The utility of pulmonary function testing in the preoperative risk stratification of patients undergoing transcatheter aortic valve replacement

Pino, Jesus; Shah, Varun; Tuarez, Fergie J. Ramos; Kreidieh, Omar; Donath, Elie; Lovitz, Lawrence; Rothenberg, Mark; Cubeddu, Roberto J.; Nores, Marcos; Chait, Robert

doi:10.1002/ccd.28402

Cited by 3 publications

(3 citation statements)

References 22 publications

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“…Studies [ 32 , 33 ] have pointed out that low serum albumin levels increase the risk of pneumonia, because wounds, fracture healing, and muscle strength recovery require a large amount of protein supplementation. When protein is insufficient, muscle strength and limb function decline, causing the prolonging duration of bed time [ 34 ]. Besides, some patients are in a state of malnutrition when they are admitted to the hospital, coupled with increased catabolism caused by trauma and surgery, and increased demand for nutrients, resulting in a further sharp decline in nutritional status, weakened immunity, and increased risk of postoperative pulmonary infection [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Determination of risk factors of postoperative pneumonia in elderly patients with hip fracture: What can we do?

Yan

Zheng

2022

PLoS ONE

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Background Postoperative pneumonia is a serious complication in elderly patients with hip fracture. It is necessary to identify the influencing factors of postoperative pneumonia in patients with hip fracture. Methods Elderly patients with hip fractures admitted to a tertiary hospital in China from January 1, 2020 to August 31, 2021 were included. The characteristics of patients with and without postoperative pneumonia were evaluated and compared. Logistic multivariate regression analyses were conducted to assess the risk factors of postoperative pneumonia. Results 267 patients with hip fracture were included, the incidence of postoperative pneumonia in patients with hip fracture was 13.11%. There were significant differences in the age, diabetes mellitus, anemia, hypoalbuminemia, anesthesia method and duration of surgery between infection and no infection group, no significant differences in the gender, BMI, hypertension, hyperlipidemia, type of fracture, preoperative oxygen saturation, white blood cell count, platelet count, red blood cell count, creatinine, alanine aminotransferase, aspartate aminotransferase, estimated blood loss during surgery were detected between infection and no infection group. Logistic regression analysis showed that age≥70y (OR2.326, 95%CI1.248~3.129), diabetes mellitus (OR2.123, 95%CI1.021~3.551), anemia (OR3.199,95%CI1.943~5.024), hypoalbuminemia (OR2.377, 95%CI1.211~3.398), general anesthesia (OR1.947, 95%CI1.115~3.038), duration of surgery≥120min (OR1.621, 95%CI1.488~2.534) were the risk factors of postoperative pneumonia in elderly patients with hip fracture (all p<0.05). Escherichia Coli (33.33%), Klebsiella pneumoniae (28.57%), Staphylococcus aureus (21.43%) were the most common bacteria of pulmonary infection. Conclusion There are many risk factors for postoperative pneumonia in elderly patients with hip fractures after surgery. In clinical practice, medical workers should take targeted interventions for those risk factors to reduce postoperative pneumonia.

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Section: Discussionmentioning

confidence: 99%

Determination of risk factors of postoperative pneumonia in elderly patients with hip fracture: What can we do?

Yan

Zheng

2022

PLoS ONE

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“…Studies [30,31] have pointed out that low serum albumin levels increase the risk of pneumonia, because wounds, fracture healing, and muscle strength recovery require a large amount of protein supplementation. When protein is insu cient, muscle strength and limb function decline, causing the prolonging duration of bed time [32]. Besides, some patients are in a state of malnutrition when they are admitted to the hospital, coupled with increased catabolism caused by trauma and surgery, and increased demand for nutrients, resulting in a further sharp decline in nutritional status, weakened immunity, and increased risk of pulmonary infection [33].…”

Section: Discussionmentioning

confidence: 99%

Postoperative Pulmonary Infection in Elderly Patients With Hip Fracture: More Attention Needed

Zheng

2021

Preprint

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Background: Postoperative pulmonary infection is a serious complication in elderly patients with hip fracture, it’s necessary to identify the influencing factors of pulmonary infection in patients with hip fracture.Methods: Elderly patients with hip fractures admitted from January 1, 2020 to July 31, 2021 were included. The characteristics of patients with pulmonary infection and no infection were evaluated and compared. Logistic multivariate regression analyses were conducted to assess the risk factors of pulmonary infection.Results: 267 patients with hip fracture were included, the incidence of pulmonary infection in patients with hip fracture was 13.11%. There were significant differences in the age, diabetes mellitus, anemia, hypoalbuminemia, anesthesia method and duration of surgery between infection and no infection group, no significant differences in the gender, BMI, hypertension, hyperlipidemia, type of fracture, preoperative oxygen saturation, white blood cell count, platelet count, red blood cell count, creatinine, alanine aminotransferase, aspartate aminotransferase, estimated blood loss during surgery were detected between infection and no infection group. Logistic regression analysis showed that age≥70y(OR2.326 , 95%CI1.248~3.129), diabetes mellitus(OR2.123, 95%CI1.021~3.551), anemia(OR3.199,95%CI1.943~5.024), hypoalbuminemia(OR2.377, 95%CI1.211~3.398), general anesthesia(OR1.947, 95%CI1.115~3.038), duration of surgery≥120min(OR1.621 , 95%CI1.488~2.534) were the risk factors of pulmonary infection in elderly patients with hip fracture(all p<0.05). Escherichia Coli(33.33%), Klebsiella pneumoniae(28.57%), Staphylococcus aureus(21.43%) were the most common bacteria of pulmonary infection.Conclusion: There are many risk factors for pulmonary infection in elderly patients with hip fractures after surgery. In clinical practice, medical workers should take targeted interventions for those risk factors to reduce the risk of pulmonary infection.

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“…Other studies including but not limited to pulmonary function testing 40 (PFT) and carotid artery ultrasound 41 are performed only if clinically indicated. In fact, the American Board of Internal Medicine (ABIM) and Society of Thoracic Surgeons' (STS) Choosing Wisely Campaign recommends against routine PFTs and carotid ultrasound prior to cardiac surgery.…”

Section: Intake and Evaluationmentioning

confidence: 99%

Best Practice Recommendations for Optimizing Care in Structural Heart Programs: Planning Efficient and Resource Leveraging Systems (PEARLS)

et al. 2021

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The COVID19 pandemic brought unprecedented disruption to healthcare. Staggering morbidity, mortality, and economic losses prompted the review and refinement of care for structural heart disease (SHD). To mitigate negative impacts in the face of crisis or capacity constraints, this paper offers best practice recommendations for Planning Efficient and Resource Leveraging Systems (PEARLS) in structural heart programs. A systematic assessment is recommended for hospital capacity, Heart Team roles and functions, and patient and procedural risks associated with increased resource utilization. Strategies, tactics, and pathways are provided for the delivery of patient-centered, efficient and resource-leveraging care from referral to follow-up. Through the optimal use of capacity and resources, paired with dynamic triage, forecasting, and surveillance, Heart Teams may aspire to plan and implement an optimized system of care for SHD.

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The utility of pulmonary function testing in the preoperative risk stratification of patients undergoing transcatheter aortic valve replacement

Abstract: Background: The role of pulmonary function testing (PFT) as a predictor of clinically relevant endpoints in transcatheter aortic valve replacement (TAVR) is unclear.Objective: To determine the utility of PFT in the preoperative risk stratification of patients undergoing TAVR.

Cited by 3 publications

References 22 publications

Determination of risk factors of postoperative pneumonia in elderly patients with hip fracture: What can we do?

Determination of risk factors of postoperative pneumonia in elderly patients with hip fracture: What can we do?

Postoperative Pulmonary Infection in Elderly Patients With Hip Fracture: More Attention Needed

Best Practice Recommendations for Optimizing Care in Structural Heart Programs: Planning Efficient and Resource Leveraging Systems (PEARLS)

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