal, N., Fasih, T., Jackson, C., Siddiqui, M. N., Chishti, I. A., Fordham, I. J., Siddiqui, Z., Bausbacher, H., Geogloma, I., Gurung, K., Tsavellas, G., Basynat, P., Shrestha, A. K., Basu, S., Harilingam, A. C. M., Rabie, M., Akhtar, M., Kumar, P., Jafferbhoy, S. F., Hussain, N., Raza, S., Haque, M., Alam, I., Aseem, R., Patel, S., Asad, M., Booth, M. I., Ball, W. R., Wood, C. P. J., Pinho-Gomes, A. C., Kausar, A., Obeidallah, M. R., Varghase, J., Lodhia, J., Bradley, D., Rengifo, C., Lindsay, D., Gopalswamy, S., Finlay, I., Wardle, S., Bullen, N., Iftikhar, S. Y., Awan, A., Ahmed, J., Leeder, P., Fusai, G., Bond-Smith, G., Psica, A., Puri, Y., Hou, D., Noble, F., Szentpali, K., Broadhurst, J., Date, R., Hossack, M. R., Goh, Y. L., Turner, P., Shetty, V., Riera, M., Macano, C. A. W., Sukha, A., Preston, S. R., Hoban, J. R., Puntis, D. J., Williams, S. V., Krysztopik, R., Kynaston, J., Batt, J., Doe, M., Goscimski, A., Jones, G. H., Hall, C., Carty, N., Panteleimonitis, S., Gunasekera, R. T., Sheel, A. R. G., Lennon, H., Hindley, C., Reddy, M., Kenny, R., Elkheir, N., Mcglone, E. R., Rajaganeshan, R., Hancorn, K., Hargreaves, A., Prasad, R., Longbotham, D. A., Vijayanand, D., Wijetunga, I., Ziprin, P., Nicolay, C. R., Yeldham, G., Read, E., Gossage, J. A., Rolph, R. C., Ebied, H., Phull, M., Khan, M. A., Popplewell, M., Kyriakidis, D., Henley, N., Packer, J. R., Derbyshire, L., Porter, J., Appleton, S., Farouk, M., Basra, M., Jennings, N. A., Ali, S., Kanakala, V., Ali, H., Lane, R., Dickson-Lowe, R., Zarsadias, P., Mirza, D., Puig, S., Amari, K. A., Vijayan, D., Sutcliffe, R., Marudanayagam, R., Hamady, Z., Prasad, A. R., Patel, A., Durkin, D., Kaur, P., Bowen, L., Byrne, J. P., Pearson, K. L., Delisle, T. G., Davies, J., Tomlinson, M. A., Johnpulle, M. A., Slawinski, C., Macdonald, A., Nicholson, J., Newton, K., Mbuvi, J., Farooq, A., Mothe, B. S., Zafrani, Z., Brett, D., Francombe, J., Barnes, J., Cheung, M., Al-Bahrani, A. Z., Preziosi, G., Urbonas, T., Alberts, J., Mallik, M., Patel, K., Segaran, A., Doulias, T., Sufi, P. A., Yao, C., Pollock, S., Manzelli, A., Wajed, S., Kourkulos, M., Pezzuto, R., Wadley, M., Hamilton, E., Jaunoo, S., Padwick, R., Sayegh, M., Newton, R. C., Hebbar, M., Farag, S. F., Spearman, J., Hamdan, M. F., D'Costa, C., Blane, C., Giles, M., Peter, M. B., Hirst, N. A., Hossain, T., El-Dhuwaib, A. P. Y., Morrison, T. E. M., Taylor, G. W., Thompson, R. L. E., Mccune, K., Loughlin, P., Lawther, R., Byrnes, C. K., Simpson, D. J., Mawhinney, A., Warren, C., Mckay, D., Mcilmunn, C., Martin, S., Macartney, M., Diamond, T., Davey, P., Jones, C., Clements, J. M., Digney, R., Chan, W. M., Mccain, S., Gull, S., Janeczko, A., Dorrian, E., Harris, A., Dawson, S., Johnston, D., Mcaree, B., Ghareeb, E., Thomas, G., Connelly, M., Mckenzie, S., Cieplucha, K., Spence, G., Campbell, W., Hooks, G., Bradley, N., Hill, A. D. K., Cassidy, J. T., Boland, M., Burke, P., Nally, D. M., Khogali, E., Shabo, W., Iskandar, E., Mcentee, G. P., O'Neill, M. A., Peirce, C., Lyons, E. M., O'Sullivan, A. W., Thakkar, R., Carroll, P., Ivanovski, I., Balfe, P., Lee, M., Winter, D. C., Kelly, M. E., Hoti, E., Maguire, D., Karunakaran, P., Geoghegan, J. G., Mcdermott, F., Martin, S. T., Cross, K. S., Cooke, F., Zeeshan, S., Murphy, J. O., Mealy, K., Mohan, H. M., Nedujchelyn, Y., Ullah, M. F., Ahmed, I., Giovinazzo, F., Milburn, J., Prince, S., Brooke, E., Buchan, J., Khalil, A. M., Vaughan, E. M., Ramage, M. I., Aldridge, R. C., Gibson, S., Nicholson, G. A., Vass, D. G., Grant, A. J., Holroyd, D. J., Angharad Jones, M., Sutton, C. M. L. R., O'Dwyer, P., Nilsson, F., Weber, B., Williamson, T. K., Lalla, K., Bryant, A., Ross Carter, C., Forrest, C. R., Hunter, D. I., Nassar, A. H., Orizu, M. N., Knight, K., Qandeel, H., Suttie, S., Belding, R., Mcclarey, A., Boyd, A. T., Guthrie, G. J. K., Lim, P. J., Luhmann, A., Watson, A. J. M., Richards, C. H., Nicol, L., Madurska, M., Harrison, E., Boyce, K. M., Roebuck, A., Ferguson, G., Pati, P., Wilson, M. S. J., Dalgaty, F., Fothergill, L., Driscoll, P. J., Mozolowski, K. L., Banwell, V., Bennett, S. P., Rogers, P. N., Skelly, B. L., Rutherford, C. L., Mirza, A. K., Lazim, T., Lim, H. C. C., Duke, D., Ahmed, T., Beasley, W. D., Wilkinson, M. D., Maharaj, G., Malcolm, C., Brown, T. H., Al-Sarireh, B., Shingler, G. M., Mowbray, N., Radwan, R., Morcous, P., Wood, S., Kadhim, A., Stewart, D. J., Baker, A. L., Tanner, N., Shenoy, H., Hafiz, S., De Marchi, J. A., Singh-Ranger, D., Hisham, E., Ainley, P., John Terrace, S. O. N., Napetti, S., Hopwood, B., Rhys, T., Downing, J., Kanavati, O., Coats, M., Aleksandrov, D., Kallaway, C., Yahya, S., Templeton, A., Trotter, M., Lo, C., Dhillon, A., Heywood, N., Aawsaj, Y., Hamdan, A., Reece-Bolton, O., Mcguigan, A., Shahin, Y., Aymon, Luther, A. A., Nicholson, J. A., Rajendran, I., Boal, M., and Ritchie, J.

Subjects
Adult, Male, operative difficulty, medicine.medical_specialty, MEDLINE, cholecystectomy, difficulty grading, laparoscopic, Surgery, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, Internal medicine, medicine, Humans, Prospective Studies, GeneralLiterature_REFERENCE(e.g.,dictionaries,encyclopedias,glossaries), Laparoscopic cholecystectomy, Aged, business.industry, General surgery, Correction, Hepatology, Length of Stay, Middle Aged, Conversion to Open Surgery, Cholecystectomy, Laparoscopic, ROC Curve, 030220 oncology & carcinogenesis, Multivariate Analysis, 030211 gastroenterology & hepatology, Female, business, Grading scale, Abdominal surgery
Abstract

A reliable system for grading operative difficulty of laparoscopic cholecystectomy would standardise description of findings and reporting of outcomes. The aim of this study was to validate a difficulty grading system (Nassar scale), testing its applicability and consistency in two large prospective datasets.Patient and disease-related variables and 30-day outcomes were identified in two prospective cholecystectomy databases: the multi-centre prospective cohort of 8820 patients from the recent CholeS Study and the single-surgeon series containing 4089 patients. Operative data and patient outcomes were correlated with Nassar operative difficultly scale, using Kendall's tau for dichotomous variables, or Jonckheere-Terpstra tests for continuous variables. A ROC curve analysis was performed, to quantify the predictive accuracy of the scale for each outcome, with continuous outcomes dichotomised, prior to analysis.A higher operative difficulty grade was consistently associated with worse outcomes for the patients in both the reference and CholeS cohorts. The median length of stay increased from 0 to 4 days, and the 30-day complication rate from 7.6 to 24.4% as the difficulty grade increased from 1 to 4/5 (both p 0.001). In the CholeS cohort, a higher difficulty grade was found to be most strongly associated with conversion to open and 30-day mortality (AUROC = 0.903, 0.822, respectively). On multivariable analysis, the Nassar operative difficultly scale was found to be a significant independent predictor of operative duration, conversion to open surgery, 30-day complications and 30-day reintervention (all p 0.001).We have shown that an operative difficulty scale can standardise the description of operative findings by multiple grades of surgeons to facilitate audit, training assessment and research. It provides a tool for reporting operative findings, disease severity and technical difficulty and can be utilised in future research to reliably compare outcomes according to case mix and intra-operative difficulty.

Published
2018

13. The development and validation of a scoring tool to predict the operative duration of elective laparoscopic cholecystectomy

Author

Bharamgoudar, R., Sonsale, A., Hodson, J., Griffiths, E., Vohra, R.S., Kirkham, A.J., Pasquali, S., Marriott, P., Johnstone, M., Spreadborough, P., Alderson, D., Griffiths, E.A., Fenwick, S., Elmasry, M., Nunes, Q.M., Kennedy, D., Khan, R.B., Khan, M.A.S., Magee, C.J., Jones, S.M., Mason, D., Parappally, C.P., Mathur, P., Saunders, M., Jamel, S., Haque, S.U., Zafar, S., Shiwani, M.H., Samuel, N., Dar, F., Jackson, A., Lovett, B., Dindyal, S., Winter, H., Fletcher, T., Rahman, S., Wheatley, K., Nieto, T., Ayaani, S., Youssef, H., Nijjar, R.S., Watkin, H., Naumann, D., Emesih, S., Sarmah, P.B., Lee, K., Joji, N., Lambert, J., Heath, J., Teasdale, R.L., Weerasinghe, C., Needham, P.J., Welbourn, H., Forster, L., Finch, D., Blazeby, J.M., Robb, W., McNair, A.G.K., Hrycaiczuk, A., Charalabopoulos, A., Kadirkamanathan, S., Tang, C.-B., Jayanthi, N.V.G., Noor, N., Dobbins, B., Cockbain, A.J., Nilsen-Nunn, A., de Siqueira, J., Pellen, M., Cowley, J.B., Ho, W.-M., Miu, V., White, T.J., Hodgkins, K.A., Kinghorn, A., Tutton, M.G., Al-Abed, Y.A., Menzies, D., Ahmad, A., Reed, J., Khan, S., Monk, D., Vitone, L.J., Murtaza, G., Joel, A., Brennan, S., Shier, D., Zhang, C., Yoganathan, T., Robinson, S.J., McCallum, I.J.D., Jones, M.J., Elsayed, M., Tuck, L., Wayman, J., Carney, K., Aroori, S., Hosie, K.B., Kimble, A., Bunting, D.M., Fawole, A.S., Basheer, M., Dave, R.V., Sarveswaran, J., Jones, E., Kendal, C., Tilston, M.P., Gough, M., Wallace, T., Singh, S., Mockford, J.D.K.A., Issa, E., Shah, N., Chauhan, N., Wilson, T.R., Forouzanfar, A., Wild, J.R.L., Nofal, E., Bunnell, C., Madbak, K., Rao, S.T.V., Devoto, L., Siddiqi, N., Khawaja, Z., Hewes, J.C., Gould, L., Chambers, A., Rodriguez, D.U., Sen, G., Robinson, S., Bartlett, F., Rae, D.M., Stevenson, T.E.J., Sarvananthan, K., Dwerryhouse, S.J., Higgs, S.M., Old, O.J., Hardy, T.J., Shah, R., Hornby, S.T., Keogh, K., Frank, L., Al-Akash, M., Upchurch, E.A., Frame, R.J., Hughes, M., Jelley, C., Weaver, S., Roy, S., Sillo, T.O., Galanopoulos, G., Cuming, T., Cunha, P., Tayeh, S., Kaptanis, S., Heshaishi, M., Eisawi, A., Abayomi, M., Ngu, W.S., Fleming, K., Bajwa, D.S., Chitre, V., Aryal, K., Ferris, P., Silva, M., Lammy, S., Mohamed, S., Khawaja, A., Hussain, A., Ghazanfar, M.A., Bellini, M.I., Ebdewi, H., Elshaer, M., Gravante, G., Drake, B., Ogedegbe, A., Mukherjee, D., Arhi, C., Giwa, L., Iqbal, N., Watson, N.F., Aggarwal, S.K., Orchard, P., Villatoro, E., Willson, P.D., Mok, K.W.J., Woodman, T., Deguara, J., Garcea, G., Babu, B.I., Dennison, A.R., Malde, D., Lloyd, D., Satheesan, S., Al-Taan, O., Boddy, A., Slavin, J.P., Jones, R.P., Ballance, L., Gerakopoulos, S., Jambulingam, P., Mansour, S., Sakai, N., Acharya, V., Sadat, M.M., Karim, L., Larkin, D., Amin, K., Khan, A., Law, J., Jamdar, S., Smith, S.R., Sampat, K., O?shea, K.M., Manu, M., Asprou, F.M., Malik, N.S., Chang, J., Lewis, M., Roberts, G.P., Karavadra, B., Photi, E., Hewes, J., Rodriguez, D., O?Reilly, D.A., Rate, A.J., Sekhar, H., Henderson, L.T., Starmer, B.Z., Coe, P.O., Tolofari, S., Barrie, J., Bashir, G., Sloane, J., Madanipour, S., Halkias, C., Trevatt, A.E.J., Borowski, D.W., Hornsby, J., Courtney, M.J., Virupaksha, S., Seymour, K., Hawkins, H., Bawa, S., Gallagher, P.V., Reid, A., Wood, P., Finch, J.G., Guy Finch, J., Parmar, J., Stirland, E., Gardner-Thorpe, J., Al-Muhktar, A., Peterson, M., Majeed, A., Bajwa, F.M., Martin, J., Choy, A., Tsang, A., Pore, N., Andrew, D.R., Al-Khyatt, W., Taylor, C., Bhandari, S., Subramanium, D., Toh, S.K.C., Carter, N.C., Tate, S., Pearce, B., Wainwright, D., Mercer, S.J., Knight, B., Vijay, V., Alagaratnam, S., Sinha, S., El-Hasani, S.S., Hussain, A.A., Bhattacharya, V., Kansal, N., Fasih, T., Jackson, C., Siddiqui, M.N., Chishti, I.A., Fordham, I.J., Siddiqui, Z., Bausbacher, H., Geogloma, I., Gurung, K., Tsavellas, G., Basynat, P., Shrestha, A.K., Basu, S., Chhabra, A., Harilingam, M., Rabie, M., Akhtar, M., Kumar, P., Jafferbhoy, S.F., Hussain, N., Raza, S., Haque, M., Alam, I., Aseem, R., Patel, S., Asad, M., Booth, M.I., Ball, W.R., Wood, C.P.J., Pinho-Gomes, A.C., Kausar, A., Obeidallah, M.R., Varghase, J., Lodhia, J., Bradley, D., Rengifo, C., Lindsay, D., Gopalswamy, S., Finlay, I., Wardle, S., Bullen, N., Iftikhar, S.Y., Awan, A., Ahmed, J., Leeder, P., Fusai, G., Bond-Smith, G., Psica, A., Puri, Y., Hou, D., Noble, F., Szentpali, K., Broadhurst, J., Date, R., Hossack, M.R., Goh, Y.L., Turner, P., Shetty, V., Riera, M., Macano, C.A.W., Sukha, A., Preston, S.R., Hoban, J.R., Puntis, D.J., Williams, S.V., Krysztopik, R., Kynaston, J., Batt, J., Doe, M., Goscimski, A., Jones, G.H., Hall, C., Carty, N., Panteleimonitis, S., Gunasekera, R.T., Sheel, A.R.G., Lennon, H., Hindley, C., Reddy, M., Kenny, R., Elkheir, N., McGlone, E.R., Rajaganeshan, R., Hancorn, K., Hargreaves, A., Prasad, R., Longbotham, D.A., Vijayanand, D., Wijetunga, I., Ziprin, P., Nicolay, C.R., Yeldham, G., Read, E., Gossage, J.A., Rolph, R.C., Ebied, H., Phull, M., Khan, M.A., Popplewell, M., Kyriakidis, D., Henley, N., Packer, J.R., Derbyshire, L., Porter, J., Appleton, S., Farouk, M., Basra, M., Jennings, N.A., Ali, S., Kanakala, V., Ali, H., Lane, R., Dickson-Lowe, R., Zarsadias, P., Mirza, D., Puig, S., Al Amari, K., Vijayan, D., Sutcliffe, R., Marudanayagam, R., Hamady, Z., Prasad, A.R., Patel, A., Durkin, D., Kaur, P., Bowen, L., Byrne, J.P., Pearson, K.L., Delisle, T.G., Davies, J., Tomlinson, M.A., Johnpulle, M.A., Slawinski, C., Macdonald, A., Nicholson, J., Newton, K., Mbuvi, J., Farooq, A., Mothe, B.S., Zafrani, Z., Brett, D., Francombe, J., Barnes, J., Cheung, M., Al-Bahrani, A.Z., Preziosi, G., Urbonas, T., Alberts, J., Mallik, M., Patel, K., Segaran, A., Doulias, T., Sufi, P.A., Yao, C., Pollock, S., Manzelli, A., Wajed, S., Kourkulos, M., Pezzuto, R., Wadley, M., Hamilton, E., Jaunoo, S., Padwick, R., Sayegh, M., Newton, R.C., Hebbar, M., Farag, S.F., Spearman, J., Hamdan, M.F., D?Costa, C., Blane, C., Giles, M., Peter, M.B., Hirst, N.A., Hossain, T., Pannu, A., El-Dhuwaib, Y., Morrison, T.E.M., Taylor, G.W., Thompson, R.L.E., McCune, K., Loughlin, P., Lawther, R., Byrnes, C.K., Simpson, D.J., Mawhinney, A., Warren, C., McKay, D., McIlmunn, C., Martin, S., MacArtney, M., Diamond, T., Davey, P., Jones, C., Clements, J.M., Digney, R., Chan, W.M., McCain, S., Gull, S., Janeczko, A., Dorrian, E., Harris, A., Dawson, S., Johnston, D., McAree, B., Ghareeb, E., Thomas, G., Connelly, M., McKenzie, S., Cieplucha, K., Spence, G., Campbell, W., Hooks, G., Bradley, N., Hill, A.D.K., Cassidy, J.T., Boland, M., Burke, P., Nally, D.M., Khogali, E., Shabo, W., Iskandar, E., McEntee, G.P., O?Neill, M.A., Peirce, C., Lyons, E.M., O?Sullivan, A.W., Thakkar, R., Carroll, P., Ivanovski, I., Balfe, P., Lee, M., Winter, D.C., Kelly, M.E., Hoti, E., Maguire, D., Karunakaran, P., Geoghegan, J.G., McDermott, F., Martin, S.T., Cross, K.S., Cooke, F., Zeeshan, S., Murphy, J.O., Mealy, K., Mohan, H.M., Nedujchelyn, Y., Ullah, M.F., Ahmed, I., Giovinazzo, F., Milburn, J., Prince, S., Brooke, E., Buchan, J., Khalil, A.M., Vaughan, E.M., Ramage, M.I., Aldridge, R.C., Gibson, S., Nicholson, G.A., Vass, D.G., Grant, A.J., Holroyd, D.J., Jones, M.A., Sutton, C.M.L.R., O?Dwyer, P., Nilsson, F., Weber, B., Williamson, T.K., Lalla, K., Bryant, A., Carter, C.R., Forrest, C.R., Hunter, D.I., Nassar, A.H., Orizu, M.N., Knight, K., Qandeel, H., Suttie, S., Belding, R., McClarey, A., Boyd, A.T., Guthrie, G.J.K., Lim, P.J., Luhmann, A., Watson, A.J.M., Richards, C.H., Nicol, L., Madurska, M., Harrison, E., Boyce, K.M., Roebuck, A., Ferguson, G., Pati, P., Wilson, M.S.J., Dalgaty, F., Fothergill, L., Driscoll, P.J., Mozolowski, K.L., Banwell, V., Bennett, S.P., Rogers, P.N., Skelly, B.L., Rutherford, C.L., Mirza, A.K., Lazim, T., Lim, H.C.C., Duke, D., Ahmed, T., Beasley, W.D., Wilkinson, M.D., Maharaj, G., Malcolm, C., Brown, T.H., Al-Sarireh, B., Shingler, G.M., Mowbray, N., Radwan, R., Morcous, P., Wood, S., Kadhim, A., Stewart, D.J., Baker, A.L., Tanner, N., Shenoy, H., Hafiz, S., De Marchi, J.A., Singh-Ranger, D., Hisham, E., Ainley, P., O?Neill, S., Terrace, J., Napetti, S., Hopwood, B., Rhys, T., Downing, J., Kanavati, O., Coats, M., Aleksandrov, D., Kallaway, C., Yahya, S., Templeton, A., Trotter, M., Lo, C., Dhillon, A., Heywood, N., Aawsaj, Y., Hamdan, A., Reece-Bolton, O., McGuigan, A., Shahin, Y., Aymon, Luther, A.A., Nicholson, J.A., Rajendran, I., Boal, M., and Ritchie, J.

Subjects
Adult, Male, Scoring tool, medicine.medical_specialty, Patient factors, medicine.medical_treatment, Operative Time, Operative duration, 030230 surgery, Logistic regression, Article, patient factors, 03 medical and health sciences, Laparoscopic cholecystectomy, 0302 clinical medicine, Patient satisfaction, 030202 anesthesiology, Interquartile range, medicine, Humans, theatre utilisation, Propensity Score, Aged, Framingham Risk Score, Receiver operating characteristic, business.industry, prediction, Middle Aged, operative duration, Cholecystectomy, Laparoscopic, ROC Curve, scoring tool, Centre for Surgical Research, Elective Surgical Procedures, Theatre utilisation, Emergency medicine, Cohort, Propensity score matching, Female, Surgery, Cholecystectomy, Prediction, business
Abstract

Background The ability to accurately predict operative duration has the potential to optimise theatre efficiency and utilisation, thus reducing costs and increasing staff and patient satisfaction. With laparoscopic cholecystectomy being one of the most commonly performed procedures worldwide, a tool to predict operative duration could be extremely beneficial to healthcare organisations. Methods Data collected from the CholeS study on patients undergoing cholecystectomy in UK and Irish hospitals between 04/2014 and 05/2014 were used to study operative duration. A multivariable binary logistic regression model was produced in order to identify significant independent predictors of long (> 90 min) operations. The resulting model was converted to a risk score, which was subsequently validated on second cohort of patients using ROC curves. Results After exclusions, data were available for 7227 patients in the derivation (CholeS) cohort. The median operative duration was 60 min (interquartile range 45–85), with 17.7% of operations lasting longer than 90 min. Ten factors were found to be significant independent predictors of operative durations > 90 min, including ASA, age, previous surgical admissions, BMI, gallbladder wall thickness and CBD diameter. A risk score was then produced from these factors, and applied to a cohort of 2405 patients from a tertiary centre for external validation. This returned an area under the ROC curve of 0.708 (SE = 0.013, p 90 min increasing more than eightfold from 5.1 to 41.8% in the extremes of the score. Conclusion The scoring tool produced in this study was found to be significantly predictive of long operative durations on validation in an external cohort. As such, the tool may have the potential to enable organisations to better organise theatre lists and deliver greater efficiencies in care.

Published
2018
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14. The Metaphor of Sweetness in Medieval and Modern Music Listening

Author

Stoessel, Jason, Spreadborough, Kristal, and Antón-Méndez, Inés

Abstract

Historical listening has long been a topic of interest for musicologists. Yet, little attention has been given to the systematic study of historical listening practices before the common practice era (c. 1700–present). In the first study of its kind, this research compared a model of medieval perceptions of “sweetness” based on writings of medieval music theorists with modern day listeners’ aesthetic responses. Responses were collected through two experiments. In an implicit associations experiment, participants were primed with a more or less consonant musical excerpt, then presented with a sweet or bitter target word, or a non-word, on which to make lexical decisions. In the explicit associations experiment, participants were asked to rate on a three-point Likert scale perceived sweetness of short musical excerpts that varied in consonance and sound quality (male, female, organ). The results from these experiments were compared to predictions from a medieval perception model to investigate whether early and modern listeners have similar aesthetic responses. Results from the implicit association test were not consistent with the predictions of the model, however, results from the explicit associations experiment were. These findings indicate the metaphor of sweetness may be useful for comparing the aesthetic responses of medieval and modern listeners.

Published
2021
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15. Population-based cohort study of outcomes following cholecystectomy for benign gallbladder diseases

Author

Vohra, RS, Pasquali, S, Kirkham, AJ, Marriott, P, Johnstone, M, Spreadborough, P, Alderson, D, Griffiths, EA, Fenwick, S, Elmasry, M, Nunes, Q, Kennedy, D, Khan, RB, Khan, MAS, Magee, CJ, Jones, SM, Mason, D, Parappally, CP, Mathur, P, Saunders, M, Jamel, S, Ul Haque, S, Zafar, S, Shiwani, MH, Samuel, N, Dar, F, Jackson, A, Lovett, B, Dindyal, S, Winter, H, Fletcher, T, Rahman, S, Wheatley, K, Nieto, T, Ayaani, S, Youssef, H, Nijjar, RS, Watkin, H, Naumann, D, Emeshi, S, Sarmah, PB, Lee, K, Joji, N, Heath, J, Teasdale, RL, Weerasinghe, C, Needham, PJ, Welbourn, H, Forster, L, Finch, D, Blazeby, JM, Robb, W, McNair, AGK, Hrycaiczuk, A, Kadirkamanathan, S, Tang, C-B, Jayanthi, NVG, Noor, N, Dobbins, B, Cockbain, AJ, Nilsen-Nunn, A, de Siqueira, J, Pellen, M, Cowley, JB, Ho, W-M, Miu, V, White, TJ, Hodgkins, KA, Kinghorn, A, Tutton, MG, Al-Abed, YA, Menzies, D, Ahmad, A, Reed, J, Khan, S, Monk, D, Vitone, LJ, Murtaza, G, Joel, A, Brennan, S, Shier, D, Zhang, C, Yoganathan, T, Robinson, SJ, McCallum, IJD, Jones, MJ, Elsayed, M, Tuck, L, Wayman, J, Carney, K, Aroori, S, Hosie, KB, Kimble, A, Bunting, DM, Fawole, AS, Basheer, M, Dave, RV, Sarveswaran, J, Jones, E, Kendal, C, Tilston, MP, Gough, M, Wallace, T, Singh, S, Downing, J, Mockford, KA, Issa, E, Shah, N, Chauhan, N, Wilson, TR, Forouzanfar, A, Wild, JRL, Nofal, E, Bunnell, C, Madbak, K, Rao, STV, Devoto, L, Siddiqi, N, Khawaja, Z, Hewes, JC, Gould, L, Chambers, A, Rodriguez, DU, Sen, G, Robinson, S, Bartlett, F, Rae, DM, Stevenson, TEJ, Sarvananthan, K, Dwerryhouse, SJ, Higgs, SM, Old, OJ, Hardy, TJ, Shah, R, Hornby, ST, Keogh, K, Frank, L, Al-Akash, M, Upchurch, EA, Frame, RJ, Hughes, M, Jelley, C, Weaver, S, Roy, S, Sillo, TO, Galanopoulos, G, Cuming, T, Cunha, P, Tayeh, S, Kaptanis, S, Heshaishi, M, Eisawi, A, Abayomi, M, Ngu, WS, Fleming, K, Bajwa, DS, Chitre, V, Aryal, K, Ferris, P, Silva, M, Lammy, S, Mohamed, S, Khawaja, A, Hussain, A, Ghazanfar, MA, Bellini, MI, Ebdewi, H, Elshaer, M, Gravante, G, Drake, B, Ogedegbe, A, Mukherjee, D, Arhi, C, Iqbal, LGN, Watson, NF, Aggarwal, SK, Orchard, P, Villatoro, E, Willson, PD, Wa, K, Mok, J, Woodman, T, Deguara, J, Garcea, G, Babu, BI, Dennison, AR, Malde, D, Lloyd, D, Satheesan, S, Al-Taan, O, Boddy, A, Slavin, JP, Jones, RP, Ballance, L, Gerakopoulos, S, Jambulingam, P, Mansour, S, Sakai, N, Acharya, V, Sadat, MM, Karim, L, Larkin, D, Amin, K, Khan, A, Law, J, Jamdar, S, Smith, SR, Sampat, K, O'Shea, KM, Manu, M, Asprou, FM, Malik, NS, Chang, J, Lewis, M, Roberts, GP, Karavadra, B, Photi, E, Hewes, J, Rodriguez, D, O'Reilly, DA, Rate, AJ, Sekhar, H, Henderson, LT, Starmer, BZ, Coe, PO, Tolofari, S, Barrie, J, Bashir, G, Sloane, J, Madanipour, S, Halkias, C, Trevatt, AEJ, Borowski, DW, Hornsby, J, Courtney, MJ, Seymour, K, Hawkins, H, Bawa, S, Gallagher, PV, Reid, A, Wood, P, Finch, JG, Parmar, J, Stirland, E, Gardner-Thorpe, J, Al-Muhktar, A, Peterson, M, Majeed, A, Bajwa, FM, Martin, J, Choy, A, Tsang, A, Pore, N, Andrew, DR, Al-Khyatt, W, Taylor, C, Bhandari, S, Subramanium, D, Toh, SKC, Carter, NC, Mercer, SJ, Knight, B, Tate, S, Pearce, B, Wainwright, D, Vijay, V, Alagaratnam, S, Sinha, S, El-Hasani, SS, Hussain, AA, Bhattacharya, V, Kansal, N, Fasih, T, Jackson, C, Siddiqui, MN, Chishti, IA, Fordham, IJ, Siddiqui, Z, Bausbacher, H, Geogloma, I, Gurung, K, Tsavellas, G, Basynat, P, Shrestha, AK, Basu, S, Harilingam, ACM, Rabie, M, Akhtar, M, Kumar, P, Jafferbhoy, SF, Hussain, N, Raza, S, Haque, M, Alam, I, Aseem, R, Patel, S, Asad, M, Booth, MI, Ball, WR, Wood, CPJ, Pinho-Gomes, AC, Kausar, A, Obeidallah, MR, Varghase, J, Lodhia, J, Bradley, D, Rengifo, C, Lindsay, D, Gopalswamy, S, Finlay, I, Wardle, S, Bullen, N, Iftikhar, SY, Awan, A, Ahmed, J, Leeder, P, Fusai, G, Bond-Smith, G, Psica, A, Puri, Y, Hou, D, Noble, F, Szentpali, K, Broadhurst, J, Date, R, Hossack, MR, Goh, YL, Turner, P, Shetty, V, Riera, M, Macano, CAW, Sukha, A, Preston, SR, Hoban, JR, Puntis, DJ, Williams, SV, Krysztopik, R, Kynaston, J, Batt, J, Doe, M, Goscimski, A, Jones, GH, Hall, C, Carty, N, Panteleimonitis, S, Gunasekera, RT, Sheel, ARG, Lennon, H, Hindley, C, Reddy, M, Kenny, R, Elkheir, N, McGlone, ER, Rajaganeshan, R, Hancorn, K, Hargreaves, A, Prasad, R, Longbotham, DA, Vijayanand, D, Wijetunga, I, Ziprin, P, Nicolay, CR, Yeldham, G, Read, E, Gossage, JA, Rolph, RC, Ebied, H, Phull, M, Khan, MA, Popplewell, M, Kyriakidis, D, Henley, N, Packer, JR, Derbyshire, L, Porter, J, Appleton, S, Farouk, M, Basra, M, Jennings, NA, Ali, S, Kanakala, V, Ali, H, Lane, R, Dickson-Lowe, R, Zarsadias, P, Mirza, D, Puig, S, Al Amari, K, Vijayan, D, Sutcliffe, R, Marudanayagam, R, Hamady, Z, Prasad, AR, Patel, A, Durkin, D, Kaur, P, Bowen, L, Byrne, JP, Pearson, KL, Delisle, TG, Davies, J, Tomlinson, MA, Johnpulle, MA, Slawinski, C, Macdonald, A, Nicholson, J, Newton, K, Mbuvi, J, Farooq, A, Mothe, BS, Zafrani, Z, Brett, D, Francombe, J, Barnes, J, Cheung, M, Al-Bahrani, AZ, Preziosi, G, Urbonas, T, Alberts, J, Mallik, M, Patel, K, Segaran, A, Doulias, T, Sufi, PA, Yao, C, Pollock, S, Manzelli, A, Wajed, S, Kourkulos, M, Pezzuto, R, Wadley, M, Hamilton, E, Jaunoo, S, Padwick, R, Sayegh, M, Newton, RC, Hebbar, M, Farag, SF, Spearman, J, Hamdan, MF, D'Costa, C, Blane, C, Giles, M, Peter, MB, Hirst, NA, Hossain, T, Pannu, A, El-Dhuwaib, Y, Morrison, TEM, Taylor, GW, Thompson, RLE, McCune, K, Loughlin, P, Lawther, R, Byrnes, CK, Simpson, DJ, Mawhinney, A, Warren, C, Mckay, D, McIlmunn, C, Martin, S, MacArtney, M, Diamond, T, Davey, P, Jones, C, Clements, JM, Digney, R, Chan, WM, McCain, S, Gull, S, Janeczko, A, Dorrian, E, Harris, A, Dawson, S, Johnston, D, McAree, B, Ghareeb, E, Thomas, G, Connelly, M, McKenzie, S, Cieplucha, K, Spence, G, Campbell, W, Hooks, G, Bradley, N, Hill, ADK, Cassidy, JT, Boland, M, Burke, P, Nally, DM, Khogali, E, Shabo, W, Iskandar, E, McEntee, GP, O'Neill, MA, Peirce, C, Lyons, EM, O'Sullivan, AW, Thakkar, R, Carroll, P, Ivanovski, I, Balfe, P, Lee, M, Winter, DC, Kelly, ME, Hoti, E, Maguire, D, Karunakaran, P, Geoghegan, JG, Martin, ST, McDermott, F, Cross, KS, Cooke, F, Zeeshan, S, Murphy, JO, Mealy, K, Mohan, HM, Nedujchelyn, Y, Ullah, MF, Ahmed, I, Giovinazzo, F, Milburn, J, Prince, S, Brooke, E, Buchan, J, Khalil, AM, Vaughan, EM, Ramage, MI, Aldridge, RC, Gibson, S, Nicholson, GA, Vass, DG, Grant, AJ, Holroyd, DJ, Jones, MA, Sutton, CMLR, O'Dwyer, P, Nilsson, F, Weber, B, Williamson, TK, Lalla, K, Bryant, A, Carter, CR, Forrest, CR, Hunter, DI, Nassar, AH, Orizu, MN, Knight, K, Qandeel, H, Suttie, S, Belding, R, McClarey, A, Boyd, AT, Guthrie, GJK, Lim, PJ, Luhmann, A, Watson, AJM, Richards, CH, Nicol, L, Madurska, M, Harrison, E, Boyce, KM, Roebuck, A, Ferguson, G, Pati, P, Wilson, MSJ, Dalgaty, F, Fothergill, L, Driscoll, PJ, Mozolowski, KL, Banwell, V, Bennett, SP, Rogers, PN, Skelly, BL, Rutherford, CL, Mirza, AK, Lazim, T, Lim, HCC, Duke, D, Ahmed, T, Beasley, WD, Wilkinson, MD, Maharaj, G, Malcolm, C, Brown, TH, Shingler, GM, Mowbray, N, Radwan, R, Morcous, P, Wood, S, Kadhim, A, Stewart, DJ, Baker, AL, Tanner, N, Shenoy, H, Hafiz, S, De Marchi, JA, Singh-Ranger, D, Hisham, E, Ainley, P, O'Neill, S, Terrace, J, Napetti, S, Hopwood, B, Rhys, T, Kanavati, O, Coats, M, Aleksandrov, D, Kallaway, C, Yahya, S, Templeton, A, Trotter, M, Lo, C, Dhillon, A, Heywood, N, Aawsaj, Y, Hamdan, A, Reece-Bolton, O, McGuigan, A, Shahin, Y, Ali, A, Luther, A, Nicholson, JA, Rajendran, I, Boal, M, Ritchie, J, Grp, CS, and Collaborative, WMR

Subjects
Male, medicine.medical_treatment, 030230 surgery, outcomes, 0302 clinical medicine, Postoperative Complications, 80 and over, Prospective Studies, Prospective cohort study, Aged, 80 and over, education.field_of_study, Middle Aged, Conversion to Open Surgery, medicine.anatomical_structure, Treatment Outcome, Cholecystectomy, Laparoscopic, Centre for Surgical Research, Elective Surgical Procedures, 030220 oncology & carcinogenesis, Cohort, Female, Elective Surgical Procedure, Adult, medicine.medical_specialty, Population, Gallbladder disease, Gallbladder Diseases, Aged, Ambulatory Surgical Procedures, Cholecystectomy, Emergency Treatment, Humans, Ireland, Patient Readmission, Time-to-Treatment, United Kingdom, Surgery, benign disease, 03 medical and health sciences, Laparoscopic, medicine, education, business.industry, General surgery, Gallbladder, medicine.disease, business, Complication
Abstract

Background The aim was to describe the management of benign gallbladder disease and identify characteristics associated with all-cause 30-day readmissions and complications in a prospective population-based cohort. Methods Data were collected on consecutive patients undergoing cholecystectomy in acute UK and Irish hospitals between 1 March and 1 May 2014. Potential explanatory variables influencing all-cause 30-day readmissions and complications were analysed by means of multilevel, multivariable logistic regression modelling using a two-level hierarchical structure with patients (level 1) nested within hospitals (level 2). Results Data were collected on 8909 patients undergoing cholecystectomy from 167 hospitals. Some 1451 cholecystectomies (16·3 per cent) were performed as an emergency, 4165 (46·8 per cent) as elective operations, and 3293 patients (37·0 per cent) had had at least one previous emergency admission, but had surgery on a delayed basis. The readmission and complication rates at 30 days were 7·1 per cent (633 of 8909) and 10·8 per cent (962 of 8909) respectively. Both readmissions and complications were independently associated with increasing ASA fitness grade, duration of surgery, and increasing numbers of emergency admissions with gallbladder disease before cholecystectomy. No identifiable hospital characteristics were linked to readmissions and complications. Conclusion Readmissions and complications following cholecystectomy are common and associated with patient and disease characteristics.

Published
2016
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16. Population-based cohort study of variation in the use of emergency cholecystectomy for benign gallbladder diseases

Author

Vohra, R. S., Pasquali, S., Kirkham, A. J., Marriott, P., Johnstone, M., Spreadborough, P., Alderson, D., Griffiths, E. A., Fenwick, S., Elmasry, M., Nunes, Q., Kennedy, D., Basit Khan, R., Khan, M. A. S., Magee, C. J., Jones, S. M., Mason, D., Parappally, C. P., Mathur, P., Saunders, M., Jamel, S., Ul Haque, S., Zafar, S., Shiwani, M. H., Samuel, N., Dar, F., Jackson, A., Lovett, B., Dindyal, S., Winter, H., Fletcher, T., Rahman, S., Wheatley, K., Nieto, T., Ayaani, S., Youssef, H., Nijjar, R. S., Watkin, H., Naumann, D., Emeshi, S., Sarmah, P. B., Lee, K., Joji, N., Heath, J., Teasdale, R. L., Weerasinghe, C., Needham, P. J., Welbourn, H., Forster, L., Finch, D., Blazeby, J. M., Robb, W., Mcnair, A. G. K., Hrycaiczuk, A., Charalabopoulos, A., Kadirkamanathan, S., Tang, C. -B., Jayanthi, N. V. G., Noor, N., Dobbins, B., Cockbain, A. J., Nilsen-Nunn, A., de Siqueira, J., Pellen, M., Cowley, J. B., W. -M., Ho, Miu, V., White, T. J., Hodgkins, K. A., Kinghorn, A., Tutton, M. G., Al-Abed, Y. A., Menzies, D., Ahmad, A., Reed, J., Khan, S., Monk, D., Vitone, L. J., Murtaza, G., Joel, A., Brennan, S., Shier, D., Zhang, C., Yoganathan, T., Robinson, S. J., Mccallum, I. J. D., Jones, M. J., Elsayed, M., Tuck, L., Wayman, J., Carney, K., Aroori, S., Hosie, K. B., Kimble, A., Bunting, D. M., Fawole, A. S., Basheer, M., Dave, R. V., Sarveswaran, J., Jones, E., Kendal, C., Tilston, M. P., Gough, M., Wallace, T., Singh, S., Downing, J., Mockford, K. A., Issa, E., Shah, N., Chauhan, N., Wilson, T. R., Forouzanfar, A., Wild, J. R. L., Nofal, E., Bunnell, C., Madbak, K., Rao, S. T. V., Devoto, L., Siddiqi, N., Khawaja, Z., Hewes, J. C., Gould, L., Chambers, A., Urriza Rodriguez, D., Sen, G., Robinson, S., Bartlett, F., Rae, D. M., Stevenson, T. E. J., Sarvananthan, K., Dwerryhouse, S. J., Higgs, S. M., Old, O. J., Hardy, T. J., Shah, R., Hornby, S. T., Keogh, K., Frank, L., Al-Akash, M., Upchurch, E. A., Frame, R. J., Hughes, M., Jelley, C., Weaver, S., Roy, S., Sillo, T. O., Galanopoulos, G., Cuming, T., Cunha, P., Tayeh, S., Kaptanis, S., Heshaishi, M., Eisawi, A., Abayomi, M., Ngu, W. S., Fleming, K., Singh Bajwa, D., Chitre, V., Aryal, K., Ferris, P., Silva, M., Lammy, S., Mohamed, S., Khawaja, A., Hussain, A., Ghazanfar, M. A., Bellini, M. I., Ebdewi, H., Elshaer, M., Gravante, G., Drake, B., Ogedegbe, A., Mukherjee, D., Arhi, C., Giwa Nusrat Iqbal, L., Watson, N. F., Kumar Aggarwal, S., Orchard, P., Villatoro, E., Willson, P. D., Wa, K., Mok, J., Woodman, T., Deguara, J., Garcea, G., Babu, B. I., Dennison, A. R., Malde, D., Lloyd, D., Satheesan, S., Al-Taan, O., Boddy, A., Slavin, J. P., Jones, R. P., Ballance, L., Gerakopoulos, S., Jambulingam, P., Mansour, S., Sakai, N., Acharya, V., Sadat, M. M., Karim, L., Larkin, D., Amin, K., Khan, A., Law, J., Jamdar, S., Smith, S. R., Sampat, K., M O'shea, K., Manu, M., Asprou, F. M., Malik, N. S., Chang, J., Lewis, M., Roberts, G. P., Karavadra, B., Photi, E., Hewes, J., Rodriguez, D., O'Reilly, D. A., Rate, A. J., Sekhar, H., Henderson, L. T., Starmer, B. Z., Coe, P. O., Tolofari, S., Barrie, J., Bashir, G., Sloane, J., Madanipour, S., Halkias, C., Trevatt, A. E. J., Borowski, D. W., Hornsby, J., Courtney, M. J., Virupaksha, S., Seymour, K., Hawkins, H., Bawa, S., Gallagher, P. V., Reid, A., Wood, P., Finch, J. G., Parmar, J., Stirland, E., Gardner-Thorpe, J., Al-Muhktar, A., Peterson, M., Majeed, A., Bajwa, F. M., Martin, J., Choy, A., Tsang, A., Pore, N., Andrew, D. R., Al-Khyatt, W., Taylor, C., Bhandari, S., Subramanium, D., Toh, S. K. C., Carter, N. C., Mercer, S. J., Knight, B., Tate, S., Pearce, B., Wainwright, D., Vijay, V., Alagaratnam, S., Sinha, S., El-Hasani, S. S., Hussain, A. A., Bhattacharya, V., Kansal, N., Fasih, T., Jackson, C., Siddiqui, M. N., Chishti, I. A., Fordham, I. J., Siddiqui, Z., Bausbacher, H., Geogloma, I., Gurung, K., Tsavellas, G., Basynat, P., Kiran Shrestha, A., Basu, S., Chhabra Mohan Harilingam, A., Rabie, M., Akhtar, M., Kumar, P., Jafferbhoy, S. F., Hussain, N., Raza, S., Haque, M., Alam, I., Aseem, R., Patel, S., Asad, M., Booth, M. I., Ball, W. R., Wood, C. P. J., Pinho-Gomes, A. C., Kausar, A., Rami Obeidallah, M., Varghase, J., Lodhia, J., Bradley, D., Rengifo, C., Lindsay, D., Gopalswamy, S., Finlay, I., Wardle, S., Bullen, N., Iftikhar, S. Y., Awan, A., Ahmed, J., Leeder, P., Fusai, G., Bond-Smith, G., Psica, A., Puri, Y., Hou, D., Noble, F., Szentpali, K., Broadhurst, J., Date, R., Hossack, M. R., Li Goh, Y., Turner, P., Shetty, V., Riera, M., Macano, C. A. W., Sukha, A., Preston, S. R., Hoban, J. R., Puntis, D. J., Williams, S. V., Krysztopik, R., Kynaston, J., Batt, J., Doe, M., Goscimski, A., Jones, G. H., Hall, C., Carty, N., Panteleimonitis, S., Gunasekera, R. T., Sheel, A. R. G., Lennon, H., Hindley, C., Reddy, M., Kenny, R., Elkheir, N., Mcglone, E. R., Rajaganeshan, R., Hancorn, K., Hargreaves, A., Prasad, R., Longbotham, D. A., Vijayanand, D., Wijetunga, I., Ziprin, P., Nicolay, C. R., Yeldham, G., Read, E., Gossage, J. A., Rolph, R. C., Ebied, H., Phull, M., Khan, M. A., Popplewell, M., Kyriakidis, D., Henley, N., Packer, J. R., Derbyshire, L., Porter, J., Appleton, S., Farouk, M., Basra, M., Jennings, N. A., Ali, S., Kanakala, V., Ali, H., Lane, R., Dickson-Lowe, R., Zarsadias, P., Mirza, D., Puig, S., Al Amari, K., Vijayan, D., Sutcliffe, R., Marudanayagam, R., Hamady, Z., Prasad, A. R., Patel, A., Durkin, D., Kaur, P., Bowen, L., Byrne, J. P., Pearson, K. L., Delisle, T. G., Davies, J., Tomlinson, M. A., Johnpulle, M. A., Slawinski, C., Macdonald, A., Nicholson, J., Newton, K., Mbuvi, J., Farooq, A., Sidhartha Mothe, B., Zafrani, Z., Brett, D., Francombe, J., Barnes, J., Cheung, M., Al-Bahrani, A. Z., Preziosi, G., Urbonas, T., Alberts, J., Mallik, M., Patel, K., Segaran, A., Doulias, T., Sufi, P. A., Yao, C., Pollock, S., Manzelli, A., Wajed, S., Kourkulos, M., Pezzuto, R., Wadley, M., Hamilton, E., Jaunoo, S., Padwick, R., Sayegh, M., Newton, R. C., Hebbar, M., Farag, S. F., Spearman, J., Hamdan, M. F., D'Costa, C., Blane, C., Giles, M., Peter, M. B., Hirst, N. A., Hossain, T., Pannu, A., El-Dhuwaib, Y., Morrison, T. E. M., Taylor, G. W., Thompson, R. L. E., Mccune, K., Loughlin, P., Lawther, R., Byrnes, C. K., Simpson, D. J., Mawhinney, A., Warren, C., Mckay, D., Mcilmunn, C., Martin, S., Macartney, M., Diamond, T., Davey, P., Jones, C., Clements, J. M., Digney, R., Chan, W. M., Mccain, S., Gull, S., Janeczko, A., Dorrian, E., Harris, A., Dawson, S., Johnston, D., Mcaree, B., Ghareeb, E., Thomas, G., Connelly, M., Mckenzie, S., Cieplucha, K., Spence, G., Campbell, W., Hooks, G., Bradley, N., Hill, A. D. K., Cassidy, J. T., Boland, M., Burke, P., Nally, D. M., Khogali, E., Shabo, W., Iskandar, E., Mcentee, G. P., O'Neill, M. A., Peirce, C., Lyons, E. M., O'Sullivan, A. W., Thakkar, R., Carroll, P., Ivanovski, I., Balfe, P., Lee, M., Winter, D. C., Kelly, M. E., Hoti, E., Maguire, D., Karunakaran, P., Geoghegan, J. G., Martin, S. T., Mcdermott, F., Cross, K. S., Cooke, F., Zeeshan, S., Murphy, J. O., Mealy, K., Mohan, H. M., Nedujchelyn, Y., Fahad Ullah, M., Ahmed, I., Giovinazzo, F., Milburn, J., Prince, S., Brooke, E., Buchan, J., Khalil, A. M., Vaughan, E. M., Ramage, M. I., Aldridge, R. C., Gibson, S., Nicholson, G. A., Vass, D. G., Grant, A. J., Holroyd, D. J., Jones, M. A., Sutton, C. M. L. R., O'Dwyer, P., Nilsson, F., Weber, B., Williamson, T. K., Lalla, K., Bryant, A., Carter, C. R., Forrest, C. R., Hunter, D. I., Nassar, A. H., Orizu, M. N., Knight, K., Qandeel, H., Suttie, S., Belding, R., Mcclarey, A., Boyd, A. T., Guthrie, G. J. K., Lim, P. J., Luhmann, A., Watson, A. J. M., Richards, C. H., Nicol, L., Madurska, M., Harrison, E., Boyce, K. M., Roebuck, A., Ferguson, G., Pati, P., Wilson, M. S. J., Dalgaty, F., Fothergill, L., Driscoll, P. J., Mozolowski, K. L., Banwell, V., Bennett, S. P., Rogers, P. N., Skelly, B. L., Rutherford, C. L., Mirza, A. K., Lazim, T., Lim, H. C. C., Duke, D., Ahmed, T., Beasley, W. D., Wilkinson, M. D., Maharaj, G., Malcolm, C., Brown, T. H., Shingler, G. M., Mowbray, N., Radwan, R., Morcous, P., Wood, S., Kadhim, A., Stewart, D. J., Baker, A. L., Tanner, N., Shenoy, H., Hafiz, S., De Marchi, J. A., Singh-Ranger, D., Hisham, E., Ainley, P., O'Neill, S., Terrace, J., Napetti, S., Hopwood, B., Rhys, T., Kanavati, O., Coats, M., Aleksandrov, D., Kallaway, C., Yahya, S., Templeton, A., Trotter, M., Lo, C., Dhillon, A., Heywood, N., Aawsaj, Y., Hamdan, A., Reece-Bolton, O., Mcguigan, A., Shahin, Y., Ali, A., Luther, A., Nicholson, J. A., Rajendran, I., Boal, M., and Ritchie, J.

Subjects
Adult, Male, medicine.medical_specialty, medicine.medical_treatment, Gallbladder disease, Population, Gallbladder Diseases, 030230 surgery, Biliary colic, Time-to-Treatment, 03 medical and health sciences, 0302 clinical medicine, Emergency cholecystectomy, benign gallbladder disease, hospital care, 80 and over, Medicine, Humans, Cholecystectomy, Prospective Studies, Prospective cohort study, education, Emergency Treatment, Aged, Aged, 80 and over, education.field_of_study, Endoscopic retrograde cholangiopancreatography, medicine.diagnostic_test, business.industry, General surgery, Gallbladder, Middle Aged, medicine.disease, Hospitals, United Kingdom, Hospitalization, medicine.anatomical_structure, Centre for Surgical Research, 030220 oncology & carcinogenesis, Female, Ireland, Surgery, medicine.symptom, business, Cohort study
Abstract

Background The aims of this prospective population-based cohort study were to identify the patient and hospital characteristics associated with emergency cholecystectomy, and the influences of these in determining variations between hospitals. Methods Data were collected for consecutive patients undergoing cholecystectomy in acute UK and Irish hospitals between 1 March and 1 May 2014. Potential explanatory variables influencing the performance of emergency cholecystectomy were analysed by means of multilevel, multivariable logistic regression modelling using a two-level hierarchical structure with patients (level 1) nested within hospitals (level 2). Results Data were collected on 4744 cholecystectomies from 165 hospitals. Increasing age, lower ASA fitness grade, biliary colic, the need for further imaging (magnetic retrograde cholangiopancreatography), endoscopic interventions (endoscopic retrograde cholangiopancreatography) and admission to a non-biliary centre significantly reduced the likelihood of an emergency cholecystectomy being performed. The multilevel model was used to calculate the probability of receiving an emergency cholecystectomy for a woman aged 40 years or over with an ASA grade of I or II and a BMI of at least 25·0 kg/m2, who presented with acute cholecystitis with an ultrasound scan showing a thick-walled gallbladder and a normal common bile duct. The mean predicted probability of receiving an emergency cholecystectomy was 0·52 (95 per cent c.i. 0·45 to 0·57). The predicted probabilities ranged from 0·02 to 0·95 across the 165 hospitals, demonstrating significant variation between hospitals. Conclusion Patients with similar characteristics presenting to different hospitals with acute gallbladder pathology do not receive comparable care.

Published
2016
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18. Cost-effectiveness of emergency versus delayed laparoscopic cholecystectomy for acute gallbladder pathology

Author

Sutton, A J, primary, Vohra, R S, additional, Hollyman, M, additional, Marriott, P J, additional, Buja, A, additional, Alderson, D, additional, Pasquali, S, additional, Griffiths, E A, additional, Spreadborough, P, additional, Kirkham, A, additional, Fenwick, S, additional, Elmasry, M, additional, Nunes, Q M, additional, Kennedy, D, additional, Khan, R B, additional, Khan, M A S, additional, Magee, C J, additional, Jones, S M, additional, Mason, D, additional, Parappally, C P, additional, Mathur, P, additional, Saunders, M, additional, Jamel, S, additional, Ul Haque, S, additional, Zafar, S, additional, Shiwani, M H, additional, Samuel, N, additional, Dar, F, additional, Jackson, A, additional, Lovett, B, additional, Dindyal, S, additional, Winter, H, additional, Fletcher, T, additional, Rahman, S, additional, Wheatley, K, additional, Nieto, T, additional, Ayaani, S, additional, Youssef, H, additional, Nijjar, R S, additional, Watkin, H, additional, Naumann, D, additional, Emesih, S, additional, Sarmah, P B, additional, Lee, K, additional, Joji, N, additional, Heath, J, additional, Teasdale, R L, additional, Weerasinghe, C, additional, Needham, P J, additional, Welbourn, H, additional, Forster, L, additional, Finch, D, additional, Blazeby, J M, additional, Robb, W, additional, McNair, A G K, additional, Hrycaiczuk, A, additional, Charalabopoulos, A, additional, Kadirkamanathan, S, additional, Tang, C-B, additional, Jayanthi, N V G, additional, Noor, N, additional, Dobbins, B, additional, Cockbain, A J, additional, Nilsen-Nunn, A, additional, de Siqueira, J, additional, Pellen, M, additional, Cowley, J B, additional, Ho, W-M, additional, Miu, V, additional, White, T J, additional, Hodgkins, K A, additional, Kinghorn, A, additional, Tutton, M G, additional, Al-Abed, Y A, additional, Menzies, D, additional, Ahmad, A, additional, Reed, J, additional, Khan, S, additional, Monk, D, additional, Vitone, L J, additional, Murtaza, G, additional, Joel, A, additional, Brennan, S, additional, Shier, D, additional, Zhang, C, additional, Yoganathan, T, additional, Robinson, S J, additional, McCallum, I J D, additional, Jones, M J, additional, Elsayed, M, additional, Tuck, E, additional, Wayman, J, additional, Carney, K, additional, Aroori, S, additional, Hosie, K B, additional, Kimble, A, additional, Bunting, D M, additional, Fawole, A S, additional, Basheer, M, additional, Dave, R V, additional, Sarveswaran, J, additional, Jones, E, additional, Kendal, C, additional, Tilston, M P, additional, Gough, M, additional, Wallace, T, additional, Singh, S, additional, Downing, J, additional, Mockford, K A, additional, Issa, E, additional, Shah, N, additional, Chauhan, N, additional, Wilson, T R, additional, Forouzanfar, A, additional, Wild, J R L, additional, Nofal, E, additional, Bunnell, C, additional, Madbak, K, additional, Rao, S T V, additional, Devoto, L, additional, Siddiqi, N, additional, Khawaja, Z, additional, Hewes, J C, additional, Gould, L, additional, Chambers, A, additional, Rodriguez, D U, additional, Sen, G, additional, Robinson, S, additional, Bartlett, F, additional, Rae, D M, additional, Stevenson, T E J, additional, Sarvananthan, K, additional, Dwerryhouse, S J, additional, Higgs, S M, additional, Old, O J, additional, Hardy, T J, additional, Shah, R, additional, Hornby, S T, additional, Keogh, K, additional, Frank, L, additional, Al-Akash, M, additional, Upchurch, E A, additional, Frame, R J, additional, Hughes, M, additional, Jelley, C, additional, Weaver, S, additional, Roy, S, additional, Sillo, T O, additional, Galanopoulos, G, additional, Cuming, T, additional, Cunha, P, additional, Tayeh, S, additional, Kaptanis, S, additional, Heshaishi, M, additional, Eisawi, A, additional, Abayomi, M, additional, Ngu, W S, additional, Fleming, K, additional, Bajwa, D S, additional, Chitre, V, additional, Aryal, K, additional, Ferris, P, additional, Silva, M, additional, Lammy, S, additional, Mohamed, S, additional, Khawaja, A, additional, Hussain, A, additional, Ghazanfar, M A, additional, Bellini, M I, additional, Ebdewi, H, additional, Elshaer, M, additional, Gravante, G, additional, Drake, B, additional, Ogedegbe, A, additional, Mukherjee, D, additional, Arhi, C, additional, Iqbal, L G N, additional, Watson, N F, additional, Aggarwal, S K, additional, Orchard, P, additional, Villatoro, E, additional, Willson, P D, additional, Mok, J, additional, Woodman, T, additional, Deguara, J, additional, Garcea, G, additional, Babu, B I, additional, Dennison, A R, additional, Malde, D, additional, Lloyd, D, additional, Satheesan, S, additional, Al-Taan, O, additional, Boddy, A, additional, Slavin, J P, additional, Jones, R P, additional, Ballance, L, additional, Gerakopoulos, S, additional, Jambulingam, P, additional, Mansour, S, additional, Sakai, N, additional, Acharya, V, additional, Sadat, M M, additional, Karim, L, additional, Larkin, D, additional, Amin, K, additional, Khan, A, additional, Law, J, additional, Jamdar, S, additional, Smith, S R, additional, Sampat, K, additional, O'shea, K M, additional, Manu, M, additional, Asprou, F M, additional, Malik, N S, additional, Chang, J, additional, Johnstone, M, additional, Lewis, M, additional, Roberts, G P, additional, Karavadra, B, additional, Photi, E, additional, Hewes, J, additional, Rodriguez, D, additional, O'Reilly, D A, additional, Rate, A J, additional, Sekhar, H, additional, Henderson, L T, additional, Starmer, B Z, additional, Coe, P O, additional, Tolofari, S, additional, Barrie, J, additional, Bashir, G, additional, Sloane, J, additional, Madanipour, S, additional, Halkias, C, additional, Trevatt, A E J, additional, Borowski, D W, additional, Hornsby, J, additional, Courtney, M J, additional, Virupaksha, S, additional, Seymour, K, additional, Hawkins, H, additional, Bawa, S, additional, Gallagher, P V, additional, Reid, A, additional, Wood, P, additional, Finch, J G, additional, Parmar, J, additional, Stirland, E, additional, Gardner-Thorpe, J, additional, Al-Muhktar, A, additional, Peterson, M, additional, Majeed, A, additional, Bajwa, F M, additional, Martin, J, additional, Choy, A, additional, Tsang, A, additional, Pore, N, additional, Andrew, D R, additional, Al-Khyatt, W, additional, Taylor, C, additional, Bhandari, S, additional, Subramanium, D, additional, Toh, S K C, additional, Carter, N C, additional, Tate, S, additional, Pearce, B, additional, Wainwright, D, additional, Mercer, S J, additional, Knight, B, additional, Vijay, V, additional, Alagaratnam, S, additional, Sinha, S, additional, El-Hasani, S S, additional, Hussain, A A, additional, Bhattacharya, V, additional, Kansal, N, additional, Fasih, T, additional, Jackson, C, additional, Siddiqui, M N, additional, Chishti, I A, additional, Fordham, I J, additional, Siddiqui, Z, additional, Bausbacher, H, additional, Geogloma, I, additional, Gurung, K, additional, Tsavellas, G, additional, Basynat, P, additional, Shrestha, A K, additional, Basu, S, additional, Mohan, A C, additional, Harilingam, M, additional, Rabie, M, additional, Akhtar, M, additional, Kumar, P, additional, Jafferbhoy, S F, additional, Hussain, N, additional, Raza, S, additional, Haque, M, additional, Alam, I, additional, Aseem, R, additional, Patel, S, additional, Asad, M, additional, Booth, M I, additional, Ball, W R, additional, Wood, C P J, additional, Pinho-Gomes, A C, additional, Kausar, A, additional, Obeidallah, M R, additional, Varghase, J, additional, Lodhia, J, additional, Bradley, D, additional, Rengifo, C, additional, Lindsay, D, additional, Gopalswamy, S, additional, Finlay, I, additional, Wardle, S, additional, Bullen, N, additional, Iftikhar, S Y, additional, Awan, A, additional, Ahmed, J, additional, Leeder, P, additional, Fusai, G, additional, Bond-Smith, G, additional, Psica, A, additional, Puri, Y, additional, Hou, D, additional, Noble, F, additional, Szentpali, K, additional, Broadhurst, J, additional, Date, R, additional, Hossack, M R, additional, Goh, Y L, additional, Turner, P, additional, Shetty, V, additional, Riera, M, additional, Macano, C A W, additional, Sukha, A, additional, Preston, S R, additional, Hoban, J R, additional, Puntis, D J, additional, Williams, S V, additional, Krysztopik, R, additional, Kynaston, J, additional, Batt, J, additional, Doe, M, additional, Goscimski, A, additional, Jones, G H, additional, Hall, C, additional, Carty, N, additional, Panteleimonitis, S, additional, Gunasekera, R T, additional, Sheel, A R G, additional, Lennon, H, additional, Hindley, C, additional, Reddy, M, additional, Kenny, R, additional, Elkheir, N, additional, McGlone, E R, additional, Rajaganeshan, R, additional, Hancorn, K, additional, Hargreaves, A, additional, Prasad, R, additional, Longbotham, D A, additional, Vijayanand, D, additional, Wijetunga, I, additional, Ziprin, P, additional, Nicolay, C R, additional, Yeldham, G, additional, Read, E, additional, Gossage, J A, additional, Rolph, R C, additional, Ebied, H, additional, Phull, M, additional, Khan, M A, additional, Popplewell, M, additional, Kyriakidis, D, additional, Henley, N, additional, Packer, J R, additional, Derbyshire, L, additional, Porter, J, additional, Appleton, S, additional, Farouk, M, additional, Basra, M, additional, Jennings, N A, additional, Ali, S, additional, Kanakala, V, additional, Ali, H, additional, Lane, R, additional, Dickson-Lowe, R, additional, Zarsadias, P, additional, Mirza, D, additional, Puig, S, additional, Al Amari, K, additional, Vijayan, D, additional, Sutcliffe, R, additional, Marudanayagam, R, additional, Hamady, Z, additional, Prasad, A R, additional, Patel, A, additional, Durkin, D, additional, Kaur, P, additional, Bowen, L, additional, Byrne, J P, additional, Pearson, K L, additional, Delisle, T G, additional, Davies, J, additional, Tomlinson, M A, additional, Johnpulle, M A, additional, Slawinski, C, additional, Macdonald, A, additional, Nicholson, J, additional, Newton, K, additional, Mbuvi, J, additional, Farooq, A, additional, Mothe, B S, additional, Zafrani, Z, additional, Brett, D, additional, Francombe, J, additional, Barnes, J, additional, Cheung, M, additional, Al-Bahrani, A Z, additional, Preziosi, G, additional, Urbonas, T, additional, Alberts, J, additional, Mallik, M, additional, Patel, K, additional, Segaran, A, additional, Doulias, T, additional, Sufi, P A, additional, Yao, C, additional, Pollock, S, additional, Manzelli, A, additional, Wajed, S, additional, Kourkulos, M, additional, Pezzuto, R, additional, Wadley, M, additional, Hamilton, E, additional, Jaunoo, S, additional, Padwick, R, additional, Sayegh, M, additional, Newton, R C, additional, Hebbar, M, additional, Farag, S F, additional, Spearman, J, additional, Hamdan, M F, additional, D'Costa, C, additional, Blane, C, additional, Giles, M, additional, Peter, M B, additional, Hirst, N A, additional, Hossain, T, additional, Pannu, A, additional, El-Dhuwaib, Y, additional, Morrison, T E M, additional, Taylor, G W, additional, Thompson, R L E, additional, McCune, K, additional, Loughlin, P, additional, Lawther, R, additional, Byrnes, C K, additional, Simpson, D J, additional, Mawhinney, A, additional, Warren, C, additional, McKay, D, additional, McIlmunn, C, additional, Martin, S, additional, MacArtney, M, additional, Diamond, T, additional, Davey, P, additional, Jones, C, additional, Clements, J M, additional, Digney, R, additional, Chan, W M, additional, McCain, S, additional, Gull, S, additional, Janeczko, A, additional, Dorrian, E, additional, Harris, A, additional, Dawson, S, additional, Johnston, D, additional, McAree, B, additional, Ghareeb, E, additional, Thomas, G, additional, Connelly, M, additional, McKenzie, S, additional, Cieplucha, K, additional, Spence, G, additional, Campbell, W, additional, Hooks, G, additional, Bradley, N, additional, Hill, A D K, additional, Cassidy, J T, additional, Boland, M, additional, Burke, P, additional, Nally, D M, additional, Khogali, E, additional, Shabo, W, additional, Iskandar, E, additional, McEntee, G P, additional, O'Neill, M A, additional, Peirce, C, additional, Lyons, E M, additional, O'Sullivan, A W, additional, Thakkar, R, additional, Carroll, P, additional, Ivanovski, I, additional, Balfe, P, additional, Lee, M, additional, Winter, D C, additional, Kelly, M E, additional, Hoti, E, additional, Maguire, D, additional, Karunakaran, P, additional, Geoghegan, J G, additional, McDermott, F, additional, Martin, S T, additional, Cross, K S, additional, Cooke, F, additional, Zeeshan, S, additional, Murphy, J O, additional, Mealy, K, additional, Mohan, H M, additional, Nedujchelyn, Y, additional, Ullah, M F, additional, Ahmed, I, additional, Giovinazzo, F, additional, Milburn, J, additional, Prince, S, additional, Brooke, E, additional, Buchan, J, additional, Khalil, A M, additional, Vaughan, E M, additional, Ramage, M I, additional, Aldridge, R C, additional, Gibson, S, additional, Nicholson, G A, additional, Vass, D G, additional, Grant, A J, additional, Holroyd, D J, additional, Jones, M A, additional, Sutton, C M L R, additional, O'Dwyer, P, additional, Nilsson, F, additional, Weber, B, additional, Williamson, T K, additional, Lalla, K, additional, Bryant, A, additional, Carter, C R, additional, Forrest, C R, additional, Hunter, D I, additional, Nassar, A H, additional, Orizu, M N, additional, Knight, K, additional, Qandeel, H, additional, Suttie, S, additional, Belding, R, additional, McClarey, A, additional, Boyd, A T, additional, Guthrie, G J K, additional, Lim, P J, additional, Luhmann, A, additional, Watson, A J M, additional, Richards, C H, additional, Nicol, L, additional, Madurska, M, additional, Harrison, E, additional, Boyce, K M, additional, Roebuck, A, additional, Ferguson, G, additional, Pati, P, additional, Wilson, M S J, additional, Dalgaty, F, additional, Fothergill, L, additional, Driscoll, P J, additional, Mozolowski, K L, additional, Banwell, V, additional, Bennett, S P, additional, Rogers, P N, additional, Skelly, B L, additional, Rutherford, C L, additional, Mirza, A K, additional, Lazim, T, additional, Lim, H C C, additional, Duke, D, additional, Ahmed, T, additional, Beasley, W D, additional, Wilkinson, M D, additional, Maharaj, G, additional, Malcolm, C, additional, Brown, T H, additional, Shingler, G M, additional, Mowbray, N, additional, Radwan, R, additional, Morcous, P, additional, Wood, S, additional, Kadhim, A, additional, Stewart, D J, additional, Baker, A L, additional, Tanner, N, additional, Shenoy, H, additional, Hafiz, S, additional, De Marchi, J A, additional, Singh-Ranger, D, additional, Hisham, E, additional, Ainley, P, additional, O'Neill, S, additional, Terrace, J, additional, Napetti, S, additional, Hopwood, B, additional, Rhys, T, additional, Kanavati, O, additional, Coats, M, additional, Aleksandrov, D, additional, Kallaway, C, additional, Yahya, S, additional, Templeton, A, additional, Trotter, M, additional, Lo, C, additional, Dhillon, A, additional, Heywood, N, additional, Aawsaj, Y, additional, Hamdan, A, additional, Reece-Bolton, O, additional, McGuigan, A, additional, Shahin, Y, additional, Ali, A, additional, Luther, A, additional, Nicholson, J A, additional, Rajendran, I, additional, Boal, M, additional, and Ritchie, J, additional

Published
2016
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20. Outcome of appendicectomy in children performed in paediatric surgery units compared with general surgery units

Author

Tiboni, S, primary, Bhangu, A, additional, Hall, N J, additional, Panagiotopoulou, I G, additional, Chatzizacharias, N, additional, Rana, M, additional, Rollins, K, additional, Ejtehadi, F, additional, Jha, B, additional, Tan, Y-W, additional, Fanous, N, additional, Markides, G, additional, Tan, A, additional, Marshal, C, additional, Akhtar, S, additional, Mullassery, D, additional, Ismail, A, additional, Hitchins, C, additional, Sharif, S P, additional, Osborne, L, additional, Sengupta, N, additional, Challand, C, additional, Pournaras, D, additional, Bevan, K, additional, King, J, additional, Massey, J, additional, Sandhu, I, additional, Wells, J M, additional, Teichmann, D A, additional, Peckham-Cooper, A, additional, Sellers, M, additional, Folaranmi, S E, additional, Davies, B, additional, Loukogeorgakis, S P, additional, Kalaiselvan, R, additional, Marzouk, S, additional, Turner, E J H, additional, Kaptanis, S, additional, Kaur, V, additional, Shingler, G, additional, Bennett, A, additional, Aly, M, additional, Coad, J, additional, Khong, T, additional, Nouman, Z, additional, Crawford, J, additional, Szatmary, P, additional, West, H, additional, MacDonald, A L, additional, Hanks, K A, additional, Griggs, E, additional, Humphreys, L, additional, Torrance, A, additional, Hardman, J, additional, Taylor, L, additional, Rex, D, additional, Bennett, J, additional, Crowther, N, additional, McAree, B, additional, Flexer, S, additional, Mistry, P, additional, Jain, P, additional, Hwang, M, additional, Oswald, N, additional, Wells, A, additional, Newsome, H, additional, Campbell, A, additional, Carradice, D, additional, Gohil, R, additional, Mount, M, additional, Iype, S, additional, Dyson, E, additional, Groot-Wassink, T, additional, Ross, A R, additional, Jones, C, additional, Baylem, N, additional, Voll, J, additional, Sian, T, additional, Creedon, L, additional, Charlesworth, P, additional, Goring, J, additional, Ng, V, additional, Tiboni, S, additional, Palser, T, additional, Rees, B, additional, Ravindra, P, additional, Neophytou, C, additional, Dent, H, additional, Lo, T, additional, Broom, L, additional, O'Connell, M, additional, Foulkes, R, additional, Griffith, D, additional, Butcher, K, additional, Mclaren, O, additional, Tai, A, additional, Torrance, H D T, additional, Moussa, O, additional, Mittapalli, D, additional, Watt, D, additional, Basson, S, additional, Wilkins, A, additional, Yee, J, additional, Cain, H, additional, Wilson, M, additional, Pearson, J, additional, Turnbull, E, additional, Brigic, A, additional, Yassin, N A, additional, Clarke, J, additional, Mallappa, S, additional, Jackson, P, additional, Jones, C E, additional, Lakshminarayanan, B, additional, Fareed, K, additional, Yip, G, additional, Brown, A, additional, Patel, N, additional, Ghisel, M, additional, Tanner, N, additional, Jones, H, additional, Witherspoon, J, additional, Phillips, M, additional, Mitchell, W K, additional, Amawi, F, additional, Dickson, E, additional, Aggarwal, S, additional, Satherley, L K, additional, Asprou, F, additional, Keys, C, additional, Steven, M, additional, Muhlschlegel, J, additional, Hamilton, E, additional, Yin, J, additional, Dilworth, M, additional, Wright, A, additional, Spreadborough, P, additional, Singh, M, additional, Mockford, K, additional, Morgan, J, additional, Ball, W, additional, Royle, J, additional, Lacy-Colson, J, additional, Batterbsy, C, additional, Hateley, C A, additional, Penkethman, A, additional, Lambden, C, additional, Lai, W, additional, Griffiths, S, additional, Mitchell, S, additional, Parsons, C, additional, Conway, A, additional, Dent, P, additional, Yacob, D, additional, Tennuci, C, additional, Battersby, N, additional, Wilkin, R, additional, Lloyd, C, additional, Sein, E, additional, McEvoy, K, additional, Whisker, L, additional, Austin, S, additional, Colori, A, additional, Sinclair, P, additional, Loughran, M, additional, Lawrence, A, additional, Pisesky, A, additional, Mastoridis, S, additional, Solanki, K, additional, Siddiq, I, additional, Merker, L, additional, Sarmah, P, additional, Richardson, C, additional, Pinkney, T, additional, Battersby, C, additional, Beral, D, additional, Cornish, J, additional, Strong, S, additional, and Velineni, R, additional

Published
2014
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21. Correction: The Cholecystectomy As A Day Case (CAAD) Score: A Validated Score of Preoperative Predictors of Successful Day-Case Cholecystectomy Using the CholeS Data Set.

Author

El-Sharkawy, A. M., Tewari, N., Vohra, R. S., CholeS Study Group, West Midlands Research Collaborative, Pasquali, S., Kirkham, A. J., Marriott, P., Johnstone, M., Spreadborough, P., Alderson, D., Griffiths, E. A., Fenwick, S., Elmasry, M., Nunes, Q., Kennedy, D., Basit Khan, R., Khan, M. A., Magee, C. J., Jones, S. M., and Mason, D.

Subjects
CHOLECYSTECTOMY
Abstract

B Correction: World J Surg (2019) 43:1928-1934 b https://doi.org/10.1007/s00268-019-04981-5 Since the publication of this work, S. Kanavati has changed their name from O. Kanavati. Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. [Extracted from the article]

Published
2023
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22. Population-based cohort study of outcomes following cholecystectomy for benign gallbladder diseases.

Author

Vohra, R. S., Pasquali, S., Kirkham, A. J., Marriott, P., Johnstone, M., Spreadborough, P., Alderson, D., Griffiths, E. A., Fenwick, S., Elmasry, M., Nunes, Q., Kennedy, D., Basit Khan, R., Khan, M. A. S., Magee, C. J., Jones, S. M., Mason, D., Parappally, C. P., Mathur, P., and Saunders, M.

Subjects
CHOLECYSTECTOMY, HEALTH outcome assessment, DISEASE management, PATIENT readmissions, LOGISTIC regression analysis
Abstract

Background The aim was to describe the management of benign gallbladder disease and identify characteristics associated with all-cause 30-day readmissions and complications in a prospective population-based cohort. Methods Data were collected on consecutive patients undergoing cholecystectomy in acute UK and Irish hospitals between 1 March and 1 May 2014. Potential explanatory variables influencing all-cause 30-day readmissions and complications were analysed by means of multilevel, multivariable logistic regression modelling using a two-level hierarchical structure with patients (level 1) nested within hospitals (level 2). Results Data were collected on 8909 patients undergoing cholecystectomy from 167 hospitals. Some 1451 cholecystectomies (16·3 per cent) were performed as an emergency, 4165 (46·8 per cent) as elective operations, and 3293 patients (37·0 per cent) had had at least one previous emergency admission, but had surgery on a delayed basis. The readmission and complication rates at 30 days were 7·1 per cent (633 of 8909) and 10·8 per cent (962 of 8909) respectively. Both readmissions and complications were independently associated with increasing ASA fitness grade, duration of surgery, and increasing numbers of emergency admissions with gallbladder disease before cholecystectomy. No identifiable hospital characteristics were linked to readmissions and complications. Conclusion Readmissions and complications following cholecystectomy are common and associated with patient and disease characteristics. [ABSTRACT FROM AUTHOR]

Published
2016
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24. Prevalence of undiagnosed urinary tract infections on admission to a rehabilitation unit.

Author

Matthews, Shaun, Barnard, Alan, McMillan, Renee, Spreadborough, Trish, and Horton, Eleanor

Abstract

Background Through clinical observation nursing staff of an inpatient rehabilitation unit identified a link between incontinence and undiagnosed urinary tract infections (UTIs). Further, clinical observation and structured continence management led to the realisation that urinary incontinence often improved, or resolved completely, after treatment with antibiotics. In 2009 a small study found that 30% of admitted rehabilitation patients had an undiagnosed UTI, with the majority admitted post-orthopaedic fracture. We suspected that the frequent use of indwelling urinary catheters (IDCs) in the orthopaedic environment may have been a contributing factor. Therefore, a second, more thorough, study was commenced in 2010 and completed in 2011. Aim The aim of this study was to identify what proportion of patients were admitted to one rehabilitation unit with an undiagnosed UTI over a 12-month period. We wanted to identify and highlight the presence of known risk factors associated with UTI and determine whether urinary incontinence was associated with the presence of UTI. Methods Data were collected from every patient that was admitted over a 12-month period (n=140). The majority of patients were over the age of 65 and had an orthopaedic fracture (36.4%) or stroke (27.1%). Mid-stream urine (MSU) samples, routinely collected and sent for culture and sensitivity as part of standard admission procedure, were used by the treating medical officer to detect the presence of UTI. A data collection sheet was developed, reviewed and trialled, before official data collection commenced. Data were collected as part of usual practice and collated by a research assistant. Inferential statistics were used to analyse the data. Results This study found that 25 (17.9%) of the 140 patients admitted to rehabilitation had an undiagnosed UTI, with a statistically significant association between prior presence of an IDC and the diagnosis of UTI. Urinary incontinence improved after the completion of treatment with antibiotics. Results further demonstrated a significant association between the confirmation of a UTI on culture and sensitivity and the absence of symptoms usually associated with UTI, such as burning or stinging on urination. Overall, this study suggests careful monitoring of urinary symptoms in patients admitted to rehabilitation, especially in patients with a prior IDC, is warranted. [ABSTRACT FROM AUTHOR]

Published
2013

25. A Pilot Survey of Undiagnosed Urinary Tract Infections on Admission to a Rehabilitation Unit.

Author

Matthews, Shaun, McMillan, Renee, Robinson, Simone, and Spreadborough, Trish

Abstract

Many patients admitted to Rehabilitation Units are at risk of developing urinary tract infections (UTI) due to the effects of the acute event, and co-morbidities. We conducted a 6 month survey of all patients (n =79) admitted to the Redcliffe Hospital Rehabilitation Unit and found that approximately 1/3 of those patients had an undiagnosed UTI. UTI's in this patient group can be difficult to diagnose due to cognitive and communication impairments that prevent the patient reporting symptoms, and the fact that elderly patients do not always display multiple or explicit symptoms of UTI. Therefore, it is necessary for nurses practicing in all settings, including rehabilitation, to be aware of the sometimes subtle indicators that their patient may have a UTI. [ABSTRACT FROM AUTHOR]

Published
2010

27. Relationship between in vitro chromosomal radiosensitivity of peripheral blood lymphocytes and the expression of normal tissue damage following radiotherapy for breast cancer

Author

Barber, James B.P, Burrill, Wayne, Spreadborough, Anne R, Levine, Ed, Warren, Coleen, Kiltie, Anne E, Roberts, Steve A, and Scott, David

Abstract

Background and purpose: There is a need for rapid and reliable tests for the prediction of normal tissue responses to radiotherapy, as this could lead to individualization of patient radiotherapy schedules and thus improvements in the therapeutic ratio. Because the use of cultured fibroblasts is too slow to be practicable in a clinical setting, we evaluated the predictive role of assays of lymphocyte chromosomal radiosensitivity in patients having radiotherapy for breast cancer.

Published
2000
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28. Effects of Alloying Elements on the Mechanical Properties of Steels at Low Temperatures

Author

Anderson, E., Bode, R., Dorn, J. E., and Spreadborough, J.

Abstract

The low-temperature tensile properties of dilute Fe–C, Fe–Nb–C, Fe–V–C, Fe–N, Fe–Nb–V–N, and Fe–V–N steels have been analysed. The major differences in the plastic behaviour of the alloys arise from their athermal stress/strain behaviour. The lower yield strength vs. temperature relations correspond qualitatively with the Peierls mechanism for thermally activated deformation. The activation volumes also agree well with expectations based only on the Peierls mechanism. The results suggest that the Peierls stress, kink energy, and shapes of the Peierls hills are insensitive to alloy composition and heat-treatment. The fact that higher yield stresses at 298° K also gave higher values of Tc, the temperature at which plastic behaviour becomes athermal, has been interpreted to mean that the product, ρL, of the density of mobile dislocations times the dislocation length swept out by a pair of kinks decreased as the athermal component of stress increased.

Published
1976
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29. Radiation-induced G2 Delay and Spontaneous Chromosome Aberrations in Ataxia-telangiectasia Homozygotes and Heterozygotes

Author

Scott, D., Spreadborough, A. R., and Roberts, S. A.

Abstract

The extent of cell cycle delay of lymphocytes X-irradiated in G2 phase was measured by mitotic inhibition determinations in 66 controls, 14 ataxia-telangiectasia (A-T) homozygotes and 27 obligate heterozygotes. Homozygotes had a significantly reduced mitotic index (MI) in unirradiated samples and showed significantly less radiation-induced mitotic inhibition than controls. This confirms our earlier disputed observations on A-T fibroblasts and demonstrates a G2 checkpoint defect in addition to the well-known defects in S phase and at the G1-S phase transition. There are two separate and opposite abnormal G2 responses of A-T cells; a primary event in which cells in G2 at the time of irradiation suffer less delay than controls, and a secondary event in which cells irradiated at earlier stages of the cycle are more delayed when they pass into G2. The MI of unirradiated heterozygote cells and the extent of mitotic inhibition were indistinguishable from controls. Spontaneous unstable chromosome aberrations were, as previously reported, significantly higher in homozygotes than in controls. This was true for breaks, but not for gaps. There was a suggestion of an increase in breaks in heterozygotes, but a much larger study would be required to confirm or refute this.

Published
1994
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30. The occurrence of stacking faults in metallic systems

Author

Spreadborough, J.

Abstract

A possible qualitative interpretation of the occurrence of stacking faults in metals and alloys is outlined, using an extension of the ideas of Altmann, Coulson and Hume-Rothery. The metals calcium, scandium and titanium, the ε-phase in iron-manganese. and the α-solid solutions of various B subgroup elements in the noble metals are treated as examples. The effect of temperature on hybrids is briefly discussed.

Published
1958
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34. Action of Graphite as a Lubricant

Author

BOLLMANN, W. and SPREADBOROUGH, J.

Abstract

THE lubricating properties of graphite have considerable practical importance and scientific interest. The explanation often quoted for the mechanism is based on the assumption that the loosely bound graphite layers slide easily over each other like a pack of cards when graphite is used as a lubricant between moving surfaces1. In this communication we report briefly on experiments which indicate that a hitherto unconsidered mechanism might be important.

Published
1960
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35. A New Pressure-Regulated, Partial Resuscitative Endovascular Balloon Occlusion of the Aorta Device Achieves Targeted Distal Perfusion.

Author

White JM, Ronaldi AE, Polcz JE, Spreadborough P, Madurska M, Mares JA, Leung LY, and Rasmussen TE

Subjects
Animals, Aorta, Abdominal physiopathology, Arterial Pressure physiology, Balloon Occlusion adverse effects, Balloon Occlusion instrumentation, Carotid Arteries physiopathology, Disease Models, Animal, Female, Humans, Regional Blood Flow physiology, Resuscitation adverse effects, Resuscitation instrumentation, Shock, Hemorrhagic physiopathology, Sus scrofa, Balloon Occlusion methods, Catheters, Pressure, Resuscitation methods, Shock, Hemorrhagic therapy
Abstract

Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) reduces blood loss and improves hemodynamics. Complete occlusion results in distal ischemia, limiting its use for prolonged care. This study evaluated two next-generation partial REBOA (pREBOA) catheters and their ability to achieve targeted distal aortic flow., Materials and Methods: Swine underwent hemorrhagic shock, complete aortic occlusion, controlled continuous balloon deflation, and targeted distal perfusion (TDP; 300-mL/min) phases. They were randomized into three groups (n = 6/group), one managed with the current ER-REBOA (ER), and two with the new pREBOA technologies: a bilobed (BL) device and a semicompliant pREBOA-PRO (PRP). Hemodynamics including flow rates and mean arterial pressures at the carotid artery and infrarenal aorta were recorded., Results: Hemodynamics were comparable between groups during hemorrhage and complete occlusion phases. During the controlled continuous balloon deflation phase, the distal aortic flow rate strongly correlated with percent balloon volume in BL and PRP groups, suggesting a precise control of distal perfusion. The slope of flow-balloon-volume curves was greater in the ER group than BL and PRP groups, indicating the change in distal aortic flow rate was more sensitive to the balloon volume (less titratable) when using ER. During the TDP phase, variation in distal aortic flow and mean arterial pressure with respect to the target flow was lower in ER and PRP groups, than the BL group., Conclusions: Pressure-regulated occlusion using the next-generation pREBOA catheters is more controlled than the first-generation ER-REBOA catheter and allow for targeted and precise distal perfusion., (Published by Elsevier Inc.)

Published
2020
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36. Emulsion Effect on the Measurement of Standard Laboratory Blood Parameters.

Author

Arnaud F, Spreadborough P, Mehalick M, and Goforth C

Subjects
Animals, Emulsions, Fentanyl, Laboratories, Swine, Anesthetics, Intravenous, Propofol
Abstract

Background: A number of pharmaceutical agents have limited water solubility and are therefore often prepared in a lipid emulsion. Emulsion renders plasma opaque and this could interfere with the accuracy of some standardized laboratory measurements, especially for optical or mechanical based assays. We determined the interference on some laboratory diagnostic values of blood specimens after propofol addition in vitro as well as in vivo when infused into swine., Methods: In vitro, laboratory parameters were measured immediately after mixing swine blood diluted with increasing amounts of propofol emulsion in the range of 3 to 23%, v/v. The contact time of a 9% v/v mixture of blood and propofol was also examined over a 3-hours period. Saline-diluted samples served as controls. Cellular volume, hematocrit, hemoglobin, potassium, and coagulation were measured with various instruments. In addition, similar parameters were analyzed from swine blood following a 9 - 10 hours infusion with propofol/fentanyl compared to infusion with ketamine/midazolam., Results: In vitro, blood cell volume increased immediately upon contact with a mixture exceeding 6% propofol. Above 9% of the mixture, the cellular volume expanded significantly with extracellular K+ leakage. Hematocrit increased but the hemoglobin was dependent on the instrument type. Coagulation was altered when the emulsion was present. Interestingly, in vivo these effects were significant less pronounced in blood collected from experimental swine under total intravenous propofol anesthesia, but they departed from water-based anesthesia in control swine., Conclusions: The in vitro studies indicate that results from certain assays of blood samples rich in lipid emulsion may not be accurate due to interference with optical, mechanical or ion selective electrode methodology. Although in vivo samples may be less impacted, there is still a risk of deviation from accuracy.

Published
2020
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37. A systematic review and meta-analysis of perioperative oral decontamination in patients undergoing major elective surgery.

Author

Spreadborough P, Lort S, Pasquali S, Popplewell M, Owen A, Kreis I, Tucker O, and Vohra RS

Abstract

Background: Oral antiseptics reduce nosocomial infections and ventilator-associated pneumonia in critically ill medical and surgical patients intubated for prolonged periods. However, the role of oral antiseptics given before and after planned surgery is not clear. The aim of this systematic review and meta-analysis is to determine the effect of oral antiseptics (chlorhexidine or povidone-iodine) when administered before and after major elective surgery., Methods: Searches were conducted of the MEDLINE, EMBASE and Cochrane databases. The analysis was performed using the random-effects method and the risk ratio (RR) with 95 % confidence interval (CI)., Results: Of 1114 unique identified articles, perioperative chlorhexidine was administered to patients undergoing elective surgery in four studies. This identified 2265 patients undergoing elective cardiac surgery, of whom 1093 (48.3 %) received perioperative chlorhexidine. Postoperative pneumonia and nosocomial infections were observed in 5.3 and 20.2 % who received chlorhexidine compared to 10.4 and 31.3 % who received a control preparation, respectively. Oral perioperative chlorhexidine significantly reduced the risk of postoperative pneumonia (RR = 0.52; 95 % CI 0.39-0.71; p < 0.01) and overall nosocomial infections (RR = 0.65; 95 % CI 0.52-0.81; p < 0.01), with no effect on in-hospital mortality (RR = 1.01; 95 % CI 0.49-2.09; p = 0.98)., Conclusions: Perioperative oral chlorhexidine significantly decreases the incidence of nosocomial infection and postoperative pneumonia in patients undergoing elective cardiac surgery. There are no randomised controlled studies of this simple and cheap intervention in patients undergoing elective non-cardiac surgery., Trial Registration: This systematic review was registered with the International prospective register of systematic reviews (PROSPERO). The registration number is CRD42015016063.

Published
2016
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38. Protocol for a multicentre, prospective, population-based cohort study of variation in practice of cholecystectomy and surgical outcomes (The CholeS study).

Author

Vohra RS, Spreadborough P, Johnstone M, Marriott P, Bhangu A, Alderson D, Morton DG, and Griffiths EA

Subjects
Adult, Cholecystectomy methods, Clinical Audit, Cross-Sectional Studies, Elective Surgical Procedures, Female, Humans, Ireland, Length of Stay statistics & numerical data, Logistic Models, Male, Operative Time, Patient Readmission statistics & numerical data, Postoperative Complications, Prospective Studies, United Kingdom, Cholecystectomy standards, Gallbladder Diseases surgery
Abstract

Introduction: Cholecystectomy is one of the most common general surgical operations performed. Despite level one evidence supporting the role of cholecystectomy in the management of specific gallbladder diseases, practice varies between surgeons and hospitals. It is unknown whether these variations account for the differences in surgical outcomes seen in population-level retrospective data sets. This study aims to investigate surgical outcomes following acute, elective and delayed cholecystectomies in a multicentre, contemporary, prospective, population-based cohort., Methods and Analysis: UK and Irish hospitals performing cholecystectomies will be recruited utilising trainee-led research collaboratives. Two months of consecutive, adult patient data will be included. The primary outcome measure of all-cause 30-day readmission rate will be used in this study. Thirty-day complication rates, bile leak rate, common bile duct injury, conversion to open surgery, duration of surgery and length of stay will be measured as secondary outcomes. Prospective data on over 8000 procedures is anticipated. Individual hospitals will be surveyed to determine local policies and service provision. Variations in outcomes will be investigated using regression modelling to adjust for confounders., Ethics and Dissemination: Research ethics approval is not required for this study and has been confirmed by the online National Research Ethics Service (NRES) decision tool. This novel study will investigate how hospital-level surgical provision can affect patient outcomes, using a cross-sectional methodology. The results are essential to inform commissioning groups and implement changes within the National Health Service (NHS). Dissemination of the study protocol is primarily through the trainee-led research collaboratives and the Association of Upper Gastrointestinal Surgeons (AUGIS). Individual centres will have access to their own results and the collective results of the study will be published in peer-reviewed journals and presented at relevant surgical conferences., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)

Published
2015
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