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  • 1
    In: Journal of Vascular Nursing, Elsevier BV, Vol. 32, No. 1 ( 2014-03), p. 29-30
    Type of Medium: Online Resource
    ISSN: 1062-0303
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2014
    detail.hit.zdb_id: 2048804-X
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  • 2
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2014
    In:  British Journal of Surgery Vol. 101, No. 5 ( 2014-03-13), p. 582-589
    In: British Journal of Surgery, Oxford University Press (OUP), Vol. 101, No. 5 ( 2014-03-13), p. 582-589
    Abstract: With advances in operative technique and perioperative care, traditional endpoints such as morbidity and mortality provide an incomplete description of surgical outcomes. There is increasing emphasis on the need for patient-reported outcomes (PROs) to evaluate fully the effectiveness and quality of surgical interventions. The objective of this study was to identify the outcomes reported in clinical studies published in high-impact surgical journals and the frequency with which PROs are used. Methods Electronic versions of material published between 2008 and 2012 in the four highest-impact non-subspecialty surgical journals (Annals of Surgery, British Journal of Surgery (BJS), Journal of the American College of Surgeons (JACS), Journal of the American Medical Association (JAMA) Surgery) were hand-searched. Clinical studies of adult patients undergoing planned abdominal, thoracic or vascular surgery were included. Reported outcomes were classified into five categories using Wilson and Cleary's conceptual model. Results A total of 893 articles were assessed, of which 770 were included in the analysis. Some 91·6 per cent of studies reported biological and physiological outcomes, 36·0 per cent symptoms, 13·4 per cent direct indicators of functional status, 10·6 per cent general health perception and 14·8 per cent overall quality of life (QoL). The proportion of studies with at least one PRO was 38·7 per cent overall and 73·4 per cent in BJS (P & lt; 0·001). The proportion of studies using a formal measure of health-related QoL ranged from 8·9 per cent (JAMA Surgery) to 33·8 per cent (BJS). Conclusion The predominant reporting of clinical endpoints and the inconsistent use of PROs underscore the need for further research and education to enhance the applicability of these measures in specific surgical settings.
    Type of Medium: Online Resource
    ISSN: 0007-1323 , 1365-2168
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2014
    detail.hit.zdb_id: 2006309-X
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  • 3
    Online Resource
    Online Resource
    SAGE Publications ; 2014
    In:  Annals of Clinical Biochemistry: International Journal of Laboratory Medicine Vol. 51, No. 2 ( 2014-03), p. 258-268
    In: Annals of Clinical Biochemistry: International Journal of Laboratory Medicine, SAGE Publications, Vol. 51, No. 2 ( 2014-03), p. 258-268
    Abstract: Non-cardiac surgery is associated with major vascular complications and higher incidences of elevated plasma troponin (cTn) concentration. Goal-directed therapy (GDT) is a stroke volume (SV)-guided approach to intravenous (IV) fluid therapy that improves tissue perfusion, oxygenation and reduces post-operative complications. In patients undergoing major gastro-intestinal surgery, we compared high sensitive and contemporary troponin assays and correlated results with patient outcome. Methods Patients ( n = 135) were randomized to receive IV fluid, guided by either the central venous pressure (CVP group, n = 45) or SV (± dopexamine inotrope, n = 45 per group). Serum was obtained pre- and post-operatively (0, 8 and 24 h) for troponin analysis by a prototype hs-cTnI assay (Abbott Laboratories), hs-cTnT (Roche Diagnostics) and contemporary cTnI (Beckman Coulter) assays. Results All troponin measurements were increased ( P ≤ 0.05) post-operatively but there was no difference ( P  〉  0.05) amongst treatments. Post-operative increases were reported more frequently ( P ≤ 0.05) and earlier with hs-cTnI. Temporal increases ( P ≤ 0.05) were reported in patients with and without complications for hs-cTnI/T assays but only in the complications group for cTnI measurements. Elevations ≥99th centile occurred most often ( P ≤ 0.05) for hs-cTnT measurements but with similar frequency for both outcome groups (all assays). Only the hs-cTnI assay showed an increased relative risk of mortality ( P ≤ 0.05) for elevations ≥99th centile Conclusions Our study may suggest a possible preference for the hs-cTnI assay in the peri-operative setting; however, our findings should be verified for larger cohort studies where emerging reference range data is incorporated for improving risk prediction with hs-cTn assays.
    Type of Medium: Online Resource
    ISSN: 0004-5632 , 1758-1001
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2014
    detail.hit.zdb_id: 2041298-8
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