378 results found
Bergner R, Onida S, Velineni R, et al., 2023, Metabolic profiling reveals changes in serum predictive of venous ulcer healing, Annals of Surgery, Vol: 277, Pages: e467-e474, ISSN: 0003-4932
Objective: The aim of this study was to identify potential biomarkers predictive of healing or failure to heal in a population with venous leg ulceration.Summary Background Data: Venous leg ulceration presents important physical, psychological, social and financial burdens. Compression therapy is the main treatment, but it can be painful and time-consuming, with significant recurrence rates. The identification of a reliable biochemical signature with the ability to identify nonhealing ulcers has important translational applications for disease prognostication, personalized health care and the development of novel therapies.Methods: Twenty-eight patients were assessed at baseline and at 20 weeks. Untargeted metabolic profiling was performed on urine, serum, and ulcer fluid, using mass spectrometry and nuclear magnetic resonance spectroscopy.Results: A differential metabolic phenotype was identified in healing (n = 15) compared to nonhealing (n = 13) venous leg ulcer patients. Analysis of the assigned metabolites found ceramide and carnitine metabolism to be relevant pathways. In this pilot study, only serum biofluids could differentiate between healing and nonhealing patients. The ratio of carnitine to ceramide was able to differentiate between healing phenotypes with 100% sensitivity, 79% specificity, and 91% accuracy.Conclusions: This study reports a metabolic signature predictive of healing in venous leg ulceration and presents potential translational applications for disease prognostication and development of targeted therapies.
The Vascular and Endovascular Research Network VERN Executive Committee, Hitchman L, Birmpili P, et al., 2023, The DEFINITE Audit: a prospective audit of diabetic foot debridement in theatre, Journal of Vascular Societies Great Britain and Ireland
Machin M, Peerbux S, Whittley S, et al., 2023, Examining the benefit of graduated compression stockings in the prevention of hospital-associated venous thromboembolism in low-risk surgical patients: a multicentre cluster randomised controlled trial (PETS Trial), BMJ Open, Vol: 13, Pages: 1-7, ISSN: 2044-6055
Introduction Hospital-acquired thrombosis (HAT) is defined as any venous thromboembolism (VTE)-related event during a hospital admission or occurring up to 90 days post discharge, and is associated with significant morbidity, mortality and healthcare-associated costs. Although surgery is an established risk factor for VTE, operations with a short hospital stay (<48 hours) and that permit early ambulation are associated with a low risk of VTE. Many patients undergoing short-stay surgical procedures and who are at low risk of VTE are treated with graduated compression stockings (GCS). However, evidence for the use of GCS in VTE prevention for this cohort is poor.Methods and analysis A multicentre, cluster randomised controlled trial which aims to determine whether GCS are superior in comparison to no GCS in the prevention of VTE for surgical patients undergoing short-stay procedures assessed to be at low risk of VTE. A total of 50 sites (21 472 participants) will be randomised to either intervention (GCS) or control (no GCS). Adult participants (18–59 years) who undergo short-stay surgical procedures and are assessed as low risk of VTE will be included in the study. Participants will provide consent to be contacted for follow-up at 7-days and 90-days postsurgical procedure. The primary outcome is the rate of symptomatic VTE, that is, deep vein thrombosis or pulmonary embolism during admission or within 90 days. Secondary outcomes include healthcare costs and changes in quality of life. The main analysis will be according to the intention-to-treat principle and will compare the rates of VTE at 90 days, measured at an individual level, using hierarchical (multilevel) logistic regression.Ethics and dissemination Ethical approval was granted by the Camden and Kings Cross Research Ethics Committee (22/LO/0390). Findings will be published in a peer-reviewed journal and presented at national and international conferences.Trial registration number ISRCT
Turner B, Jasionowska S, Machin M, et al., 2023, Systematic review and meta-analysis of exercise therapy for venous leg ulcer healing and recurrence, Journal of vascular surgery. Venous and lymphatic disorders, Vol: 11, Pages: 219-226, ISSN: 2213-3348
Objective:National guidelines in the United Kingdom have recommended regular exercise for individuals with venous leg ulceration. However, data on the effects of exercise on ulcer healing and recurrence are sparse. In the present study, we aimed to quantify the evidence for exercise regarding venous ulcer healing with respect to the primary outcomes of the proportion of healed ulcers and rate of ulcer recurrence. The secondary outcomes were improvement in ulcer symptoms, ulcer healing time, quality of life, compliance, and adverse events reported.Methods:The review followed PRISMA (preferred reporting items for systematic reviews and meta-analyses) guidelines using a registered protocol (CRD42021220925). The MEDLINE and Embase databases and Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, European Union Clinical Trials, and International Standard Randomised Controlled Trial Number registries were searched up to April 6, 2022 and included studies comparing exercise therapy and compression vs compression alone. Data for the proportion of healed ulcers were pooled using a fixed effects meta-analysis.Results:After screening 1046 reports, 7 were included, with 121 participants allocated to exercise therapy and 125 to compression alone. All the reports were of randomized controlled trials and had reported ulcer healing at 12 weeks, with a pooled relative risk of ulcer healing of 1.38 for exercise vs compression (95% confidence interval, 1.11-1.71). Only one study had reported on recurrence; thus, data pooling was not performed. No differences between exercise and usual care were demonstrated. Compliance with exercise ranged from 33% to 81%. The included studies demonstrated low enrollment and a high risk of bias. Also, most of the trials had failed to demonstrate any differences in activity completed between the intervention and control arms.Conclusions:A paucity of studies has examined leg ulcer recurrence after exercise programs, with no evidence to s
Jani C, Abdallah N, Mouchati C, et al., 2022, Trends of kidney cancer burden from 1990 to 2019 in European Union 15+ countries and World Health Organization regions, Scientific Reports, Vol: 12, ISSN: 2045-2322
In recent decades, variability in the incidence and mortality of kidney cancer (KC) has been reported. This study aimed to compare trends in incidence, mortality, and disability-adjusted life years (DALY) of KC between the European Union (EU) 15 + countries and 6 World Health Organization (WHO) regions. The data of KC Age-standardized incidence rates (ASIRs), age-standardized mortality rates (ASMRs), and age-standardized DALYs were extracted from the Global Burden of Disease database. Joinpoint regression was employed to examine trends. From 1990 to 2019, the ASIR increased in most countries except for Luxembourg (males), the USA (females) and Austria and Sweden (both sexes). ASIR increased across all 6 WHO regions for both sexes except for females in Americas. The ASMR increased in 10/19 countries for males and 9/19 for females as well across most WHO regions. The mortality-to-incidence ratio (MIR) decreased in all countries and WHO regions. Trends in DALYs were variable across countries and WHO regions. While the incidence and mortality from KC rose in most EU15 + countries and WHO regions from 1990 to 2019, the universal drop in MIR suggests an overall improvement in KC outcomes. This is likely multifactorial, including earlier detection of KC and improved treatments.
Ghajar A, Essa M, DeLago A, et al., 2022, Atrial fibrillation/atrial flutter related mortality trends in the US population 2010–2020: regional, racial, sex variations, Pacing and Clinical Electrophysiology, ISSN: 0147-8389
Jani C, Mouchati C, Abdallah N, et al., 2022, Trends in Prostate Cancer Mortality in the United States of America, by State and Race, from 1999 to 2019: estimates from the Centers for Disease Control WONDER Database, Prostate Cancer and Prostatic Diseases
Hammond-Haley M, Hartley A, Al-Khayatt BM, et al., 2022, Trends in the incidence and mortality of infective endocarditis in high-income countries between 1990 and 2019, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 371, Pages: 441-451, ISSN: 0167-5273
Al Omari O, Jani C, Ahmed A, et al., 2022, Lung cancer mortality in the United States between 1999 and 2019: an observational analysis of disparities by sex and race, Annals of the American Thoracic Society, ISSN: 1546-3222
Ojha U, Marshall DC, Salciccioli JD, et al., 2022, Temporal trend analysis of rheumatic heart disease burden in high-income countries between 1990 and 2019., European Heart Journal - Quality of Care and Clinical Outcomes, ISSN: 2058-5225
AIMS: To assesses trends in rheumatic heart disease (RHD) burden in high-income, European Union 15+ (EU15+) countries between 1990 and 2019. METHODS AND RESULTS: Cross-sectional analysis of the incidence and mortality of RHD was conducted using data from the Global Burden of Disease Study (GBD) database. Age-standardized incidence rates (ASIRs) and age-standardized mortality rates (ASMRs) were extracted for EU15 + countries per sex for each of the years from 1990-2019, inclusive, and mortality-to-incidence indices (MII) were computed. Joinpoint regression analysis was used for the description of trends. Over 29 years, an overall declining trend in RHD incidence and mortality across EU 15 + nations were observed. There was significant variability in RHD incidence and mortality rates across high-income countries. However, both RHD incidence and mortality were higher among females compared to males across EU15 + countries over the observed period. The most recent incidence trend, starting predominantly after 2014, demonstrated a rise in RHD incidence in most countries for both sexes. The timing of this RHD resurgence corresponds temporally with an influx of migrants and refugees into Europe. The recent increasing RHD incidence rates ranged from + 0.4% to + 24.7% for males, and + 0.6% to + 11.4% for females. CONCLUSIONS: More than half of EU15 + nations display a recent increase in RHD incidence rate across both sexes. Possible factors associated with this rise are discussed and include increase in global migration from nations with higher RHD prevalence, host nation factors such as migrants' housing conditions, healthcare access and migrant health status on arrival.
Otunla AA, Shanmugarajah K, Salciccioli JD, et al., 2022, Symptomatic atherosclerotic vascular disease and graft survival in primary kidney transplant recipients - Observational analysis of the united network of organ sharing database, TRANSPLANT IMMUNOLOGY, Vol: 75, ISSN: 0966-3274
Panhelleux B, Shalhoub J, Silverman A, et al., 2022, A review of through-knee amputation, Vascular, Vol: 30, Pages: 1149-1159, ISSN: 0967-2109
Objectives: Through knee amputation (TKA) is an umbrella term for several different surgical techniques, which may affect clinical and functional outcomes. This makes it hard to evaluate the benefits and need for a TKA approach. This paper seeks to: (1) Determine the number of TKAs performed compared with other major lower limb amputations (MLLA) in England over the past decade; (2) identify the theoretical concepts behind TKA surgical approaches and their potential effect on functional and clinical outcomes; and (3) provide a platform for discussion and research on TKA and surgical outcomes.Methods: National Health Service Hospital Episodes Statistics were used to obtain recent numbers of MLLAs in England. EMBASE and MEDLINE were searched using a systematic approach with predefined criteria for relevant literature on TKA surgery.Results: In the past decade, 4.6% of MLLA in England were TKAs. Twenty-six articles presenting TKA surgical techniques met our criteria. These articles detailed three TKA surgical techniques; the classical approach, which keeps the femur intact and retains the patella; the Mazet technique, which shaves the femoral condyles into a box shape; and the Gritti-Stokes technique, which divides the femur proximal to the level of the condyles and attaches the patella at the distal cut femur.Conclusions: TKA has persisted as a surgical approach over the past decade, with three core approaches identified. Studies reporting clinical, functional, and biomechanical outcomes of TKA frequently fail to distinguish between the 3 distinct and differing approaches, making direct comparisons difficult. Future studies that compare TKA approaches to one another and to other amputation levels are needed.
Hanna L, Sounderajah V, Abdullah AA, et al., 2022, Trends in Thoracic Aortic Aneurysm Hospital Admissions, Interventions, and Mortality in England between 1998 and 2020: An Observational Study, Journal of Vascular Surgery, Vol: 76, Pages: 1755-1755, ISSN: 0741-5214
Jasionowska S, Turner B, Machin M, et al., 2022, Systematic review of exercise therapy in the management of post-thrombotic syndrome, Phlebology, Vol: 37, Pages: 695-700, ISSN: 0268-3555
ObjectivesExercise improves haemodynamic parameters in patients with chronic venous disease. There is a paucity of evidence on its effect in post-thrombotic syndrome (PTS). The aim of this systematic review is to assess the impact of exercise in PTS.MethodsAdhering to PRISMA guidelines and following PROSPERO registration (CRD42021220924), MEDLINE, Cochrane Library, EMBASE database, and trial registries were searched on 19th May 2022.ResultsOne article met the inclusion criteria and a narrative synthesis was carried out. The included randomised controlled trial reported a between-group mean difference of 4.6 points (p = .027) in the VEINES-QOL score and −2.0 points (p = .14) in the Villalta score, in favour of exercise therapy. The statistical significance threshold was not reached.ConclusionData on exercise in PTS remains sparse but exercise appears to be a safe intervention. In the context of this literature, a potential future trial and outcome reporting measures are suggested.
Sugand K, Ali R, Goodall R, et al., 2022, Trends in Neck of Femur Fracture Incidence in EU15+ Countries from 1990-2017, Injury
NIHR Global Health Unit on Global Surgery, COVIDSurg Collaborative, 2022, Elective surgery system strengthening: development, measurement, and validation of the surgical preparedness index across 1632 hospitals in 119 countries., The Lancet, Vol: 400, Pages: 1607-1617, ISSN: 0140-6736
BACKGROUND: The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index to support local elective surgical system strengthening and address growing backlogs. METHODS: First, we performed an international consultation through a four-stage consensus process to develop a multidomain index for hospital-level assessment (surgical preparedness index; SPI). Second, we measured surgical preparedness across a global network of hospitals in high-income countries (HICs), middle-income countries (MICs), and low-income countries (LICs) to explore the distribution of the SPI at national, subnational, and hospital levels. Finally, using COVID-19 as an example of an external system shock, we compared hospitals' SPI to their planned surgical volume ratio (SVR; ie, operations for which the decision for surgery was made before hospital admission), calculated as the ratio of the observed surgical volume over a 1-month assessment period between June 6 and Aug 5, 2021, against the expected surgical volume based on hospital administrative data from the same period in 2019 (ie, a pre-pandemic baseline). A linear mixed-effects regression model was used to determine the effect of increasing SPI score. FINDINGS: In the first phase, from a longlist of 103 candidate indicators, 23 were prioritised as core indicators of elective surgical system preparedness by 69 clinicians (23 [33%] women; 46 [67%] men; 41 from HICs, 22 from MICs, and six from LICs) from 32 countries. The multidomain SPI included 11 indicators on facilities and consumables, two on staffing, two on prioritisation, and eight on systems. Hospitals were scored from 23 (least prepared) to 115 points (most prepared). In the second phase, surgical preparedness
Normahani P, Burgess L, Norrie J, et al., 2022, Study protocol for a multicentre comparative diagnostic accuracy study of tools to establish the presence and severity of Peripheral Arterial Disease in people with Diabetes Mellitus: the DM PAD study, BMJ Open, Vol: 12, Pages: 1-9, ISSN: 2044-6055
Introduction:Peripheral arterial disease (PAD) is a key risk factor for cardiovascular disease, foot ulceration and lower limb amputation in people with diabetes. Early diagnosis of PAD can enable optimisation of therapies to manage these risks. Its diagnosis is fundamental though challenging in the context of diabetes. Although a variety of diagnostic bedside tests are available, there is no agreement as to which is the most accurate in routine clinical practice. The aim of this study is to determine the diagnostic performance of a variety of tests (audible waveform assessment, visual waveform assessment, ankle brachial pressure index (ABPI), exercise ABPI and toe brachial pressure index (TBPI)) for the diagnosis of PAD in people with diabetes as determined by a reference test (computed tomography angiography (CTA) or magnetic resonance angiography (MRA)). In selected centres, we also aim to evaluate the performance of a new point-of-care duplex ultrasound scan (PAD-scan).Methods and analysis:A prospective multicentre diagnostic accuracy study (ClinicalTrials.gov Identifier NCT05009602). We aim to recruit 730 people with diabetes from 18 centres across the United Kingdom (UK), covering primary and secondary healthcare. Consenting participants will undergo the tests under investigation. Reference tests (CTA or MRA) will be performed within six weeks of the index tests. Imaging will be reported by blinded consultant radiologists at a core imaging lab, using a validated scoring system, which will also be used to categorise PAD severity. The presence of one or more arterial lesions of 50% stenosis, or tandem lesions with a combined value of 50%, will be used as the threshold for the diagnosis of PAD. The primary outcome measure of diagnostic performance will be test sensitivity.Ethics and Dissemination: The study has received approval from the National Research Ethics Service (NRES) (REC reference 21/PR/1221). Results will be disseminated through research presentatio
Salciccioli I, Mariano M, Goodall R, et al., 2022, PRIMARY IMMUNODEFICIENCY DISEASE MORTALITY TRENDS ACROSS EU15+COUNTRIES: AN EPIDEMIOLOGICAL ANALYSIS, Publisher: ELSEVIER SCIENCE INC, Pages: S57-S57, ISSN: 1081-1206
Houdmont J, Daliya P, Adiamah A, et al., 2022, Identification of Surgeon Burnout via a Single-Item Measure, Occupational Medicine, ISSN: 0962-7480
Yang D, Borsky K, Jani C, et al., 2022, Trends in keratinocyte skin cancer incidence, mortality and burden of disease in 33 countries between 1990 and 2017, British Journal of Dermatology, ISSN: 0007-0963
Gueroult A, Al-Balah A, Shalhoub J, et al., 2022, Nickel hypersensitivity and endovascular devices: a systematic review and meta-analysis, Heart, Vol: 108, Pages: 1707-1715, ISSN: 1355-6037
Objective Nickel allergy is common; endovascular specialists are often confronted with nickel allergic patients ahead of the implantation of endovascular devices, many of which are nickel-containing. Our aim was to elucidate whether nickel hypersensitivity is significantly associated with worse or adverse outcomes after placement of a nickel-containing endovascular device.Methods Inclusion criteria were: endovascular and transcatheter procedures for coronary, structural heart, neurovascular and peripheral vascular pathology involving nickel-allergic patients. All adverse outcomes were included as defined by included studies. A systematic review and meta-analysis were undertaken using a random-effects model. Searches of MEDLINE and EMBASE were conducted for articles published 1947–2019.Results 190 records were identified, 78 articles were included for qualitative synthesis and 15 met criteria for meta-analysis. Patch-test confirmed nickel allergy was associated with an increased risk of adverse outcomes following implantation of a nickel-containing endovascular device (n=14 articles, 1740 patients; OR 2.61, 95% CI 1.41 to 4.85). This finding further was observed in coronary (n=12 articles, 1624 patients; OR 1.94, 95% CI 1.16 to 3.23) and structural heart subgroups (n=2 articles, 83 patients; OR 52.28, 95% CI 1.31 to 2079.14), but not in the neurovascular subgroup (n=1 article, 33 patients; OR 3.04, 95% CI 0.59 to 15.72) or with a patient-reported history of nickel allergy (n=2 articles, 207 patients; OR 2.14, 95% CI 0.23 to 19.70).Conclusions Patch-tested nickel allergy is associated with an increased risk of adverse outcomes following endovascular device implantation and alternative treatment options should be considered. Specialists faced with patients’ self-reporting nickel allergy should consider proceeding to diagnostic patch-testing.
Benson R, Nandhra S, The VERN COVER Collaborative, et al., 2022, Recovery of vascular services and adaptation of clinical practice in Europe following the initial COVID-19 pandemic peak, EJVES Vascular Forum
The Vascular and Endovascular Research Network VERN COVER Study Collaborative, Shalhoub J, 2022, The impact of the COronaVIrus Disease 2019 (COVID-19) pandemic on the clinical management of patients with vascular diseases - Findings from Tier 3 of the COVID-19 Vascular sERvice (COVER) Study, Journal of the Vascular Societies Great Britain and Ireland
Eves J, Sudarsanam A, Shalhoub J, et al., 2022, Augmented reality in vascular and endovascular surgery: a scoping review, JMIR Serious Games, Vol: 10, ISSN: 2291-9279
Background: Technological advances have transformed vascular intervention over recent decades. In particular, improvements in imaging and data processing have allowed for the development of increasingly complex endovascular and hybrid interventions. Augmented reality (AR) is a subject of growing interest within surgery, with potential to improve clinicians’ understanding of 3D anatomy and aid the processing of real-time information. This paper hopes to elucidate the potential impact of AR technology in the rapidly evolving field of vascular and endovascular surgery.Objective: The aim of this review was to summarise the fundamental concepts of augmented reality technologies, and to conduct a scoping review of the impact of AR and mixed reality within vascular and endovascular surgery.Methods: A systematic search of MEDLINE, Scopus and Embase was performed in accordance with the Preferred Reporting Items on Systematic Reviews and Meta-analysis (PRISMA) guidelines. All studies written in English from inception until 8th of January 2021 were included in the search. Combinations of the following keywords were used in the systematic search string: (‘augmented reality’ OR ‘hololens’ OR ‘image overlay’ OR ‘daqri’ OR ‘magic leap’ OR ‘immersive reality’ OR ‘extended reality’ OR ‘mixed reality’ OR ‘head mounted display’) AND (‘vascular surgery’ OR ‘endovascular’). Studies were selected by a blinded process between two investigators and assessed with data quality tools.Results: AR technologies have had a number of applications across vascular and endovascular surgery. The majority of studies use 3D imaging of CT angiogram-derived images of vascular anatomy to augment the clinicians anatomical understanding during procedures. A wide range of AR technologies have been employed, with ‘heads up’ fusion imaging and AR head-mounted disp
Turner B, Machin M, Jasionowska S, et al., 2022, Systematic review and meta-analysis of the additional benefit of pharmacological thromboprophylaxis for endovenous varicose vein interventions, Annals of Surgery, ISSN: 0003-4932
Objective: The primary objective of this systematic review and meta-analysis was to elucidate the rate of venous thromboembolism (VTE) following endovenous varicose vein intervention with mechanical thromboprophylaxis and additional pharmacological thromboprophylaxis, versus mechanical thromboprophylaxis alone.Summary Background Data: The VTE rate following endovenous procedures is higher than other day-case procedures and could be reduced with pharmacological thromboprophylaxis.Methods: The review followed PRISMA guidelines with a registered protocol (PROSPERO: CRD42021274963). Studies of endovenous intervention for superficial venous incompetence reporting the predefined outcomes with at least 30 patients were eligible. Data were pooled with a fixed effects model.Results: There were 221 trials included in the review (47 randomised trial arms, 105 prospective cohort studies and 69 retrospective studies). In randomised trial arms, the rate of deep venous thrombosis with additional pharmacological thromboprophylaxis was 0.52% (95% CI 0.23-1.19%) (9 studies; 1095 patients; 2 events), versus 2.26% (95% CI 1.81-2.82%) (38 studies; 6951 patients; 69 events) with mechanical thromboprophylaxis alone. The rate of pulmonary embolism in randomised trial arms with additional pharmacological thromboprophylaxis was 0.45% (95% CI 0.09-2.35) (5 studies, 460 participants, 1 event) versus 0.23% (95% CI 0.1-0.52%) (28 studies, 4834 participants, 3 events) for mechanical measures alone. The rate of EHIT grade III-IV was 0.35% (95% CI 0.09-1.40) versus 0.88% (95% CI 0.28-2.70%). There was one VTE-related mortality and one instance of major bleeding, with low rates of minor bleeding.Conclusions: There is a significant reduction in the rate of DVT with additional pharmacological thromboprophylaxis and routine prescription of anticoagulation following endovenous varicose vein intervention should be considered. VTE risk for individual study participants is heterogeneous and risk stratifica
Ali R, Sugand K, Goodall R, et al., 2022, 12 Trends in Neck of Femur Fracture Incidence in EU15+Countries From 1990-2017, ASiT Surgical Conference, Publisher: OXFORD UNIV PRESS, ISSN: 0007-1323
Lawton R, Shalhoub J, Davies A, 2022, Implementation of the graduated compression as an adjunct to pharmaco-thromboprophylaxis in surgery (GAPS) trial results across the UK, Phlebology, Vol: 37, Pages: 540-542, ISSN: 0268-3555
ObjectivesTo examine uptake and dissemination of a National Institute for Health Research (NIHR) Health Technology Assessment (HTA) funded trial- Graduated compression as an Adjunct to Pharmaco-thromboprophylaxis in Surgery (GAPS) (project number: 14/140/61) amongst health professionals in the UK. To evaluate the impact of the trial on venous thromboembolism (VTE) prevention policies 7 months after publication.MethodA 12-question online survey emailed to 2750 individuals via several vascular societies, 34 VTE Exemplar Centre leads and 1 charity over a 3-month period.ResultsIn total, 250 responses were received; a 9.1% response rate. Over half of all respondents (52.4%) had read the GAPS trial results prior to completing the survey. Precisely, 77.1% said their hospital had not yet made changes or did not intend to make changes to local hospital VTE policy based on the GAPS trial.ConclusionsFindings must be interpreted in the context of the low response rate. Further in-depth interviews would aid understanding of barriers to implementing change.
Abdallah N, Mouchati C, Crowley C, et al., 2022, Trends in mortality from aortic dissection analyzed from the World Health Organization Mortality Database from 2000 to 2017, International Journal of Cardiology, Vol: 360, Pages: 83-90, ISSN: 0167-5273
Background:We assessed trends in aortic dissection (AD) death rates in 23 countries from 2000 to 2017.Methods:We extracted AD mortality data for countries with high usability data from the World Health Organization (WHO) Mortality Database and from the Center for Disease Control (CDC) WONDER Database for the United States of America (USA). Age Standardized Death Rates (ASDRs) per 100,000 population were computed. Trends were assessed by locally weighted scatter plot smoother (LOWESS) regression.Results:Between 2000 and 2017, ASDRs from AD decreased in Australia, Belgium, Croatia, Denmark, France, Italy, New Zealand, Norway, Sweden, the United Kingdom, and the USA for both sexes. Increasing AD mortality was observed in Austria, Czech Republic, Germany, Hungary, Israel, and Japan for both sexes. The largest absolute increases in ASDR were in Japan for men (+1.59) and women (+1.11). The largest percentage decreases were in Norway for men (−0.91) and in New Zealand (−0.6) for women. In 2017, the highest mortality rates were in Japan for both sexes (3.22 and 2.09, respectively). The lowest ASDR was in Kyrgyzstan for both sexes (0.16 and 0.10, respectively). ASDRs for AD in 2017 were higher for men than women in all countries included. Spain had the greatest difference between the gender's mortality rates with a 2.71-fold higher mortality average rate in men.Conclusion:We identified an overall decrease in AD mortality in most included countries, while an increase was noted in other countries including Israel and Japan.
Shalhoub J, 2022, Contracting role of graduated compression stockings in prevention of perioperative venous thromboembolism, British Journal of Surgery, Vol: 109, Pages: 669-670, ISSN: 0007-1323
Gwilym B, VERN Collaborators, PERCEIVE Collaborators, et al., 2022, Surgeons and anaesthetists predict 30-day outcomes after major lower limb amputation more accurately than most prediction tools: early results from the PERCEIVE (PrEdiction of Risk and Communication of outcomE following major lower limb amputation: a collaboratIVE) study, British Journal of Surgery, ISSN: 0007-1323
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