Association Between Laboratory Metrics and Mortality After Major Lower Extremity Amputation in Peripheral Artery Disease Patients

Journal of Clinical Medicine, Journal Year: 2025, Volume and Issue: 14(8), P. 2640 - 2640

Published: April 11, 2025

Introduction: Apart from their high burden of disease, major amputations, especially due to macro- and microangiopathic malperfusion, persist inflict a relevant socioeconomic impact in most geographic regions. It has been repeatedly shown that lower extremity amputations are associated with impaired post-operative survival. In the present study, we investigated whether metrics derived routine laboratory studies after amputation Methods: this retrospective single-center analysis, 244 patients undergoing between 2012 2016 were included. Serum hemoglobin leukocyte counts first 21 days as well analyzed addition clinical demographic variables. Kaplan–Meier estimates adjusted Cox regressions fitted including parameters. Results: summary, 71.3% underwent transtibial 28.7% transfemoral amputations. The frequent complications wound-related (43.0%). Long-term survival analyses showed advanced age higher ASA class significantly reduced survival, while no significant differences observed based on sex, smoking history, or type amputation. Laboratory parameter analysis peri-operative outcomes elevated counts, leukocyte-derived showing associations long-term adjustment for class. Conclusions: This study highlights potential parameter-derived predicting mortality PAD patients.

Language: Английский

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Time-varying mortality risk after gastrointestinal surgery complicated by postoperative infections: a Danish Nationwide study of 859,766 patients

Langenbeck s Archives of Surgery, Journal Year: 2025, Volume and Issue: 410(1)

Published: May 7, 2025

Abstract Purpose Postoperative infections are associated with increased mortality risk, but it is unclear if this risk increase persists over time. This study aims to estimate postoperative at different time-points within the first year in a nationwide cohort of gastrointestinal surgery patients. Methods We included all individuals residing Denmark who underwent between 1996 and 2018 were alive day 30. For time-intervals during one-year follow-up, we calculated rates cumulative incidences death for patients without 30-day infections. Time-varying Cox regression analyses estimated relative infection exposure. Results Of 859,766 (female:49.2%; median age:51 years), 25,126 (2.9%) had least one infection. In or infections, days 30–365 13.5% versus 4.7%. Adjusted hazard ratios (HRs) from 30, 91, 181, 271 until end follow-up (until 365) 2.25(95% CI:2.13–2.38), 1.88(1.74–2.04), 1.44(1.29–1.62), 1.11(1.00–1.28) any compared no ( p time−interaction <0.001). The adjusted HRs exposed types were: sepsis: 4.38(3.90–4.93), pneumonia: 2.60(2.37–2.85), urinary tract infection: 1.26(1.05–1.52), surgical site 1.16(1.04–1.30). Conclusion Compared infection, after 2.3-fold attributed exposure gradually diminished

Language: Английский

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Anastomotic leakage after resection for rectal cancer and recurrence-free survival in relation to postoperative C-reactive protein levels

International Journal of Colorectal Disease, Journal Year: 2024, Volume and Issue: 39(1)

Published: Dec. 2, 2024

Abstract Background Anastomotic leakage after rectal cancer surgery is linked to reduced survival and higher recurrence rates. While an aggravated inflammatory response may worsen outcomes, few studies have explored the combined effects of inflammation. Methods This a retrospective multicenter cohort study including patients operated with anterior resection for in Sweden during 2014–2018. within 12 months was exposure primary outcome recurrence-free survival. Mediation analysis performed evaluate potential effect systemic response, as measured by highest postoperative C-reactive protein (CRP) level 14 days surgery. Confounders were chosen using causal diagram. Results Some 1036 eligible analysis, whom 218 (21%) experienced anastomotic leakage. At end follow-up at median 61 surgery, amounted 82.6% 77.8% group without leakage, respectively. The CRP value (219 mg/l), compared (108 mg/l). Leakage did not lead worse (HR 0.66; 95% CI 0.43–0.94), there no apparent through 1.12; 0.93–1.29). Conclusions In conclusion, its accompanying increase, found be associated this patient cohort. Larger, even more detailed are needed further investigate topic.

Language: Английский

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Anastomotic leakage after resection for rectal cancer and recurrence-free survival in relation to postoperative C-reactive protein levels

Research Square (Research Square), Journal Year: 2024, Volume and Issue: unknown

Published: July 29, 2024

Background Anastomotic leakage following surgery for rectal cancer is associated with reduced overall survival and higher rates of recurrence. Some data suggest that an aggravated inflammatory response might lead to worse oncological outcomes, but few attempts have been made investigate inflammation in conjunction.Methods This a retrospective multicentre cohort study including patients operated anterior resection Sweden during 2014–2018. within 12 months was exposure primary outcome recurrence-free survival. Mediation analysis performed evaluate the potential effect systemic response, as measured by highest postoperative C-reactive protein (CRP) level 14 days surgery. Confounders were chosen using causal diagram, while multiple imputation used handle missing data.Results 1,036 eligible analysis, whom 218 (21%) experienced anastomotic leakage. At end follow-up at median 61 after surgery, amounted 82.6% 77.8% group without leakage, respectively. The CRP value (219 mg/l), compared (108 mg/l). Leakage did not (HR 0.66; 95% CI: 0.43–0.94), there no apparent through 1.12; 0.93–1.29).Conclusions In conclusion, its accompanying increase, found be this patient cohort. Larger, even more detailed studies are needed further topic.

Language: Английский

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Utilizing C-Reactive Protein (CRP) and CRP Ratios for Early Detection of Postoperative Complications Following Rectal Cancer Surgery

Life, Journal Year: 2024, Volume and Issue: 14(11), P. 1465 - 1465

Published: Nov. 12, 2024

Background: Surgical treatment for rectal cancer may cause complications that exacerbate the condition, lengthen hospital stays, and raise healthcare costs. Rectal surgery can be detected immediately with postoperative C-reactive protein (CRP) monitoring. Elevated levels of CRP indicate presence inflammation serve as a predictive factor future outcomes. Methods: A retrospective cohort analysis was performed on 67 patients. Prior to after surgery, were measured days 1–3 4–7. Postoperative linked CRP, surgical approach (open, laparoscopic, conversion), patient characteristics. This study included t-tests, chi-square tests, Mann–Whitney U ANOVA, Pearson Spearman correlation analyses, logistic regression. Results: There significant between high 4–7 development problems (p < 0.001). The ratios CRP/albumin CRP/platelet highly over this period = 0.000033). Patients who encountered had notably greater estimated blood loss 0.0086). Logistic regression demonstrated statistically relationship higher Charlson Comorbidity Index (CCI) scores an elevated probability experiencing 0.0078). Moreover, patients underwent laparoscopic but converted open method saw incidence 0.0022). From financial standpoint, average cost per EUR 1128.75, resulting in total 44,021.25 all 39 Conversely, did not experience any difficulties 731.25 patient, 20,475.00 28 Conclusions: Regularly monitoring particularly 4 7 following cancer, promptly identify complications. Monitoring managing abnormalities enhance outcomes reduce

Language: Английский

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