Background: Peri-operative variables associated with prolonged Intensive Care Unit (ICU) admission following cytoreductive surgery for ovarian cancer were investigated. Patients and Methods: A retrospective review was carried out of patients admitted to the ICU following cytoreductive surgery for ovarian cancer in a single tertiary referral centre from 2015-2019. Patients were categorized according to length of ICU stay (<48 h and ≥48 h), and peri-operative variables were compared across the two groups. Results: A total of 56 patients were admitted to the ICU post-operatively, 37 for <48 h and 19 for ≥48 h (range=3-11 days). Greater duration of procedure and estimated blood loss, bowel resection, higher post-operative lactate level, lower post-operative albumin level and requirement for post-operative blood products were associated with prolonged ICU stay. Increased intraoperative fluid requirement was an independent predictor of extended ICU stay. Conclusion: Utilizing identified intra-operative risk factors to perform individualized risk assessments might improve planning of ICU resources. Optimizing intraoperative fluid management may improve short-term patient outcomes.
Background: Recognising acute stroke symptoms is crucial in providing timely treatment. However, evidence suggests that females often experience unique symptoms compared with males, resulting in delays to seeking medical attention and treatment. This systematic review and meta-analysis evaluated whether sex is associated with differences in acute stroke symptoms.
Methods: Searches from 1946 to 7th September 2021 were carried out using MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and the Cochrane Library. Studies reporting acute stroke symptoms in adult females and males were eligible for inclusion. Eleven observational studies met the inclusion criteria. Methodological quality was assessed using the Newcastle–Ottawa scale (NOS). Data were meta-analysed using a random-effects model.
Results: Compared with males, females had higher odds of experiencing headache (odds ratio [OR]: 1.27; 95% confidence interval [CI]: 1.01–1.59); change in level of consciousness (OR: 1.36; 95% CI: 1.13–1.63); fatigue (OR: 1.53; 95% CI: 1.04–2.25); and incontinence (OR: 1.44; 95% CI: 1.29–1.60). In contrast, females were at lower odds of experiencing trouble speaking (OR: 0.79; 95% CI: 0.64–0.96); trouble walking, loss of balance, or co-ordination (OR: 0.55; 95% CI: 0.39–0.76); and dizziness (OR: 0.77; 95% CI: 0.64–0.94) compared with males. No difference was found in confusion, difficulty understanding speech, trouble seeing in one or both eyes, mental status change, and nausea or vomiting.
Discussion: Sex differences do exist in some acute stroke symptoms. At the same time, the overlap in symptoms between sexes was substantial. Healthcare professionals and public health campaigns should continue to promote classic symptoms of acute stroke, whilst taking into account the less common symptoms and the potential differences in symptoms experienced by females and males.
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