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Complication Risk (complication + risk)
Selected AbstractsComplication Risk with Pulse Generator Change: Implications When Reacting to a Device Advisory or RecallPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 6 2007SURAJ KAPA M.D. Background:Recent advisories and recalls of pacemakers and implantable cardioverter-defibrillators (ICDs) have highlighted the need for evidence-based recommendations regarding management of patients with advisory devices. In order to better facilitate decision-making when weighing the relative risks and benefits of performing generator changes in these patients, we conducted a review to assess operative complication rates. Methods:We reviewed generator changes performed between 2000 and 2005 at the Mayo Clinic-Rochester, including a total of 732 change-outs consisting of 570 done for elective replacement indicators (ERI) and 162 for manufacturer advisories or recalls. Complications included all those requiring reoperation, occurring within a 60-day period postoperatively and directly attributable to the generator change. These included infection requiring device excision, hematoma requiring evacuation, and incisional dehiscence requiring reclosure. Results:Operation-associated complications requiring intervention were noted in 9 patients, or 1.24% of our population. Of these nine complications, eight occurred among patients receiving pulse generator replacement for ERI (1.40%) and one occurred in a patient receiving replacement for a manufacturer advisory or recall (0.62%). Complications included 5 infections, 3 hematomas, and 1 incisional dehiscence. Conclusions:Generator replacement is not a benign procedure and associated risks must be weighed in the context of other variables when making management choices in patients with advisory or recall devices. [source] Clinical investigation of traumatic injuries in Yeditepe University, Turkey during the last 3 yearsDENTAL TRAUMATOLOGY, Issue 4 2005Nuket Sandalli Abstract,,, The aim of this study was to evaluate etiology, types of traumatic dental injuries, treatment and to determine the incidence of complications according to dental injuries in patients who referred to Yeditepe University, Faculty of Dentistry, Istanbul, Turkey. The study was based on the clinical data of the 161 traumatized teeth in 92 patients. WHO classification slightly modified by Andreasen & Andreasen for dental trauma was used. The causes and localization of trauma, traumatized teeth classification, treatment and complications were evaluated both primary and permanent teeth. The distribution of complications according to diagnosis and treatment of the injured teeth were evaluated. Of 35 (38%) girls and 56 (72%) boys with a mean age 7.6 ± 3.5 (ranging 1,14.2) participated to study and the mean followed up was 1.72 ± 1.28 years (ranging 0.10,3.8 years). From the 161 affected teeth, 69 (42.9%) were in primary teeth and 92 (57.1%) in permanent teeth. The highest frequency of trauma occurred in the 6,12 year age group. Overall boys significantly outnumbered girls by approximately 1:1.6. The most common type of injury in the primary and permanent teeth was seen as luxation (38%) and enamel fracture (20%) of the maxillary central incisors, respectively. Falls were the major sources of trauma both the primary (90%) and the permanent teeth (84%). In the primary dentition, the most common type of soft tissue injury is contusion (62.5%) and in the permanent dentition, it is laceration (49%). The most of the treatment choice was determined as examination only and extraction in primary teeth (58 and 24.6%, respectively) while it was applied as restoration and pulpectomy in permanent teeth (31.5 and 18.5%, respectively). Complications were recorded on 37 teeth (23%) with a most common type of necrosis (10.5%) and dental abscess (7.4%). Necrosis was more frequent in luxation whereas dental abscess were in crown fracture with pulpal involvement in both dentitions. The study showed that boys were more prone to dental traumas than girls. Falls were more frequent trauma type with a high complication risk. It reveals that the time of the immediate treatment showed the important predisposing factors that increase the success of treatment and decrease the risk of complication. The correct diagnosis of dental injuries is more important for eliminating the occurrence of complications. [source] Methods to avoid infections in patients with inflammatory bowel diseaseINFLAMMATORY BOWEL DISEASES, Issue 7 2005Faten N Aberra MD, MSCE Abstract Abstract Infections have been reported in patients with inflammatory bowel disease (IBD), especially in association with anti-inflammatory and immunomodulatory medications used to treat IBD. Unfortunately, there is a dearth of information on infectious complication risk in patients with IBD. This review describes infectious complications reported in patients with IBD and provides a framework for future studies to assess potential risk factors and incidence for infection. Recommendations are also provided for prevention of infection. [source] Scleral wrap increases the long-term complication risk of bone-derived hydroxyapatite orbital implantsCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 8 2008Tze'Yo Toh MBBS(Hons) Abstract Background:, This study was prompted by previous findings that suggested that scleral wrapping increased the rate of complications following insertion of bone-derived hydroxyapatite orbital implants and compared the long-term results of implants inserted with and without scleral wraps. Methods:, This retrospective case series reviewed the long-term outcomes of 159 patients who had undergone enucleation with insertion of a bone-derived hydroxyapatite orbital implant at Dunedin Hospital between 1977 and 2006. Implants were inserted with and without scleral wraps in 85 and 74 cases, respectively. Follow up was 0.5,27.5 years (mean 8.2 years) for the whole series and 9.7 years for the sclera group and 6.7 years for the group without sclera. Patient details were obtained from theatre records, case note review, patient interview and examination, interview of patient relatives and family general practitioner records. The main outcome measures were the rates of minor or major complications and their treatments and outcomes. Results:, Twenty-seven cases (17%) suffered minor complications of limited implant exposure that either healed spontaneously, with implant drilling or wound resuturing and 11 cases (7%) suffered major complications requiring explantation. Of 38 patients with postoperative complications, 31 (82%) had scleral wraps compared with 7 (18%) without sclera (P < 0.001; OR 5.14, 95% CI 2.00,14.78). Conclusion:, Bone-derived hydroxyapatite orbital implants inserted without scleral wrap were associated with better clinical outcomes and a lower rate of long-term complications. It is therefore recommended that these implants be inserted without a scleral wrap. [source] Communicating breast cancer treatment complication risks: When words are likely to failASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY, Issue 3 2009Peter H GRAHAM Abstract Aim: The aim of the present study was to describe women's preferences for the quantification of the risk of a serious complication after regional nodal radiotherapy for breast cancer and women's interpretation of a range of descriptive terms. Methods: A cross-sectional survey was conducted to elicit risk expression preferences and interpretation of words commonly used to describe the risk or frequency of a complication. Two hundred and sixty-two women who had experienced breast-only radiotherapy for early breast cancer at a Sydney teaching hospital were recruited for the survey. Results: The most preferred single method of expression of a risk is descriptive words, for example "uncommon" (52%), followed by percentages (27%) and numbers, for example 1 in 100 (21%). Lower education levels, more advanced cancer stage and older age increase the preference for descriptive words. When considering a serious complication of treatment, such as loss of the function of an arm, the modal interpretation of the descriptors "sometimes" was 1/100 (36% of women), "uncommon" was 1/1000 (35%), "very uncommon" was 1/10 000 (40%), "rare" was 1/10 000 (58%) and "very rare" was 1/10 000 (51%). However, the range of interpretations and the consistent assignment of extremely low frequencies of risk generally render descriptive words without numerical quantification inadequate for informed consent. Conclusion: Although risks of side-effects are often described in words such as common, uncommon and rare, qualification should be provided with numerical values to ensure better understanding of risk. [source] | ||||||||||