رسالة جامعية
The predictive performance of the POSSUM scoring system and early indicatosrs of peripheral perfusion for complications after major abdominal surgery ; Značaj POSSUM skora i ranih pokazatelja periferne perfuzije za predviđanje postoperativnih komplikacija u hirurgiji digestivnog sistema
| العنوان: | The predictive performance of the POSSUM scoring system and early indicatosrs of peripheral perfusion for complications after major abdominal surgery ; Značaj POSSUM skora i ranih pokazatelja periferne perfuzije za predviđanje postoperativnih komplikacija u hirurgiji digestivnog sistema |
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| المؤلفون: | Veličković, Jelena |
| المساهمون: | Bumbaširević, Vesna, Palibrk, Ivan, Simić, Aleksandar P., Jovanović, Bojan, Grasselli, Giacomo |
| المصدر: | Универзитет у Београду |
| بيانات النشر: | Универзитет у Београду, Медицински факултет |
| سنة النشر: | 2020 |
| المجموعة: | NaRDuS (National Repository of Dissertations in Serbia) / Nacionalni Repozitorijum Disertacija u Srbiji |
| مصطلحات موضوعية: | major abdominal surgery, elika abdominalna hirurgija, postoperative complications, peripheral perfusion, POSSUM score, postoperativne komplikacije, periferna perfuzija, POSSUM skor |
| الوصف: | Postoperative complications are the major cause of postoperative morbidity and mortality and remain to be a serious burden for a healthcare system. The early identification of patients at risk may play a pivotal role in rational decisions regarding perioperative management. The aim of this study was to explore the characteristics of complications in high-risk patients after major abdominal surgery. We also assessed and compared the accuracy of the Clavien-Dindo classification (CDC) and the Comprehensive Complication Index (CCI) for evaluation of postoperative morbidity and the predictive performance of the POSSUM scoring system for complications and mortality. Finally, we wanted to explore the significance of early indicators of altered peripheral perfusion after major abdominal surgery for the occurrence of severe complications. A prospective, observational, cohort study included 206 high-risk surgical patients undergoing major abdominal surgery at the Clinic for Digestive Surgery, Clinical Center of Serbia, from November 2016 to October 2017. We found that the complication rate in our cohort was 60.7% and that the occurrence of complications was associated with the longer ICU stay (p<0.001), postoperative length of stay (p<0.001) and lower functional activity at hospital discharge (p<0.001). The CCI was shown to be of superior accuracy in high-risk patients with multiple complications compared to the CDC as it demonstrated a higher correlation to the resource utilization indicators (p<0.001). The POSSUM scoring system showed the sub-optimal performance for prediction of morbidity and mortality in this cohort of patients (AUCmorbidity= 0.708, O:E ratio=1.07; AUCmortality= 0.744, O:E ratio=0.38). We found that the alterations of peripheral perfusion early after the operation were more pronounced in patients who developed more severe complications. Capillary refill time, central-to-peripheral temperature gradient, and venoarterial pCO2 difference to arteriovenous O2 content ratio on admission to the ... |
| نوع الوثيقة: | doctoral or postdoctoral thesis |
| وصف الملف: | application/pdf |
| اللغة: | English |
| العلاقة: | http://eteze.bg.ac.rs/application/showtheses?thesesId=7284Test; https://nardus.mpn.gov.rs/handle/123456789/12140Test; https://fedorabg.bg.ac.rs/fedora/get/o:21041/bdef:Content/downloadTest; http://vbs.rs/scripts/cobiss?command=DISPLAY&base=70036&RID=51895311Test; https://nardus.mpn.gov.rs/bitstream/id/11042/Disertacija.pdfTest; https://nardus.mpn.gov.rs/bitstream/id/11043/IzvestajKomisije22200.pdfTest; http://nardus.mpn.gov.rs/bitstream/id/11042/Disertacija.pdfTest; http://nardus.mpn.gov.rs/bitstream/id/11043/IzvestajKomisije22200.pdfTest; https://hdl.handle.net/21.15107/rcub_nardus_12140Test |
| الإتاحة: | https://nardus.mpn.gov.rs/handle/123456789/12140Test http://eteze.bg.ac.rs/application/showtheses?thesesId=7284Test https://fedorabg.bg.ac.rs/fedora/get/o:21041/bdef:Content/downloadTest http://vbs.rs/scripts/cobiss?command=DISPLAY&base=70036&RID=51895311Test https://nardus.mpn.gov.rs/bitstream/id/11042/Disertacija.pdfTest https://nardus.mpn.gov.rs/bitstream/id/11043/IzvestajKomisije22200.pdfTest http://nardus.mpn.gov.rs/bitstream/id/11042/Disertacija.pdfTest http://nardus.mpn.gov.rs/bitstream/id/11043/IzvestajKomisije22200.pdfTest https://hdl.handle.net/21.15107/rcub_nardus_12140Test |
| حقوق: | openAccess ; https://creativecommons.org/licenses/by-nc-nd/4.0Test/ ; BY-NC-ND |
| رقم الانضمام: | edsbas.E0202825 |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |